Table of ContentsView AllTable of ContentsWhat It IsCausesIntensityHalf-LivesTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
What It Is
Causes
Intensity
Half-Lives
Treatment
Prevention
Reboundinsomniahappens when you have been taking sleeping pills and suddenly stop. Whether or not you get rebound insomnia when you stop takingsleeping medicationsdepends on personal factors and the sleep aid you were taking.
This article will go over why rebound insomnia occurs with medications like Ambien, Lunesta, Benadryl, Klonopin, Ativan, and trazodone and what you can do if it happens to you.
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What Is Rebound Insomnia?
Rebound insomnia is difficulty initiating or maintaining sleep that gets worse when you stop taking sleep pills all of a sudden. After stopping sleeping pills, you may experience a complete loss of sleep that lasts for hours or sleep that gets worse over days.
Sleeping pills act on chemicals that are naturally present in the brain and nervous system, such as neurotransmitters like GABA, serotonin, and tryptophan, and the hormone melatonin.
If you take sleeping pills regularly, your body adapts to the drug’s effects. Your body may even down-regulate to manage the increased chemicals. If you suddenly stop taking a sleep aid, the lack of those chemicals is not immediately compensated for, leaving your brain in a lurch.
If you develop a tolerance to sleeping pills, you may need to take more and more of the medication to get the same effect. It works less and less well and may stop working completely. Depending on the medication you take, you may develop a physical dependence on it over time.
Some prescription medications for sleep, including thebenzodiazepineslike Klonopin and Ativan, can cause withdrawal symptoms if they are taken at high doses and then suddenly stopped.
The symptoms of withdrawal can be serious and include blood pressure and heart rate changes, and in some cases, seizures.
How Long Does Rebound Insomnia Last?
Rebound insomnia is more likely to occur when you suddenly stop taking a medication you have been taking daily—especially at higher doses. It can happen with any over-the-counter (OTC) or prescription sleep aids.
The Half-Lives of Sleeping Pills
For example, if a drug has a 4-hour half-life, its levels will fall to 12.5% of the starting levels within 12 hours (50% in 4 hours, 25% in 8 hours, and 12.5% in 12 hours).
Some of the most common sleep aids and their half-lives include:
A drug with a short half-life will be out of your system quickly and the rebound insomnia may be more intense and start sooner. Fortunately, it will also resolve more quickly, often fading within a few days up to a week after stopping the medication.
Longer-acting medications may not have as noticeable rebound insomnia. However, it may take longer for the drug to fully leave your system. These drugs are also more likely to cause “morning hangover” effects.
You have a few options for managing rebound insomnia—and not all of them involve taking more medication or using a different sleep aid.
Know that the effects of rebound insomnia will not last forever. It can be helpful to reduce your dose gradually under your healthcare provider’s supervision.This is especially important if you are taking higher doses or using benzodiazepine medications.
Do not use multiple sleeping medications at once unless your provider tells you to. Do not use sleep aids with alcohol as this may potentially lead to overdose and death.
You may want to start a new medication to replace the one you’re stopping, but this is not always a helpful way to deal with or prevent rebound insomnia. There are often other elements of your sleep hygiene (or routine) and lifestyle that could be changed to help you deal with your insomnia.
For example:
In general, it is best to avoid the daily use of sleeping pills. Don’t allow yourself to escalate the doses, especially beyond what your healthcare provider has recommended for you.
Summary
Rebound insomnia can happen if you stop taking sleeping pills suddenly after taking them daily for a long time or at a high dose. Rebound insomnia can be worse than the sleeping trouble you had to start with that prompted you to start using a sleep aid.
Some medications are more likely to cause rebound insomnia than others. How long you’ll have rebound insomnia also depends on how long it takes your body to clear the medication.
If you’re taking sleeping pills and want to stop, talk to your provider. Reducing your dose gradually may help you avoid rebound insomnia.
A Word From Verywell
If you find that you need sleeping pills beyond 2 weeks, speak with your healthcare provider about other options, including the use ofcognitive behavioral therapy for insomnia (CBTI). This therapy can be very effective to help you to taper the medications while putting some other skills in place to prevent the insomnia rebound. You can use our Healthcare Provider Discussion Guide below to start that conversation with your healthcare provider.
Insomnia Healthcare Provider Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
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5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Neubauer DN, Pandi-Perumal SR, Spence DW, Buttoo K, Monti JM.Pharmacotherapy of insomnia.J Cent Nerv Syst Dis. 2018;10. doi:10.1177/1179573518770672Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med.2017;13(2):307-349. doi:10.5664/jcsm.6470DrugBank Online[database].Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD.Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2016;165(2):125-133. doi:10.7326/M15-2175Schweizer CA, Hoggatt KJ, Washington DL, et al.Use of alcohol as a sleep aid, unhealthy drinking behaviors, and sleeping pill use among women veterans.Sleep Health. 2019;5(5):495-500. doi:10.1016/j.sleh.2019.06.005
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Neubauer DN, Pandi-Perumal SR, Spence DW, Buttoo K, Monti JM.Pharmacotherapy of insomnia.J Cent Nerv Syst Dis. 2018;10. doi:10.1177/1179573518770672Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med.2017;13(2):307-349. doi:10.5664/jcsm.6470DrugBank Online[database].Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD.Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2016;165(2):125-133. doi:10.7326/M15-2175Schweizer CA, Hoggatt KJ, Washington DL, et al.Use of alcohol as a sleep aid, unhealthy drinking behaviors, and sleeping pill use among women veterans.Sleep Health. 2019;5(5):495-500. doi:10.1016/j.sleh.2019.06.005
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Neubauer DN, Pandi-Perumal SR, Spence DW, Buttoo K, Monti JM.Pharmacotherapy of insomnia.J Cent Nerv Syst Dis. 2018;10. doi:10.1177/1179573518770672Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med.2017;13(2):307-349. doi:10.5664/jcsm.6470DrugBank Online[database].Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD.Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2016;165(2):125-133. doi:10.7326/M15-2175Schweizer CA, Hoggatt KJ, Washington DL, et al.Use of alcohol as a sleep aid, unhealthy drinking behaviors, and sleeping pill use among women veterans.Sleep Health. 2019;5(5):495-500. doi:10.1016/j.sleh.2019.06.005
Neubauer DN, Pandi-Perumal SR, Spence DW, Buttoo K, Monti JM.Pharmacotherapy of insomnia.J Cent Nerv Syst Dis. 2018;10. doi:10.1177/1179573518770672
Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL.Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline.J Clin Sleep Med.2017;13(2):307-349. doi:10.5664/jcsm.6470
DrugBank Online[database].
Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD.Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians.Ann Intern Med. 2016;165(2):125-133. doi:10.7326/M15-2175
Schweizer CA, Hoggatt KJ, Washington DL, et al.Use of alcohol as a sleep aid, unhealthy drinking behaviors, and sleeping pill use among women veterans.Sleep Health. 2019;5(5):495-500. doi:10.1016/j.sleh.2019.06.005
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