Talk to me: My mum is dependent on sleeping tablets — we have argued about the best thing to do now

Psychologist Caroline Martin is here to answer your questions on whatever issues you are dealing with in life, from work pressure and stress to loneliness and grief

In a recent Irish study completed by the Health Research Board in 2020 it was found that women over 65 years had the highest rates of recent use of sedatives when compared to other ages or their same-age male peers

My mum is dependent on sleeping tablets. It's got to a point where she can't sleep through the night without them. She's in her early 70s and rang me last week, saying her doctor wouldn't prescribe any more. She wanted me to ask my GP for a prescription and when I said no, she got angry and hung up the phone.

I love my mum and want to support her but it's difficult to know what to do.

Sleep has become a large and lucrative industry, with shelves of products from magical pillowcases to teas and prescription medications promising sweet slumber. In an era of sleep deficiency, there are few friend groups and perhaps no mother groups that don’t discuss at length the need for sleep. Within such a context, it is no wonder we gravitate toward the solutions rather than addressing the underlying cause of our poor sleeping patterns and experiences. It has become the norm to camouflage the problem. Like many of our human struggles, it has become socially acceptable to medicate away sleep deprivation.

This pattern appears to be more true for women. A European-wide study in 2015, identified that women are more at risk of nonmedical use of prescription drugs and are more likely to be prescribed drugs than men across all age groups. In a recent Irish study completed by the Health Research Board in 2020 it was found that women over 65 years had the highest rates of recent use of sedatives when compared to other ages or their same-age male peers. Within our western culture, women are often prescribed medication without adequate exploration of the underlying causes of the symptoms. In most instances, women’s own GPs prescribe the medication, but the second most common source is through a family member or a friend. You are not alone.

There is growing awareness of the impact of social and environmental factors, early childhood, and life experiences on our psychological and physical health. There are additional adverse side effects that need to be considered given your mum’s age too. GPs are more likely today to take a broader, more holistic approach to women’s health. It may be the case that this is true of your mother’s GP. This change will take time and it is crucial that you keep in mind that your mum has adopted her strategies to manage her situation over a long time. She is not likely to adapt overnight to a new way of reflecting on her health and wellbeing: she will need support, empathy, and understanding.

For years your mum has had certainty that her GP would write a prescription for her sleeping tablets, she had confidence that would not change. This shift by the GP has created uncertainty. Your mum possibly does not fully understand the decision or the subsequent effect of this decision. This combination of uncertainty and lack of information can create a level of stress. However, when there is also a perceived lack of control over the situation, the stress level raises significantly. She may have thought that she could simply 'fix' the situation by asking you to source a prescription through your GP. When you said, 'no', this was possibly the proverbial last straw, as the cumulative stress became too much to bear.

Caroline Martin, psychologist. Photograph Moya Nolan

Understanding that your mum’s response to this situation may be based in fear and uncertainty can help you to offer her some reassurance and emotional support. When you rejected the idea of getting a prescription for her, she may have felt personally rejected and/or judged by you. Take time to consider that her struggles to sleep may be influenced by various factors including life experiences or undiagnosed health issues.

Engage in actively listening to your mum. Active listening means that you not only listen to the words but also to the tone and her body language. When you are actively listening, you are not rushing to say your bit, or to express your opinions. Instead, you are seeking to understand. Use open questions, rather than yes/no questions as this will help to create a safe space for your mum to express her thoughts and reflect on her experiences. Chatting the situation through together may offer greater clarity for both of you. Crucially, it will also challenge any sense that she is alone in this predicament.

Any sudden change in medication must be carefully discussed with the GP. Encourage your mum to return to her GP to discuss the situation. It is important that she understands the medical rationale behind the decision and also understands what options are available to her. While this may have been explained at the time, the shock of the GPs decision to not write the usual prescription may have meant that your mother didn’t hear what was said. This is entirely understandable and a very normal response to receiving unexpected news at a medical appointment. Suggest to your mum that you attend the GP appointment with her so that you can be a second set of ears and are better positioned to support her afterward.

In the week that the Barbie film is fast becoming one of the go-to movies of the summer, the challenges of simply existing as a woman are to the fore. As women age, they can be confronted further by reduced agency and increased uncertainty about their identity as a woman in a world that sets impossible expectations. Take this cue to reflect on the context of your own nighttime routine and if required, seek to make the necessary lifestyle adjustments in the interest of your wellbeing.

Take care.

If you have a question for Caroline, please send it to [e-mail]