When a person stops taking certain sleep medications, they may experience rebound insomnia and have difficulty falling or staying asleep. Rebound insomnia is sometimes worse than the insomnia a person had before treatment.

Rebound insomnia is difficulty sleeping that occurs when a person stops taking a medication that usually helps them sleep. It is a common side effect of some sleeping pills.

Sometimes, rebound insomnia is worse than the insomnia a person experienced before treatment.

Typically, doctors only prescribe drugs likely to cause rebound insomnia for the shortest time possible.

Benzodiazepines and so-called “Z-drugs” (non-benzodiazepine sleep medications) can cause rebound insomnia when a person stops taking them.

Both benzodiazepines and Z-drugs affect gamma-aminobutyric acid (GABA), which reduces stimulation of the nervous system. This increases feelings of relaxation and drowsiness but also comes with a risk of dependence and side effects.

Examples of Z-drugs include:

  • zolpidem (Ambien)
  • zopiclone (Imovane)
  • zaleplon (Sonata)
  • eszopiclone (Lunesta)
  • alprazolam (Xanax)
  • chlordiazepoxide (Librium)
  • lorazepam (Ativan)
  • oxazepam
  • clonazepam (Klonopin)
  • diazepam (Valium)
  • clorazepate (Tranxene)
  • estazolam
  • flurazepam
  • temazepam (Restoril)
  • triazolam (Halcion)
  • midazolam (Nayzilam)

Doctors can also prescribe other medications off-label, meaning for a purpose other than the one approved by the Food and Drug Administration (FDA).

A doctor might do this if appropriate to avoid the risk of rebound insomnia and other side effects from other medications.

These might include:

A doctor might also recommend other OTC drugs, such as melatonin or diphenhydramine (Benadryl), depending on a person’s particular sleep issue.

There is no set amount of time that rebound insomnia will last.

Each person will likely have a different experience. Generally, though, doctors expect withdrawal symptoms for benzodiazepines to last no more than 4 weeks.

The duration of withdrawal effects can depend on the drug, the change in dose, and the drug’s half-life. This is the time it takes for the amount of drug in the body to halve.

Shorter-acting benzodiazepines cause less rebound insomnia than longer-acting drugs. And more potent benzodiazepines may be more likely to cause rebound insomnia.

It might not be possible to prevent rebound insomnia in everyone, but the following might help reduce the risk:

  • use medications with a shorter half-life
  • take medications for as short a time as possible and at the lowest dose needed
  • reduce the dosage slowly

Lowering the dose slowly does not always prevent rebound insomnia, but it is crucial not to stop treatment suddenly, especially if a person has been taking the medication for more than 1 month.

Stopping benzodiazepines abruptly can cause severe symptoms, which can sometimes be fatal.

Rebound insomnia occurs because of changes in brain chemistry, and some people can find it difficult to cope with. A person may need to wait until the drug’s effects wear off before they can sleep again.

The following may help:

  • psychoeducation, which involves learning about insomnia, what contributes to it, and how to manage it
  • relaxation training, which involves learning techniques that calm the nervous system
  • cognitive behavioral therapy (CBT), which may help a person cope emotionally with withdrawal symptoms

To avoid the potential of rebound insomnia, a person might opt to choose other methods to help improve sleep. A person can also try these methods after successfully weaning off sleep medication to help prevent insomnia from returning:

  • Treating mental conditions: Stress and anxiety are common causes of insomnia. Reducing stress and seeking therapy or other treatments for anxiety may make sleeping easier.
  • Treating physical conditions: Chronic pain, breathing difficulties, and other physical conditions can also contribute to insomnia. Getting support for these may help.
  • Sleep hygiene: This involves adopting habits that promote sleep and a regular sleep-wake schedule. Getting morning daylight exposure, limiting evening light exposure, maintaining a regular daily routine, and using the bedroom only for sleep or sex are part of sleep hygiene.
  • Relaxation: A relaxing bedtime routine or a regular relaxation practice may help with sleep. This could include taking a warm bath, practicing yoga, or meditation.
  • Avoiding caffeine and alcohol: People with insomnia may feel tempted to use caffeine to cope with sleep deprivation. However, this may exacerbate insomnia. Similarly, alcohol can disrupt sleep.

There are also natural sleep aids. However, scientists have not tested all these to ensure they are safe and effective. There is also little research on whether they cause rebound insomnia.

Examples of nonprescription sleep aids include:

These sleep remedies may work in a similar way to benzodiazepines.

Melatonin is not recommended for insomnia. However, it may help with sleep disorders related to sleep timing.

Always speak with a doctor before trying any sleep supplements. This is especially important if a person takes other drugs or has other health conditions.

Resources for healthy sleep

To discover more evidence-based information and resources on the science of healthy sleep, visit our dedicated hub.

People having trouble stopping any drug because of rebound insomnia should seek medical advice.

Doctors can help a person wean off benzodiazepines and other drugs by creating a personalized treatment plan.

Do not change the dose of sleep medications without first discussing it with a doctor.

Rebound insomnia is common after stopping taking certain sleeping pills, such as benzodiazepines and Z-drugs. Off-label sleep aids may also cause rebound insomnia when stopped.

To prevent rebound insomnia, doctors suggest slowly lowering the dose of some sleep medications. This is especially important for benzodiazepines. If rebound insomnia does occur, relaxation practices and other natural strategies may help a person’s symptoms.