Coming off sleeping pills: how a safe reduction is done

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It started "just for a while" — a bereavement, a divorce, a bad spell at work. Months or years later the pill is still on the bedside table, no longer works as it did, and the idea of sleeping without it is frightening. This story repeats in thousands of homes: Portugal is among Europe's biggest consumers of medication for sleep and anxiety.

First, the most important thing

Why it is worth reducing

With prolonged use these drugs lose effectiveness (tolerance), create dependence, and are associated with daytime drowsiness, falls, and problems with memory and concentration — particularly from middle age onwards. Meanwhile the original insomnia is still there, untreated. Reducing is not about kicking away the crutch and falling: it is about treating the insomnia first, so the crutch stops being needed.

How it is done, in practice

• Medical assessment — which drug, what dose, for how long, and what other conditions are present. This is the starting point of the plan.
• Treating the insomnia in parallel — CBT-I starts before or during the taper, to build the capacity to sleep without medication. It is the single factor that most increases success.
• Gradual reduction — typically in small fractions of the dose every 1-2 weeks or slower, at your own pace, with room to pause. It is not a race.
• Support for downregulation — relaxation techniques and clinical hypnotherapy can help during the weeks in which the body readjusts.

How HICOA can help

HICOA Clinic brings together in one place the two pieces this process needs: the psychiatrist, who assesses and safely guides the reduction in medication, and the psychologists and hypnotherapist, who treat the insomnia with CBT-I and support the downregulation. All online or in Matosinhos, coordinated and at your own pace.