Rebound insomnia in normals and patients with insomnia after abrupt and tapered discontinuation
Abstract
Rebound insomnia was studied in subjects, aged 25-50 years, with insomnia complaints and normal sleep, insomnia complaints and disturbed sleep, and normal sleep with no complaints (N = 21, n = 7 per group). Standard sleep recordings were collected on a baseline night and after abrupt discontinuation of 6 nights of 0.50 mg triazolam, tapered discontinuation (3 nights of 0.50 mg, 2 nights of 0.25 mg, and 1 night of 0.125 mg triazolam) and 6 nights of placebo. Significantly disturbed sleep on the discontinuation night compared to the baseline night was found. The relative degree of rebound insomnia was greater in the abrupt condition than in either the tapered or placebo conditions. The tapered condition reduced sleep time by half that of the abrupt condition which was twice the reduction found in the placebo condition. An overall (regardless of group or condition) difference in baseline versus discontinuation sleep was found, suggesting that pill discontinuation itself leads to sleep disturbance. Subjects did not differ in rebound insomnia as a function of pre-existing sleep disturbance.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Rebound anxiety can occur during ongoing treatment with rapidly eliminated benzodiazepines when their pharmacological effects decrease.
“Rebound anxiety can also occur during ongoing treatment with rapidly eliminated benzodiazepines when their pharmacological effects decrease.”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [72]
Rebound insomnia and withdrawal can be minimized by gradually tapering both the dose and frequency of administration.
“Rebound insomnia and withdrawal can be minimized by gradually tapering both the dose and frequency of administration. 57”
From Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults (2008) · cites this paper as [57]
Tapering the frequency of administration (such as every other or every third night) has been shown to minimize rebound effects.
“Tapering the frequency of administration (such as every other or every third night) has also been shown to minimize rebound effects.”
From Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults (2008) · cites this paper as [57]
Cites
Hori, T., Sugita, Y., Koga, E., Shirakawa, S., Inoue, K., Uchida, S., Kuwahara, H., Kousaka, M., Kobayashi, T., Tsuji, Y., et al. (2001) · Psychiatry and Clinical Neurosciences · doi:10.1046/j.1440-1819.2001.00810.x · Cited by 811 · see citing works
Social and behavioral consequences of alcohol consumption and expectancy: A meta-analysis.
Hull, J. G., & Bond, C. F. (1986) · Psychological Bulletin · doi:10.1037/0033-2909.99.3.347 · Cited by 502 · see citing works
Rebound Insomnia: A New Clinical Syndrome
Kales, A., Scharf, M. B., & Kales, J. D. (1978) · Science · doi:10.1126/science.684426 · Cited by 200 · see citing works
Rebound Insomnia and Rebound Anxiety: A Review
Kales, A., Soldatos, C. R., Bixler, E. O., & Kales, J. D. (2008) · Pharmacology · doi:10.1159/000137794 · Cited by 198 · cited 1× · see citing works
“It is felt that rebound insomnia occurs because of the rapid elimination of the short- and intermediate-acting compounds which then leaves the CNS acutely deficient in inhibitory neuronal mechanisms (Kales et al. 1983).”
