Sleep-Wake Cycle and Hypnotics

As the margin between excitatory and inhibitory activity decreases with age, there is an increasing tendency towards shortened daytime sleep periods and more frequent interruption of nocturnal sleep (C). 

Use of a hypnotic drug should not be extended beyond 4 wk, because tolerance may develop. The risk of a rebound decrease in sleep propensity after drug withdrawal may be avoided by tapering off the dose over 2 to 3 wk. 

With any hypnotic, the risk of suicidal overdosage cannot be ignored. Since benzodiazepine intoxication may become life-threatening only when other central nervous depressants (ethanol) are taken simultaneously and can, moreover, be treated with specific benzodiazepine antagonists, the benzodiazepines should be given preference as sleep remedies over the all but obsolete barbiturates. 

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Wake-sleep pattern, stress, and hypnotic drug action 

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