This is despite the dose being static for well over a year (20mg/day), and they are still effective. Going three or more days without sleep was at least a monthly incident before taking tamazepam, and missing a night was weekly - three days has only occurred once since, and missing a night's sleep is rare. This has resulted in an improvement to my other symptoms.
 basically anytime I see a doctor other than my regular doctors, who understand the situation
 I do not believe thinking you have only blinked, then looking at the clock and realising over four hours have passed is a safe situation. I suspect I just fell asleep, but I don't remember that, or even waking up -- I thought I was just checking the time, and then four hours disappeared. This happened on multiple occasions, and I'm fairly sure I didn't just misremember the time (though even that would be disconcerting), as it was also brighter outside.