The nightmare of giving up sleeping pills: One woman reveals her addiction battle
By Oona Mashta
Addiction: Paula Wynne battled to wean herself off sleeping pills
Paula Wynne had always been a solid sleeper until two years ago.
Then she was made redundant from her job as a marketing manager, and soon afterwards underwent a minor operation on her shoulder.
What should have been a simple procedure went wrong, and the mother-of-one ended up needing two corrective operations over the next nine months.
The crippling pain and anxiety made it difficult to sleep and her GP prescribed the sleeping pill zopiclone until the pain subsided.
Paula, then 44, took the pills every night for six months, but when she began working again, helping her partner Ken in his business, she found giving up the tablets very difficult.
Whenever she tried, her insomnia became worse than ever before.
'It was horrible - I'd go to bed at the normal time, but just lie in bed wide awake for hours,' she recalls, two years later.
'I felt depressed. I had no energy in the morning to do anything. It was the darkest year of my life. I was only getting a few hours' sleep a night.
'I was behaving out of character, and over-reacting to even the slightest upset. I couldn't make decisions and needed my partner, Ken, to do everything for me.
'I hated not being able to sleep without the aid of medication - but giving it up only made the insomnia even worse.' Paula was suffering from 'rebound insomnia', caused specifically when you give up the pills.
Dr Cosmo Hallstrom, of the Royal College of Psychiatrists, explains: 'Rebound insomnia is like having a double dose of insomnia. The body - which couldn't sleep in the first place - adapts to needing a sleeping pill to sleep; and when it is then taken away, the insomnia is compounded.'
Sleeping pills are both physically and psychologically addictive, he says. Other withdrawal symptoms include anxiety and depression. And while most patients will suffer mild withdrawal symptoms, many suffer more extreme reactions.
Sleeping pills are a commonly prescribed drug - around nine million Britons take them occasionally, with an estimated million using them regularly, and long-term.
Many long-term users are elderly, says Dr Hallstrom. 'If you start taking them and you are in the older age group, there is a one-in- three chance of becoming a long-term user.
'And once you are a long-term user, you will stay on them indefinitely, because they are so difficult to give up. There are people who have been on sleeping pills for 10 to 20 years.'
Last week, it was reported that sleeping pills raise the risk of early death by a third.
This was true whether the pills were used long term or just occasionally, Canadian scientists found. One theory is the drugs affect alertness and co-ordination, making patients more prone to falls and other accidents. It could also be that they interfere with the breathing system and worsen any breathing problems as the person sleeps.
Although British experts questioned the numbers affected, many patients, shocked by the findings, will want to quit the drugs. But as Paula discovered, this is far easier said than done.
Beware: Paula wishes she had never turned to sleeping pills to help her insomnia (posed by model)
The most commonly used sleeping pills are benzodiazepines and newer drugs known as the 'z-drugs' (including zaleplon, zolpidem and zopiclone). They all act in a similar way. They are sedatives that depress brain chemicals in the central nervous system, making you feel relaxed.
While the newer drugs produce less of a 'hangover effect' the next day, all the drugs are potentially addictive, according to the National Institute for Health and Clinical Excellence (NICE).
'To stop people becoming addicted, they should be used only for a short period of time,' says Dr Hallstrom. Indeed, NICE recommends sleeping pills should be prescribed for a maximum of only one month.
The Royal College of Psychiatrists goes even further, advising that only when a patient is so distressed they cannot sleep at all should the pills be prescribed - and then only for less than two weeks. In fact, Paula's GP prescribed zopiclone for weeks on end.
'At first,' says Paula, 'the pills were wonderful. I went from lying in bed all night in agony to being able to drift off at 10pm.'
When one didn't do the job because the pain was particularly bad, she'd pop two at a time. And if she woke up in the night through pain, she'd pop another to get back to sleep.
'I did it because it was such an easy way to get a good night's sleep, something so many of us take for granted,' she explains.
'People think sleeping pills will help - but in fact they can make things worse'
One key concern with sleeping pills is that the body can quickly become tolerant to them, so they work less well at their recommended dose. Then - like Paula - many patients often end up taking more than they should to have an effect.
Determined to end her reliance on the sleeping tablets, for three months Paula repeatedly tried to give them up. Every time she ended up taking the pills again because the withdrawal symptoms were so bad. Without them, she would lie awake all night.
Ken couldn't sleep when she did not sleep, so eventually she'd sneak off to the spare room so at least one of them would get a decent night.
'Apart from worse insomnia than ever if I didn't take the pills, I was very anxious and depressed,' says Paula. 'I lost all interest in things. I had no energy to go out and meet friends, or anything. Moping was the only thing I could do.'
Paula talked to her GP about weaning herself off by gradually reducing the dose. She tried taking the pills on alternate nights - but that didn't work. Finally her GP started her on painkillers again, with a sedative.
Almost six months after first trying to quit, she finally took her last pill. 'My sleep patterns have been erratic, but I'm thrilled to be free of the tablets at last,' she says. 'I now appreciate every wink.'
There is no easy way to quit, Dr Hallstrom warns. Patients have to be prepared to suffer some worsening of their sleep for at least a few weeks.
'They need maybe to take the pills on alternate nights, or they could try alternative medication suggested by their GP.'
The potentially addictive nature of the drugs is why the Royal College of Psychiatrists suggests trying other approaches before even thinking of talking to your GP about sleeping problems.
It recommends self-help methods such as exercising during the day, and getting up if you cannot sleep and doing something relaxing. But that advice came too late for Paula, who warns: 'People think the pills will help - but in fact they can make things worse. I don't believe everyone is told how addictive they can be. Avoid them if you can.' www.paulawynne.com