I’ve been taking the sleeping pill zopiclone for seven months and am considering stopping. I sleep well but get a headache. Do you have any advice?
Zopiclone is a Z drug – the other is zolpidem – and these should only be used for a short time, maybe a few weeks.
Prolonged use can lead to dependency. People may find they cannot sleep without them and suffer from side effects such as brain fog, poor memory, numbness, and even anxiety and depression.
We also know that tolerance builds, so over time people need to use it more and more often.
Anyone taking a Z drug for more than a month should slowly reduce their dose because of the risk of withdrawal symptoms. These can include anxiety, tremors, sweating, and nausea.
Anyone taking a Z drug for more than a month should slowly reduce their dose because of the risk of withdrawal symptoms. These can include anxiety, tremors, sweating, and nausea
Some patients tell me their hearts are racing or their old sleep problems are coming back – but that’s just withdrawal. It’s important to talk to your family doctor to create a plan to stop.
To make it as comfortable as possible, we often do this over a period of weeks or months. It may require more than one attempt.
For long-term sleep problems, CBT-i is recommended, a special form of cognitive behavioral therapy that addresses the thoughts and behaviors that cause and worsen insomnia.
For example, relaxation therapies or sleep restrictions are used. Sleep restriction encourages the patient to limit their time in bed. You go to bed and wake up at a set time, with a time window that is initially short and then widens.
It’s quite a complicated process and a GP or therapist can help you through it. Or you can try an app like Sleepio.
Sleep hygiene is often talked about. It means creating the best possible environment and attitude for sleeping, with ideas like a room without technology and not exercising before bed. This will not cure your insomnia, but it is an important help.
I was diagnosed with moderate osteoporosis 18 months ago after tripping over a broken cobblestone and breaking my shoulder and arm. I’m 72 and have always eaten well and exercised. I was recommended a drug called zoledronate but am concerned as I have read that it can cause quite bad dental problems and I recently had a tooth extracted. What should I do?
Osteoporosis is a thinning of the bones, making them weaker and more prone to breakage.
The goal of treatment is to avoid a fracture. Falls are more common with age due to loss of muscle strength and stability and balance problems.
It can be pretty serious. For example, a hip fracture due to osteoporosis leads to permanent disability in about half of those affected.
Osteoporosis is diagnosed with a DEXA scan. The result is given as a score reflecting the different stages of bone thinning.
Whether and which treatment is involved depends on these results and a personal risk score calculated by a doctor, the so-called fragility fracture score. If you’ve already taken a break, you’ll get a higher score, but it also depends on other factors like age and family history. Treatment includes diet and exercise. Getting adequate intake of vitamin D and calcium, both of which are needed for healthy bones, is just as important as doing weight-bearing and muscle-strengthening exercises to support your bones.
The Royal Osteoporosis Society website (theros.org.uk) has helpful exercise guides and diet advice.
Medications are important for strengthening bones and there are a number of medications, including HRT, that may be appropriate for some women in this case. All medications have side effects, and the dental complications of some osteoporosis medications are important to weigh when you need dental care. If you’ve had dental problems, it’s important to tell your doctor or nurse so they can find the best treatment.
I have just returned from a holiday in Spain and had swelling in my feet and ankles after getting off the plane. This has been happening for years, but tests show that my circulation is fine. I’m 71 and active. Are there any medications I could take? When it flares up, it’s very sore and uncomfortable.
Such swelling is called edema, and while it can look and feel uncomfortable, it is generally harmless when all tests are normal.
When we sit for long periods of time, blood flow from the lower limbs back to the heart can slow down. This allows blood fluid to leak from the veins into the surrounding tissues, causing swelling.
The movement of the leg and foot muscles pushes the blood back through the veins to the heart more efficiently.
Edema is worse for people with heart or vascular problems, so doctors do heart tests and other scans to check everything is okay. Maybe you’re thinking about special socks for the plane. Compression stockings put pressure on your legs, mimicking muscles and increasing blood flow. These are measured specifically for you and you can try different gauges and lengths to see what works and is comfortable.
We sometimes prescribe water pills – diuretics. It can be something that can be taken short-term to prevent those uncomfortable symptoms while on vacation.
Did the hospital send you home without care?
Write to Dr. ellie
Do you have a question for Dr. Ellie Canon? Email [email protected]
dr Cannon cannot engage in personal correspondence and her responses should be viewed in a general context.
I heard an alarming story last week from the wife of a man who was “expelled” from the hospital after a horrific fall at home.
A few days after his admission, a hospital worker called and said he was ready to come home, even though he was practically unconscious from a broken hip.
His wife, of course, agreed. She asked if there was help. “Someone will come for an assessment,” she was assured. Then a care package – a bed downstairs, a dresser and some help – would be given out. But that never happened.
Luckily she rounded up friends to get a bed in the living room. After a few days of phoning, the GP obtained a bedpan – but she still couldn’t get hold of anyone from the hospital.
What a sad story. This scenario would fall under “Relief to be Assessed”. Since its launch in 2016, patients who are fine leaving the hospital but need extra support can be sent home and seen within days by an occupational health practitioner, who will then organize care. Obviously that doesn’t always happen.
If you have been in this situation, I would like to hear from you. Write to me at the address given above.
Heart attacks also affect women
I was irritated by a picture posted to the NHS social media Instagram account this week.
The image showed an overweight man with his hands clutching his chest, followed by part of a heart health campaign aimed at helping people spot the signs of a heart attack. But we need to stop portraying heart attacks as a problem that only affects men.
It is well known that heart attacks in women are often hidden because patients and some doctors assume that they only occur in men. This means women receive vital treatment more slowly and are at greater risk of dying from a heart attack.
Heart disease kills more than twice as many women in the UK as breast cancer. It might be time for health campaign posters to reflect this.