Rebound insomnia

Andreas Meistad profile picture
Andreas Meistad
Aug 18, 20214 min read
Girl awake at night

'You never realize the value of something until it's gone.' Anyone who has ever had trouble sleeping can understand how valuable a good night’s sleep is.

Although getting a good night's sleep may be easy for some, the reality is very different for others. The problem is only compounded when the same medication that is supposed to help you sleep causes many sleepless nights.

If you are having trouble sleeping after discontinuing your sleep pills, you may be suffering from rebound insomnia. Read on to learn precisely what it is, why it happens, and what you can do about it.

What is Rebound Insomnia?

Rebound insomnia is defined as difficulty sleeping following the abrupt discontinuation of commonly prescribed sleep medications, such as short or intermediate-acting benzodiazepine hypnotic drugs. The ease with which you fall asleep depends upon an intricate balance between neurotransmitters and chemicals in the brain.

Sleep medications temporarily tilt its balance in favor of pro-sleep neurotransmitters. For instance, Benzodiazepines, a class of Food and Drug Administration (FDA) approved drugs, induce sleep by enhancing the effect of a neurotransmitter known as gamma-aminobutyric acid (GABA) in the brain and spinal cord.

This, though, does not come without a cost. As you continue to use sleeping pills, your brain adapts to increased levels of these neurotransmitters, which is why you need to continually increase the dose to fall asleep. Further, when you stop taking these pills, the levels of pro-sleep neurotransmitters drop sharply, and with your brain used to higher than normal levels, rebound insomnia ensues. This process, known as tolerance, is also seen in alcohol and drug users.

Examples of Benzodiazepines, and other sleep medications, most commonly associated with rebound insomnia include:

  • Temazepam
  • Triazolam
  • Nitrazepam (Trade name: Mogadon)
  • Flunitrazepam
  • Lormetazepam (Trade name: Dormagen)
  • Loprazolam
  • Zolpidem
  • Eszopiclone

How Long Does Rebound Insomnia Last?

Rebound insomnia can last from anywhere from a few days to a week. The duration depends upon your susceptibility to withdrawal and the half-life and dose of the medication. The half-life of a drug is an indirect measure of the time for which it is active in the body. Sleeping medications with shorter half-lives tend to cause harsher rebound insomnia, but fortunately, the effect is short-lived. On the other hand, higher doses of insomnia medication can lead to severe and prolonged rebound insomnia.

Rebound insomnia lasts longer than other forms of insomnia, such as acute insomnia and transient insomnia. Not only that, it's also associated with poorer quality of sleep going forward. This is because chemical imbalances in acute and transient insomnia are marginal and temporary. In contrast, the chemical imbalance is not only disproportionate but rebound insomnia is also associated with structural and functional changes in the central nervous system (CNS), which take longer to reverse.

How Can I Treat Rebound Insomnia?

‘Prevention is better than cure,’ is a sentence health professionals swear by and not without good reason. Thus, unsurprisingly, the best way to evade rebound insomnia is by avoiding sleeping medications altogether.

Give it time and let your body adjust to not having to rely on medications to sleep. Try to have a consistent wake-up time to aid your natural sleep drive in getting you back on track.

If, however, you are already taking sleeping pills, it's vital that you do not discontinue their use abruptly. Gradually tapering the dose under professional supervision can help you prevent rebound insomnia. Cognitive Behavioral Therapy can also help.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is a proven and completely natural technique that can help you overcome insomnia and stay on track as you stop relying on sleeping pills to sleep. It is the best alternative to continuing to take sleeping pills.

CBT-I uses talking therapy that focuses on the idea that how we think, our habits, and our emotions are connected and influence one another. By challenging your thoughts, changing habits, and being more accepting of feelings, it can help you through the withdrawal phase as you discontinue your sleeping medication.

Ready To Overcome Rebound Insomnia?

To learn more about rebound insomnia and how to counteract the effects of weaning off of sleeping medication with Dawn's CBT-I experts, reach out to us today!

Andreas Meistad profile picture
Andreas Meistad

Therapist specializing in applying CBT principles for the treatment of insomnia.

It’s time to stop blaming the night monsters.

Let’s work together to transform your sleep for the better.