BackgroundEffect of Gradual Withdrawal on the Rebound Sleep Disorder after Discontinuation of Triazolam
Greenblatt, D. J., Harmatz, J. S., Zinny, M. A., & Shader, R. I. (1987) · New England Journal of Medicine · doi:10.1056/nejm198709173171202 · Cited by 96 · see citing works
Rebound Insomnia: Its Determinants and Significance
Roehrs, T., VOGEL, G., & Roth, T. G. (1990) · The American Journal of Medicine · doi:10.1016/s0002-9343(13)80001-0 · Cited by 84 · see citing works
Self-citationQuazepam and flurazepam: Long-term use and extended withdrawal
Kales, A., Bixler, E. O., Soldatos, C. R., Vela-Bueno, A., Jacoby, J., & Kales, J. D. (1982) · Clinical Pharmacology and Therapeutics · doi:10.1038/clpt.1982.236 · Cited by 62 · see citing works
BIXLER, E. O., KALES, A., SOLDATOS, C. R., SCHARF, M. B., & KALES, J. D. (1978) · The Journal of Clinical Pharmacology · doi:10.1002/j.1552-4604.1978.tb02430.x · Cited by 60 · see citing works
Changes in Popular Attitudes and Beliefs About Tranquilizers
Clinthorne, J. K. (1986) · Archives of General Psychiatry · doi:10.1001/archpsyc.1986.01800060017003 · Cited by 42 · see citing works
Rebound insomnia and hypnotic self administration
Roehrs, T., Merlotti, L. A., Zorick, F. J., & Roth, T. G. (1992) · Psychopharmacology · doi:10.1007/bf02245259 · Cited by 41 · see citing works
Self-citationDose determinants of rebound insomnia.
Roehrs, T., Zorick, F. J., Wittig, R., & Roth, T. G. (1986) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.1986.tb05241.x · Cited by 36 · see citing works
Self-citationWithdrawal and pseudowithdrawal from diazepam therapy.
Winokur, A., & Rickels, K. (1981) · PubMed · Cited by 26 · see citing works
Rebound insomnia: duration of use and individual differences.
Merlotti, L. A., Roehrs, T., Zorick, F. J., & Roth, T. G. (1991) · PubMed · Cited by 22 · see citing works
Self-citationBrotizolam: A sleep laboratory evaluation
Vela‐Bueno, A., Oliveros, J. R. G., Dobladez-Blanco, B., Arrigain-Ijurra, S., Soldatos, C. R., & Kales, A. (1983) · European Journal of Clinical Pharmacology · doi:10.1007/bf00544014 · Cited by 19 · see citing works
Rebound Insomnia: Duration of Use and Individual
MERLOTTI, L., ROEHRS, T., ZORICK, F., & ROTH, T. (1991) · Journal Of Clinical Psychopharmacology · doi:10.1097/00004714-199112000-00007 · Cited by 14 · see citing works
Self-citationPolysomnographic and MMPI Characteristics of Patients with Insomnia
Zorick, F. J., Kribbs, N. B., Roehrs, T., & Roth, T. G. (1984) · Psychopharmacology series · doi:10.1007/978-3-642-69659-6_1 · Cited by 11 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults
Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27286 · Cited by 1,943 · see citing works
Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications
Cosci, F., & Chouinard, G. (2020) · Psychotherapy and Psychosomatics · doi:10.1159/000506868 · Cited by 265 · see citing works
Lerner, A., & Klein, M. (2019) · Brain Communications · doi:10.1093/braincomms/fcz025 · Cited by 89 · see citing works
Rebound insomnia after hypnotic withdrawal in insomniac outpatients
Hajak, G., Clarenbach, P., Fischer, W., Rodenbeck, A., Bandelow, B., Broocks, A., & Rüther, E. (1998) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s004060050032 · Cited by 39 · see citing works
- Authors
- Roehrs, T., Merlotti, L., Zorick, F., & Roth, T.
- Affiliations
- Henry Ford Hospital (US)
- Venue
- Psychopharmacology
- Published
- 1992-07
- Volume
- 108
- Issue
- 1-2
- Pages
- 67-71
- ISSN
- 0033-3158 (ISSN-L)
- 1432-2072
- OpenAlex
- W2083046021
- Cited by
- 25
- References
- 16
- Citations by year
- 2026: 1 · 2025: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2016: 2 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01da005086-08)
- National Institute on Drug Abuse (R01 DA05086)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- rebound insomnia, triazolam, benzodiazepine withdrawal, abrupt discontinuation, sleep disorders, sleep duration
- MeSH terms
- Adult, Double-Blind Method, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Substance Withdrawal Syndrome, Triazolam
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
