Tuesday, September 17, 2013

Adverse effects of Sleeping pills ......taken by self, or given secretly by spouse or attending caregiver....

Alternatives to sleeping pills, sleep aids & medications

Research has shown that changing your sleep environment and bedtime behaviors is one of the most effective ways to combat insomnia. Even if you decide to use sleeping pills or medications in the short term, experts recommend making changes in your lifestyle and bedtime behavior as a long-term remedy to sleep problems. Behavioral and environmental changes can have more of a positive impact on sleep than sleeping pills, sleep aids, or other medications, without the risk of side effects or dependence.

Cognitive behavioral therapy (CBT) as an alternative to sleeping pills

Many people complain that frustrating, negative thoughts and worries prevent them from sleeping at night. Cognitive-behavioral therapy (CBT) is a form of psychotherapy that treats problems by modifying dysfunctional or destructive thoughts, emotions and patterns of behavior. CBT is a relatively simple treatment that can improve sleep by changing your behavior before bedtime as well as changing the ways of thinking that keep you from falling asleep. It also focuses on improving relaxation skills and changing lifestyle habits that affect sleeping patterns.
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Relaxation techniques as an alternative to sleeping pills

Relaxation techniques that can relieve stress and help you sleep include simple meditation practices, progressive muscle relaxation, yoga, tai chi, and the use of deep breathing. With a little practice, these skills can help you unwind at bedtime and improve your sleep better than a sleeping pill or sleep aid. Try:
  • A relaxing bedtime routine. Focus on quiet, soothing activities, such as reading, gentle yoga, or listening to soft music before bed. Keep the lights low to naturally boost melatonin.
  • Abdominal breathing. Most of us don’t breathe as deeply as we should. When we breathe deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, it can actually help the part of our nervous system that controls relaxation. Close your eyes and try taking deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth. Make each exhale a little longer than each inhale.
  • Progressive muscle relaxation is easier than it sounds. Lie down or make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold for a count of 10, and then relax. Continue to do this for every muscle group in your body, starting with your feet and working your way up to the top of your head.

Exercise as an alternative to sleeping pills

Studies have shown that exercise during the day can improve sleep at night. When we exercise we experience a significant rise in body temperature, followed a few hours later by a significant drop. This drop in body temperature makes it easier for us to fall and stay asleep. The best time to exercise is late afternoon or early evening, rather than just before bed.
Aerobic exercises are the best to combat insomnia as they increase the amount of oxygen that reaches the blood. Try exercise such as jogging, walking briskly, using a stationary bike or treadmill, dancing, or jumping rope. Check with your doctor first to make sure you are healthy enough for physical activity and remember to stretch before and after your workouts.
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The trouble with sleeping pills, over-the-counter (OTC) sleep aids & medications

The idea that a pill can instantly solve your sleep problems is very appealing. Unfortunately, sleeping pills don't cure the underlying cause of insomnia, and in fact can often make the problem worse in the long run. Concerns regarding over-the-counter (OTC) and prescription sleep aids include:
  • Side effects. Side effects can be severe, including prolonged drowsiness the next day, confusion, and forgetfulness.
  • Rebound insomnia. If you need to stop taking sleeping pills, sometimes the insomnia can become even worse than before.
  • Masking an underlying problem. There may be an underlying medical or mental disorder, or even a sleep disorder, causing your insomnia that can’t be treated with sleeping pills.

Side effects of sleep aids and sleeping pills

All prescription sleeping pills have side effects, which can vary depending on the specific drug, the dosage, and how long the drug lasts in your system. Common side effects include headache, muscle aches, constipation, dry mouth, daytime sleepiness, trouble concentrating, dizziness, unsteadiness, and rebound insomnia.

Some serious risks of sleeping pills

Sedative-hypnotic drug products (benzodiazepines and non-benzodiazepines) can cause severe allergic reaction, facial swelling, memory lapses, hallucinations, suicidal thoughts or actions, and complex sleep-related behaviors like sleep-walking, sleep-driving (driving while not fully awake, with no memory of the event) and sleep-eating (eating in the middle of the night with no recollection, often resulting in weight-gain). If you experience any unusual sleep-related behavior, consult your doctor immediately.

