INDICATIONS FOR DRUGS

Sleeping medication should be used for not longer than two weeks.
After two weeks the medication is no longer effective for inducing sleep and should be stopped gradually. The only reason for continued use after two weeks is perhaps to prevent the onset of rebound insomnia. Intermittent use of the drug is advisable, skipping the nightly dose after a couple of good night's sleep. Sleeping pills can be used in the following situations, but only if all the non-drug strategies are not working.
All mental illness. This should be treated appropriately by modern medicine. Mental illness still carries a stigma and people are ashamed of it In fact mental illness is an illness of the mind and is not different from physical illness such as diabetes, heart disease, and so on that require constant medication. The fact that drugs and pills which are physical agents can successfully treat mental illness implies that mental illness itself has a physical cause as it requires physical treatment. Hence the old stigma of mental illness that it is the weakling who suffers from mental illness needs to be revised. Mental illness can attack anyone, just like appendicitis does, and no one is immune. Stopping medication does not mean disappearance of mental illness.
Biological clock related insomnia. This is transient insomnia resulting either from jet lag or from shift work. If sleeping pills are required, they should be taken for not more than a few days. People who suffer jet lag can take sleeping pills for the first few nights so as to facilitate the resetting of the biological clock. This applies to shift workers also. After the first few nights, the sleeping pills should be stopped, as the biological clock should be on time with the shift by now. Longer acting pills such as Nitrazepam should be used, as they sustain sleep longer. Very often after arrival at a new destination or after starting a new shift, people feel very sleepy and have no trouble falling asleep, but they may wake up after a few hours and not be able to sleep again. This is because the waking time of their biological clock is early. They need a pill to keep them asleep so as not to wake up prematurely.
Situational insomnia. This is normally stress related and is transient. Sleeping pills can be used if necessary, but should be stopped immediately after the stress is lifted, as addiction is a distinct possibility in some people.
Pain and physical illness. These can disturb sleep, and most sleeping pills prescribed in hospital are to prevent this. Many people who are taking sleeping pills later in life recall that the first time they started taking them was when they were in hospital.
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