Typically, insomnia sufferers who are prescribed sleeping pills start off with a relatively low dose and are told to take them only on nights when they experience difficulties with sleep.
Unfortunately, many insomniacs find they need to continually increase their dose over time in order to maintain the effectiveness of their sleeping pills.
Furthermore, even though sleeping pills should only be used for the short term, very often people find they are taking them for months (or even years).
Unfortunately there is no clear consensus on how to manage insomnia with medication over the long term, and that's what prompted a recent study.
Its aim was to identify the best strategy for maintaining the effectiveness of sleeping pills over time.
The study divided 74 chronic insomniacs into three groups. All participants were given 10mg of zolpidem (Ambien) for four weeks.
Then, one group was given a nightly dose of 5mg or 10mg of Ambien every night for 12 weeks.
A second group was given 10mg three to five times per week for 12 weeks (intermittent dosing).
A third group was given 10mg nightly for 12 weeks but half of the tables were sleeping pill placebos.
Researchers found that the intermittent dosing strategy was the least effective - with participants in that group demonstrating the worst sleep quality.
In other words, the group that probably best represents how insomnia sufferers are initially directed to use sleeping pills proved to be the least effective over time, and that may be why many find their dosages increasing over time.
As the senior author of the study concluded:
"The full dose may or may not be required to get the initial effect, but certainly maintaining the effect can be done with less medication."
So it would appear that the better strategies are to start with a higher dose and potentially reduce this over time, or to start with a higher dose and mix in a placebo on some nights.
The bottom line: To maintain the effectiveness of sleeping pills, we may not necessarily need to increase (or even maintain) our initially prescribed dose.
Perhaps this will lead to alternative prescribing strategies in the future.
As always, you should speak with your doctor before making any changes to your sleeping pill regimen.
Source: Sleep Medicine
Last updated: August 20, 2015