by Sergio Silva, M.D.

Created on: August 20, 2009

How to Make Your Sleeping Pill Keep Working

Prescription sleep aides are among the most commonly administered of medications, and they can be a Godsend for many patients. Although once only approved by the FDA for brief trials, recently the FDA approved Ambien for long-term use. In actuality, any prescription sleeping pill can be used safely and reliably on a chronic (i.e., nightly) basis, with favorable results. The problem over time, however, is that a person develops tolerance to the sedative effect of these medications and requires ever-increasing dosages to reap the same benefit as when s/he first began taking them, which in many cases leads to drug dependence, withdrawal effects, and even in some cases addiction and/or overdose. This article addresses how to avoid the problem of escalating the dosage of a sleep aide, while maintaining considerable benefit from the prescribed medication.

When you have chronic insomnia that requires nightly dosing with a medication that cannot be increased indefinitely without risking serious side effects (to say nothing of the fact that, sooner rather than later, the higher dose itself will fail to work as expected), here's what you may be doing wrong, along with some secrets to preserving the efficacy of any sleeping preparation:

Begin with the lowest effective dose of the medication and do not increase it unless or until absolutely necessary. This will conserve those higher doses for when you really need them. The sooner and faster you up the dosage, the more rapidly you will develop tolerance to the sedative effect of the drug, and the sooner you will become frustrated by the fact that the medication is apparently no longer working for you.

Once you have increased the dosage once or twice, feel free to back down on those subsequent nights when you already feel especially tired, or think that you might not have particular difficulty getting to sleep; better yet, skip the medication entirely whenever you can. This will preserve efficacy over time, because tolerance is always reversible.

Take the full dose of the medication on an empty stomach, with plenty of water. This will speed the rate of absorption, which will maximize the medication's potency. With a sleeping pill, you want to absorb it rapidly and completely, so that you get to sleep in the same manner: quickly and fully. If you take the medication on a full stomach, this will result

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