Common side effects of OTC sleep aids and sleeping pills

  • Moderate to severe drowsiness the next day
  • Dizziness and forgetfulness
  • Clumsiness, feeling off balance
  • Constipation and urinary retention
  • Blurred vision
  • Dry mouth and throat

Guidelines for using sleeping pills, sleep aids & medications

If you decide to try sleeping pills, sleep aids, or sleep medications, talk to your doctor about:
  • Other medications you are taking, including non-prescription medications such as pain relievers and allergy medicines, as well as herbal supplements. Combining medications can be very dangerous.
  • Specific instructions for decreasing and/or terminating use. In some cases, stopping medication abruptly can cause uncomfortable side effects and even rebound insomnia.
  • Using the medications intermittently, rather than nightly, in order to decrease the negative side effects and to increase the sleeping pills’ efficiency when you do use them. This is not appropriate with all medications, as some cause withdrawal symptoms when stopped abruptly. 
  • Other medical conditions you have. Some sleep medications can have serious side effects for people with medical problems such as high blood pressure, liver problems, glaucoma, depression, and breathing difficulties.

Important tips when taking sleeping pills

When taking sleeping pills, sleep aids, or sleep medications, remember to:
  • Only take a sleeping pill when you will have enough time to get a full night of sleep (seven to eight hours). Otherwise you may feel very drowsy the next day.
  • Carefully read the package insert that comes with your medication. Pay careful attention to the potential side effects.
  • Never drink alcohol near the time you take a sleeping pill. Not only will alcohol disrupt your sleep even more, it can interact dangerously with the sleeping pill.
  • Never drive a car or operate machinery after taking a sleeping pill. This tip is especially important when you first start taking a new sleep aid, as you may not know how it will affect you.
  • Follow directions closely, starting with a very small dose and increasing gradually, according to the doctor’s prescription. Find out whether you should take your medication with or without food. For some medications, certain foods must be avoided.=============================================================



Adverse effects of diazepam include anterograde amnesia (especially at higher doses) and sedation, as well as paradoxical effectssuch as excitement, rage or worsening of seizures in epileptics. Benzodiazepines also can cause or worsen depressionLong-term effects of benzodiazepines such as diazepam include tolerancebenzodiazepine dependence and benzodiazepine withdrawal syndrome upon dose reduction. After cessation of benzodiazepines, cognitive deficits may persist for at least six months and it was suggested that longer than six months may be needed for recovery from some deficits.[4] Diazepam also has physical dependence potential and can cause serious problems of physical dependence with long term use. Compared to other benzodiazepines, though, physical withdrawal from diazepam following long term use is usually far more mild due to its long elimination half-life. Nevertheless, urgent action by national governments to improve prescribing practices has been recommended.[5] Diazepam is the drug of choice for treating benzodiazepine dependence, with its low potency, long duration of action and the availability of low-dose tablets making it ideal for gradual dose reduction and the circumvention of withdrawal symptoms.

The Downsides of Prozac

by Craig Lambert
May-June 2000

http://harvardmagazine.com/2000/05/the-downsides-of-prozac-html

Hence, side effects show up in the massive field trial of the marketplace. “Repeated studies have shown that about 60 percent of patients have some form of sexual dysfunction—loss of libido, difficulty reaching orgasm, impotence—on SSRIs,” Glenmullen says. “But Eli Lilly’s official figure is 2 to 5 percent.” More ominously, the Prozac “lift” has lifted some into violent rampages, like that of the Louisville printing-press operator who in 1989 killed eight and wounded a dozen more with an AK-47 assault rifle just weeks after starting Prozac. Glenmullen has seen some of his own patients besieged by suicidal thoughts of “a particularly obsessive quality” after starting Prozac, and says that the Swedish and German equivalents of thePhysician’s Desk Reference warn doctors of this potential side effect and provide guidelines for managing it.



