Sleep Aids: What You Need to Know
It is 2:00 a.m. and you are staring at the ceiling. Youcheck the clock every 5 minutes to calculate how much sleep youcan squeeze in before the alarm jolts you awake. You have tried warmmilk and relaxation tapes, yet you are still wide-awake. Should youtake a sleeping pill? If this sounds like your nightly routine, take heart. Insomnia affects millions of people, and sleep aids and other remediesclaiming to solve the problem are plentiful. What is the best courseof action and how do you know if sleeping pills or other sleeppreparations are safe enough for regular use?
Talk to Your Doctor FirstBefore taking an over-the-counter sleep aid, talk to yourdoctor. Some sleep aids are not safe for everyone. Talking to your doctor may also help you find the triggers that keep you up at night and help you find a solution that works. Keepin mind that insomnia not only results in considerable nighttimedistress for the insomnia sufferer, it is associated with next-dayimpairment, and may even have effects on health and mood.What works for your neighbor may not work for you. Insomnia treatments may be short or long term, depending on your problem. It is important to know what options are available so you can minimize any effects on your sleeping patterns.
MedicationsSleeping pills are available over-the-counter and byprescription. Use these tips when considering the use of sleepaids:
- Take the medication exactly as prescribed.
- Try the medication only after you have tried changing yourbehavior.
- Use the lowest possible effective dose.
- Do not automatically take a pill every night. Use the medicationonly when you must have an uninterrupted night of sleep. Even then, it is a good idea to take sleeping pills only a few times per week at the most.
Over-the-Counter Sleep AidsMany over-the-counter sleep aids contain antihistamines, whileothers contain the hormone melatonin. Sleep aids containing antihistamines are common. They includemedications, such as Tylenol PM , Nytol , and Unisom , among others.Some people take a pure antihistamine drug, such as Benadryl , tohelp them fall asleep. The main problem with these remedies isknown as the hangover effect. The next morning you mayfeel sluggish, sleepy, or have difficulty performing dailytasks. In some people, antihistimines have the opposite effect, which keeps them awake.Melatonin is a hormone that is secreted in the brain and helpsour bodies regulate the sleep-wake cycle. Melatonin is sold as adietary supplement, rather than as a medication and is thereforenot subject to regulation by the Food and Drug Administration for standards of potency and purity, so proceed with caution. There is some research that supports that melatonin may help treat jet lag. If you decide to try melatonin, talk to your doctor.
Prescription MedicationsThere are several prescription sleep aids available. Prescribed medications include hypnotic sedatives (benzodiazepines) that are used to treat depression, anxiety, or seizure disorder. Other medications include nonbenzodiazepine hypnotics, melatonin receptor agonists, or other types of antidepressants that have sedative effects.Sleep aids come with side effects and some may be associated with dependency with higher doses and longer treatment. Make sure that you use the medications as directed and monitor any problems you may be having with the medication.
Side effectsAccording to the National Sleep Foundation, many factors caninfluence potential side effects of prescription sleep aids,including:
- How your body uses and responds to the drug
- How long the drug stays in your body
"Rebound Insomnia"High doses of sleep medications may result in what is known as rebound insomnia. This occurs when a person stops taking asleep medication and then experiences a few nights ofinsomnia that is more severe than what was originally experiencedprior to treatment. Rebound insomnia generally occurs withmedications that have a short or intermediate half-life (how long half the drug is in your body before it is eliminated) and can be avoided byslowly tapering the dose. Consult with your doctor prior to stoppingor changing your dose.
Healthy Sleep HabitsThe goal is to have healthy sleep habits, which may prevent theneed for sleep aids. Here are some tips for a better nights sleep:
- Keep a regular sleep schedule —Our sleep-wake cycles are regulated by a circadian clock in our brain and the body's need to balancesleep and wake times. It is beneficial to go to bed and get up atthe same time each day to allow your body to get in sync withthis natural pattern.
- Avoid caffeine, nicotine, and alcohol — Caffeine and nicotine are stimulants.Caffeine-containing products include coffee, tea, and chocolate. Half the amount of caffeine ingested will remain in the body on average from 3-5 hours, but some people are affected for up to 14 hours. Alcohol causes sleep disturbances throughout the night. While alcohol may help you relax and fall asleep, it can lead to a night of disrupted sleep as the night progresses.
- Do not eat or drink too close to bedtime —It is best to avoid a heavy meal too close to bedtime. Spicyfoods may cause heartburn , which leads to difficulty staying asleep. A light snack before bed may help you sleep better.
- Exercise at the right time to promote sleep —Regular exercise is one of the most effective treatments for insomnia. However, exercising right before bedtime will make falling asleepdifficult. Besides making you more alert, exercise causes a rise in bodytemperature, which can take approximately 6 hours to begin todrop. A cooler body temperature signals the body that it is time forsleep.
- Use relaxing bedtime rituals —This may include taking a bath, reading a book, meditating, orlistening to relaxing music. Use techniques that work best for youand your bed partner.
- Create a sleep-promoting environment —The best sleep environment is a cool, quiet, and dark room. Besure to check your room for noise or other distractions. Make surethat your mattress is comfortable and supportive.
National Center on Sleep DisordersResearch
National Sleep Foundation
Better Sleep Council Canada
Healthy sleep tips. National Sleep Foundation website. Available at: http://sleepfoundation.org/sleep-tools-tips/healthy-sleep-tips. Accessed November 25, 2014.
Melatonin. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated September 18, 2014. Accessed November 25, 2014.
Sack RL, Auckley D, et al. Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders. Sleep. 2007;30:1460-1483.
Sleep aids and insomnia. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/sleep-aids-and-insomnia. Accessed November 25, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 11/2014
- Update Date: 11/25/2014