IT IS not uncommon for a patient who first received hypnotics (generally a barbiturate) as a routine order while in the hospital to continue to use them after discharge, often for years.1 In recent experiments in Great Britain two volunteers given a barbiturate at bedtime for 26 nights, at first fell asleep more quickly and slept longer than usual, as might be expected. Then tolerance began to develop until after 12 to 14 days sleep occurred later and total sleep time decreased. When the barbiturate was withdrawn after 26 days the onset of sleep was much delayed and total sleep time fell abruptly, while nightmares and restlessness were increased. Not for two weeks did sleep return to normal.
A patient who begins to use hypnotics to induce sleep soon develops a tolerance, and naturally takes an extra pill or demands a stronger drug over a period of years until
Sleep Pills. Arch Otolaryngol. 1969;90(3):263. doi:10.1001/archotol.1969.00770030265001
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