In 2023, one in five Belgians was prescribed sleep medication, making Belgium the European leader. “Many people see a sleeping pill as an innocent thing,” says GP and clinical pharmacologist Ellen Van Leeuwen, “but sleeping pills are not sweets.”
In short
- The use of sleeping pills results in dependency in just two weeks and prolonged use carries risks.
- Discontinuing sleeping pills is not simple. The best way to go about it is to follow a step-by-step plan.
- Talk to your GP and your immediate circle about your use of sleeping pills and tapering off.
Many people turn to sleeping pills to help them (get to) sleep. Sometimes on the advice of a doctor, sometimes on their own initiative. But weaning themselves off of them is often difficult due to side effects and withdrawal symptoms. So how can you safely wean off sleep medication? Ghent University experts Ellen Van Leeuwen and Melissa Ceuterick share their insights as well as practical tips.
Why is it important to gradually reduce your intake?
Sleeping pills or benzodiazepines have a short-term calming effect and help with falling asleep. However, in just 14 days patients develop a dependency on this medication and long-term use carries risks.
Ellen Van Leeuwen explains: “Dependency starts after just one or two weeks so that a higher dose is needed to achieve the same effect. This heightens the chance of side effects such as feeling drowsy the next day, less concentration and a higher risk of falling, especially in older patients. You also run more risk of getting involved in a road accident when driving.”
Melissa adds: “What’s more, sleep medication affects your sleep quality: you miss the deep, restorative sleep. Before long people think they can’t sleep without medication but that is a vicious circle. As soon as you start to taper off, you initially sleep worse, creating the impression you really need the medication. However, this is not the case. Tapering off in the long term is the best option and eventually you will feel better.”
So how do you go about tapering off sleeping pills?
1. Consult with your GP
Discontinuing sleep medication is not simple. Discuss this with your GP. “Initially you will sleep worse due to withdrawal symptoms”, Ellen warns. “Professional guidance gives you a better chance of success than when you try to give up sleep medication on your own. A doctor can establish a tapering schedule to help wean you off sleep medication one step at a time.”
2. Use a tapering schedule
Melissa: “Since 2023 you can ask your GP or pharmacist for a reimbursed tapering schedule. This programme uses smaller doses than the standard dosage to allow patients to reduce their intake very gradually.”
3. Adjust your sleeping habits
Ellen: “A good sleep hygiene makes tapering off easier. Go to bed at the same time every day and always get up at the same time, even at the weekend. Make sure you get enough exercise and go outside every day. Avoid caffeine and alcohol in the evening.”
4. Seek support and involve those around you
A key factor in successfully tapering off sleep medication is support from your immediate circle. Family members are often the first to notice that your use of sleep medication is becoming a problem.
“Sometimes a concerned remark from a partner or family member is precisely the nudge that is needed to seek help”, says Melissa. “Openly debating the use and potential consequences helps to lower the threshold for a doctor’s visit. Discuss the weaning process with your partner or family. They can provide support in tough moments and help put the stress in perspective.”
5. Also tackle other issues
Melissa: “Chronic sleep deprivation is often caused by underlying problems such as work stress or problems at home. Deal with those concerns.”
“Plan a daily ‘worrying moment’ where you consciously take the time to worry or write down your thoughts. This is a good way to keep worrying from taking over your day”, Ellen adds. Support groups, either online or in person, can also help.
What if tapering off sleeping pills is difficult?
“Tapering off is often a difficult process”, says Ellen. “This doesn’t mean you’re failing but that your body is adapting. Take small steps and don’t be too hard on yourself. If you’ve been on sleep medication for years, you will need more time to taper off. The key thing is to feel good about the taper rate and decide this in consultation with your GP.”
Melissa concludes: “Be patient and realistic. It won’t always be easy but it is feasible. Many people have gone before you and they all feel better and more energetic.”
Melissa Ceuterick is an anthropologist affiliated with the research group Hedera (Department of Sociology at Ghent University) and Ghent Health Psychology Lab. She conducts research on the stigma surrounding the use of medication.
Ellen Van Leeuwen is a GP and a clinical pharmacologist affiliated with the Department of Basic and Applied Medical Sciences and the Department of Public Health and Primary Care of the Faculty of Medicine and Health Sciences. She conducts research into the responsible use of psychopharmaceuticals and assists patients in discontinuing sleep medication.
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