Discontinuation of an hypnotic may be followed by rebound insomnia.
The severity of rebound insomnia varies with different hypnotic agents. It tends:
(1) to be greater with certain agents such as short-acting benzodiazepines
(2) to be worse if discontinuation is abrupt
Complicating factors:
(1) dependence and withdrawal
(2) rebound anxiety
(3) depression
In general:
(1) continuous use of an hypnotic for a long period of time should be avoided
(2) non-pharmacologic interventions to improve sleep should be emphasized
(3) comorbid conditions (pain, depression, anxiety, sleep apnea) need to be addressed
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Specialty: Pharmacology, clinical
