Last week, we pointed our Facebook fans to a Huffington Post article written by Dr Gayatri Devi, MD, about sleeping pills. The article generated some interesting comments, so I thought I’d jump into the conversation.
The Good
Sleeping pills have gotten a lot of flack, but would it be better if they just didn’t exist? I’m not so sure about that. When used for the right reasons and in the right way, they can be a valuable resource. Here are some reasons we may be better off having them around:
- When you absolutely, positively have to sleep over night: an appropriate dose of a newer “non”-benzodiazepine (like zaleplon aka Sonata, zolpidem aka Ambien, or eszopiclone aka Lunesta) should at least knock you out if nothing else.
- Would I rather that the guy in the car next to me were recovering from a night of “sleep” induced by a drug or a night with no sleep at all? I would take the first guy, as long as he wasn’t abusing these drug and was following doctor’s orders.
- When the search for sleep becomes desperate, sleeping pills can provide some piece of mind. This is especially true when you consider that non-drug solutions for sleep are very hard to come by. Doctors and patients alike have little time and less money, so rare solutions like Cognitive Behavioral Therapy for Insomnia just aren’t going to cut it for most people.
The Bad
There were a lot of caveats in that last section, particularly that one uses the right drugs, in the right ways, at the right times. That means:
- Limit use to the short-term if at all possible
- Use the drug as prescribed, no taking doses that could knock out a horse
- Try to stick to the newer “non”-benzos (zaleplon & zolpidem again) rather than the older ones (like diazepam aka Valium & clonazepam aka Klonipin). They tend to have safer profiles and shorter half-lives.
And of course, always follow doctor’s orders. If you have questions, concerns or comments, it’s best to share them with the person most familiar with your needs and your health.
The Ugly
Unfortunately, it’s not all black and white and the issue does get complicated quickly. Even if you can successfully avoid the traditional sleeping pills, other solutions may not be all sunshine either:
- Herbals (like Valerian) are not regulated and have no consistent evidence to suggest that they actually help sleep. And I couldn’t find a single study to suggest what it does to sleep architecture.
- Over-the-counter medications for sleep (particularly antihistamines like diphenhydramine) could actually make sleep worse rather than better.
- Melatonin, the only non-regulated human hormone, is complicated and commonly misused (its action on the body’s clock make it more complicated that straight forward hypnotics).
- Non-substance solutions, like I said, are tough to come by, and certainly require more effort than popping a pill.
The Answer
After all that – does it mean that sleeping pills are the answer? Well, maybe and maybe not. It depends on your needs. At Zeo, we firmly believe that anyone can control their sleep and find valuable and natural solutions. We also believe that people should be informed and consider all their options. For more information, check out these free articles I found at PubMed:
- The Efficacy and Safety of Drug Treatments for Chronic Insomnia in Adults: A Meta-analysis of RCTs
- Medication for sleep-wake disorders
- Valerian
Steve (ZQ: 100) is our resident Research Scientist, working to help people understand the science behind Zeo, as well as the science of sleep. He is one of the driving forces behind our Sleep Research Center.
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The trouble is, people that are having difficulties with sleep so easily fall prey to longer term habits with the pills because we are so desperate. And the pills often work just fine in the short term. But the initial results on them are very deceptive–once you’ve been taking them a while all sorts of weird things start to happen, and it’s hard to pick up on at first because it’s subtle, and hard to tell if it’s the pills or the insomnia or something else even if you do pick up on it. This is where the Zeo can help–even if you can’t tell which way is up when it comes to sleep, the Zeo can.
In my own personal experience, melatonin was not a good solution. It worked on a completely random basis and made me feel quite nauseous. Benadryl always worked really great for me and California poppy drops worked sometimes also. Sonata works okay, but is extremely lighthanded (doesn’t *keep* you down), and unfortunately my brain was so ravaged by Lunesta I can’t take any hypnotics now without being thrown into a pit of depression.
So far the drug that seems to work the absolute best is Trazodone. It’s not only helping undo the mood problems Lunesta gave me but I’m getting really good, quality sleep on it.
Angela, there’s no question that the longer term issues make sleeping pills tough to deal with. Like most things in life, there are pills for this, but there are no magic pills. In the long run, we’re all better off actually taking the time to choose a proper diet, a healthy exercise regimen, and a responsible approach to sleep. But that’s always easier said than done.
Steve, you are right on about the diet and exercise, but unfortunately there are those of us that have sleep problems caused by years of chronic pain (from failed back surgeries) who are not able to do a cardio workout. And it is a vicious circle – Zeo has proven to me that there is a direct correlation between by low deep sleep numbers and my pain levels.If I can get 25 minutes (rare) of deep sleep, i can cut back on pain meds. Going to keep on searching – please advise if you run across anything.
Good luck to you Angela, glad the trazodone is helping a bit. Didn’t increase deep sleep by any chance did it?
Dick
Hey ramdab, sorry to hear about the troubles. Like I stated, it’s always easier said than done. Of course, one of the theories behind exercise being helpful for sleep is the effect on body temperature. And there are many ways to affect body temperature without exercising: a hot bath about an hour before bedtime, wearing warm socks or using a hot water bottle to keep your feet warm when you get into bed, a small cup of ice water just before you slip into bed… The idea is to keep the extremities warm and cool the core. This mimics the natural changes in body temperature when we fall asleep. Exercising and the hot bath create an increase in core temp, which will then hopefully generate a good drop when we fall asleep. Just a thought. Keep us posted if you find anything that works for you.
@ramdab: It seems like it has altered REM and light sleep more than deep. I know there are certain antidepressants that can be helpful for chronic pain, and a lot of them make you sleepy…might ask your doctor about that!