My father has taken sleeping pills for years: is that a problem?

Taking benzodiazepines or Z drugs for years is common in Spain, but it is not what their product information recommends: it is worth reviewing with the GP and, where appropriate, tapering them off slowly.

It can be a problem, and it deserves a conversation with his GP. Benzodiazepines and the so called Z drugs work well in the short term, but they are authorised for use for the shortest time possible. When taken for years, they stop helping sleep as they did at first and, in older people, they increase the risk of falls and confusion.

That does not mean they must be stopped tomorrow. It means it is worth reviewing whether they are still needed and, if not, reducing them gradually with professional support.

Is it a problem to take sleeping pills for years?

Yes, it can be. According to the 2025 report of the Spanish Observatory on Drugs and Addictions (Ministry of Health), the product information states that insomnia treatment with these medicines should be as short as possible, with a maximum of 2 to 4 weeks including gradual tapering.

The same report explains that prolonging treatment encourages loss of effect, side effects, tolerance and dependence, and that roughly 35% of people treated with hypnotics and sedatives for more than 4 weeks develop tolerance and physical dependence. So it is reasonable to ask for a review, especially if the prescription has been renewed automatically for a long time.

What exactly are sleeping pills?

They are usually benzodiazepines (for example lorazepam, lormetazepam or diazepam) or Z drugs (zolpidem and zopiclone). All of them need a prescription and act on the central nervous system to bring on sleep and sedation.

They are very widely used in Spain. In 2023 the National Health System dispensed the equivalent of about 56 daily doses of anxiolytics and about 34 of hypnotics and sedatives per 1,000 inhabitants per day, according to the same Ministry report.

Some people also take sleep products without a prescription. MedlinePlus notes that most experts advise against antihistamines for sleep in older people, so mention any such product to the doctor or pharmacist too.

What are the risks for older people?

With age, the body clears many medicines more slowly and is more sensitive to their effects. The zolpidem product information, for example, states that older people may be particularly sensitive and warns of the risk of falls, especially when getting up at night.

The Ministry report adds that combining them with alcohol or opioids increases depression of the central nervous system and can be dangerous. If your father takes several medicines, also read our article on medicines that increase the risk of falls.

Can they be stopped? How is it done?

Yes, in many cases they can be reduced or stopped, but never suddenly. Stopping abruptly can cause withdrawal symptoms or rebound insomnia, where the original symptoms return more strongly, as the product information warns.

Tapering means reducing the dose step by step, following a plan set by the doctor that may last weeks or months. In the meantime, measures to sleep better help, and guidelines consider them the first option for insomnia. MedlinePlus recommends, among others:

• Keeping a regular time for going to bed and getting up.
• Avoiding caffeine for 3 to 4 hours before bed and avoiding alcohol and tobacco close to bedtime.
• Exercising regularly, but not in the 3 hours before sleep, and avoiding naps.
• Getting up if sleep does not come within about 20 minutes and going back to bed when feeling sleepy.

Cognitive behavioural therapy for insomnia can also help when the problem persists. And if sadness or low mood lies behind the poor sleep, the doctor should assess it: read our article on depression in older people.

A practical example: Antonio and his nightly lorazepam

Let us take the case of Antonio, aged 79, who has taken one lorazepam tablet every night since he was widowed ten years ago. His son finds out that he has fallen twice this winter going to the toilet in the early hours and that during the day he "seems half asleep".

1. Write down how long he has taken the pill, at what dose and who prescribed it, and note the falls and the drowsiness.
2. Book an appointment with the GP to review whether he still needs it and explain what has happened.
3. If the GP decides to reduce it, ask for the plan in writing, with the dates and doses for each step.
4. Let the pharmacy know so the pill organiser or multi dose pack reflects each dose change.
5. In the meantime, leave a night light on the way to the bathroom and remove loose rugs.

What he should not do is stop it from one day to the next or split the tablets on his own.

How can IMA Health help you?

Gradual tapering means frequent dose changes, and that is where mistakes happen easily. At IMA Health we coordinate with a specialised pharmacy so the medication is prepared by day and time of each dose, and each sachet contains the dose set by the current regimen. We deliver it to the home and provide personalised follow-up of every change.

Sources

• Spanish Ministry of Health, OEDA: 2025 report. Prescribed medicines use (anxiolytics, hypnotics and sedatives), 2024 (in Spanish)
• CIMA, Spanish Medicines Agency (AEMPS): zolpidem 10 mg summary of product characteristics (sections 4.2 and 4.4, in Spanish)
• MedlinePlus: aging changes in sleep (Spanish version)

This article is for information only and does not replace advice from your doctor or pharmacist.