1. Benzodiazepines & Sleep Promotion without Medication

2. Pill For Every Ill  Sleepers,  Tranquilisers,  Settlers,  Yellows,  Blues  All these terms are used to describe a class of drugs called benzodiazepines

3. Pill For Every Ill  Benzodiazepines work by increasing how well a natural chemical in released in the brain works.  This chemical decreases the signals sent in the brain  Therefore it has a calming effect on the brain

4. Pill For Every Ill  Typical Examples we see every day in community pharmacy 1. Diazepam (Valium) 2. Temazepam 3. Lorazepam 4. Nitrazepam 5. Chlordiazepoxide 6. Clonazepam (Rivotril)

5. Pill For Every Ill  Benzodiazepines have several features which make them useful in treating various medical conditions. These include…..  Sedative and hypnotic (cause sleepiness)  Anxiolytic (decrease anxiety)  Anticonvulsant (stop fits)  Muscle relaxants

6. Pill For Every Ill  Benzodiazepines can be used to treat a range of medical issues 1. Panic Disorders Because they have a very fast acting calming effect. 2. Insomnia Can be used to treat short term insomnia. Their use beyond 2-4 weeks is not recommended

7. Pill For Every Ill 3. Seizures They are fast acting and very good at controlling fits 4. Alcohol Withdrawal Help control the effects of withdrawal symptoms after stopping drinking 5. Anxiety They bring about rapid relief from symptoms

8. Pill For Every Ill  There are many problems with using benzodiazepines though  Most of the side effects are related to their sedating and muscle relaxant properties  Can be major problems as these medications can cause dependence, or addiction

9. Pill For Every Ill Shot Term Effects  They can cause drowsiness, which can be a problem with driving, etc  Decreased alertness and concentration  Can decrease blood pressure which causes dizziness  Can cause lack of coordination, both of which can lead to falls in the elderly.

10. Pill For Every Ill  Can cause nausea and lack of appetite  Blurred vision  Confusion  Even short term use can cause memory loss  Nightmares  Depersonalisation

11. Pill For Every Ill Long Term Effects  General Deterioration in both physical and mental health  Cause marked memory loss  Confusion and loss of interest  Social Phobia  Increase in anxiety and depression

12. Pill For Every Ill  The main long term side effects are tolerance and dependence Tolerance  Tolerance shows itself as a loss in medical effect  It can develop very quickly, which is why these drugs should only be used short term

13. Pill For Every Ill Dependence  Dependence is addiction  It can lead to two main problems 1. Withdrawal Effects If a patient has to discontinue benzodiazepines for any reason they can suffer withdrawal symptoms.

14. Pill For Every Ill  Most frequent withdrawal symptoms 1. Insomnia 2. Gastric Problems 3. Tremors 4. Agitation 5. Fearfulness 6. Muscle Spasm

15. Pill For Every Ill 7. Irritability 8. Sweating 9. Depression 10. Suicidal Behaviour 11. Seizures 12. Delrium Tremens Abruptly stopping benzodiazepines can be dangerous, therefor a reduction regime over several weeks should be initiated

16. Pill For Every Ill 2. Rebound Rebound symptoms are the return of the symptoms for which the patient was treated but worse than before

17. Pill For Every Ill  There are also problems associated with using benzodiazepines as sleeping aids  They improve sleep-related problems by shortening the time spent in bed before falling asleep  Prolonging the sleep time  In general, reducing wakefulness

18. Pill For Every Ill  However they worsen sleep quality  They do this by increasing light sleep and decreasing deep sleep.  Therefore although you may sleep a full night, you may not feel rested the next morning

19. Pill For Every Ill How to Promote Sleep Without Medication When night starts to fall, your body should be getting ready for sleep  As evening settles, keep the lights low and engage in relaxing, quiet activities that will prepare your body for refreshing, deep sleep.

20. Pill For Every Ill Stick to a routine - your adrenal glands will thank you  Cortisol levels should be lowest at midnight, and low cortisol levels stimulate growth hormone release.  If you overstimulate yourself with activities near bedtime, your cortisol may increase instead of decreasing at this critical hour. However, if you sleep at the same time every day and wake every day at the same time, your cortisol cycle will be correct

21. Pill For Every Ill Sleep in a pitch black room  Artificial light will trick a gland into thinking it's day and decrease melatonin production, which is needed for good quality sleep Eat a small protein snack before bed  A light snack of protein such as a handful of nuts or a glass of milk can provide a protein that the brain uses to produce melatonin and serotonin that promote high quality sleep

22. Pill For Every Ill  There are many foods which can also help promote sleep  Green leafy vegetables  Bananas  Natural Yoghurts  Chicken or turkey  Beans and lentils

23. Pill For Every Ill  There are also foods that we should avoid to promote a good nights sleep  Alcohol  Coffee  Coke  Spicy Foods  Fatty Foods

24. Pill For Every Ill Other Sleep Promoting Tips  Get into a routine whereby you go to bed and get up at the same times each day  Avoid eating heavy meals at least 2 hours before going to bed  Avoid caffeine, nicotine and alcohol late in the day or at night  Try some chamomile tea or relaxing herb tea blends

25. Pill For Every Ill  Try a relaxation technique and deep breathing  Avoid naps after 3pm  Get regular exercise, but make sure you don`t do excessive exercise later at night  If light is a problem use a sleeping mask, if noise use ear plugs  Follow a routine to help you relax and wind down before sleep eg taking a warm bath

26. Pill For Every Ill  Keep your bedroom for sleep not for TV etc  Keep your bedroom in complete darkness while you sleep  If you have things on your mind try off loading them into a journal, talking about them or trying some relaxation  If you are still awake after 20 mins of attempting to sleep, get up and do something relaxing

27. Pill For Every Ill  Don`t watch violent TV or emotionally upsetting TV as this can stimulate your brain and prevent sleep  Try to make a to do list for the following day so you don`t end up mulling over what needs to be done the next day