What Are the Side Effects of Sleeping Pills?


Sleeping pills have side effects like most medications. You won't know, though, whether you will experience side effects with a particular sleeping pill until you try it.
Your doctor may be able to alert you to the possibility of side effects if you haveasthma or other health conditions. Sleeping pills make you breathe more slowly and less deeply. That can be dangerous for people with uncontrolled lung problems such as asthma or COPD.
Common side effects of prescription sleeping pills such as Lunesta, Sonata, Ambien, Rozerem, and Halcion may include:
  • Burning or tingling in the hands, arms, feet, or legs
  • Changes in appetite
  • Constipation
  • Diarrhea
  • Difficulty keeping balance
  • Dizziness
  • Drowsiness
  • Dry mouth or throat
  • Gas
  • Headache
  • Heartburn
  • Stomach pain or tenderness
  • Uncontrollable shaking of a part of the body
  • Unusual dreams
  • Weakness
The FDA requires manufacturers of Ambien and Zolpimist to offer lower doses for women. Women clear the drugs from their systems more slowly than men and the agency says blood levels of the drugs could still be high enough the following morning to affect activities that require alertness, such as driving. The FDA says doctors should offer the lower dose to men too.
It's important to be aware of possible sleeping pill side effects so you can stop the drug and call your doctor immediately to avoid a more serious health problem.


Can I Be Allergic to Sleeping Pills?

Yes. Some people may have an allergic reaction when taking a sleeping pill and should avoid them. It's important to talk to your doctor at the first sign of these serious side effects, including:
  • Blurred vision or any other problems with your sight
  • Chest pain
  • Difficulty breathing or swallowing
  • Feeling that the throat is closing
  • Hives
  • Hoarseness
  • Itching
  • Nausea
  • Pounding heartbeat
  • Rash
  • Shortness of breath
  • Swelling of the eyes, face, lips, tongue, or throat
  • Vomiting
In addition, a serious -- even deadly -- side effect of any medicine someone is allergic to is anaphylaxis. Anaphylaxis is an acute allergic reaction. Another possible effect is angioedema, which is severe facial swelling. Again, discuss these possibilities with your doctor if you are at risk of allergic reactions.

Can I Become Dependent on Sleeping Pills?

For short-term insomnia, your doctor may prescribe sleeping pills for several weeks. Yet after regular use for a longer period, your sleeping pill may stop working as you build a tolerance to the medication. You may also become psychologically dependent on the medicine. Then the idea of going to sleep without it will make you anxious.
Without the sleeping pill, you might find it difficult to sleep. If that happens it could be a sign of a physical or emotional dependence or both. Some studies show that long-term use of sleeping pills actually interferes with sleep. The best way to avoid developing a physical or emotional dependence on sleeping pills is to follow your doctor's instructions and stop taking the drug when recommended.
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If sleeping pills cause even a small portion of the excess deaths and cancers associated with their use, they are too dangerous to use.
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Patients who took sleeping pills died 4.6 times more often (on average) than patients who avoided sleeping pills.
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physicians have become concerned about sleep apnea, a condition where there are pauses of breathing during sleep. Physicians suspect that sleep apnea can cause deaths during sleep. Not all studies are in agreement, but several studies have found that when a person with sleep apnea takes sleeping pills, there are more pauses in breathing and the pauses last longer, which could be dangerous. I was surprised to learn in the FDA data how well-documented it is that zolpidem makes sleep apnea worse. Because sleeping pills risk making apnea worse, many experts recommend that people with apnea should not be given sleeping pills. The problem is that almost everybody above age 40 has some sleep apnea, and the majority of people over 65 would meet commonly-used criteria for a diagnosis of sleep apnea. Therefore, a large proportion of people taking sleeping pills must be making their apnea worse. Over a period of many years, anything which makes sleep apnea worse would be expected to cause high blood pressure, and therefore, to increase the risk of heart attacks, heart failure, and strokes.

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