Publication
Article
Internal Medicine World Report
People with insomnia have difficulties falling asleep or staying asleep for more than a short time. Most adults need at least 8 hours of sleep every night to feel well rested. Not getting enough sleep for more than just a few days can cause serious health problems.
Any of these things can disturb your sleep:
• Stress
• A sick child
• Working long hours
• Light or noise from traffic or TV
• Feeling too hot or too cold
• Too much alcohol
If you have any of these symptoms, you probably suffer from insomnia:
• Trouble falling asleep on a regular basis
• Trouble getting back to sleep after waking up in the middle of the night
• Waking up too early in the morning
Is There Treatment for Insomnia?
If you suffer from insomnia, your physician may prescribe one of several different kinds of sleeping aids or sleep-promoting pills. Taking sleep-promoting medications, together with some changes in your daily routine, can help you manage your insomnia.
There are many prescription medications available today, but many may have side effects that you should be aware of. Not everyone has the same side effects—or even any side effects—with these drugs, so you should immediately report any side effects to your doctor. Your doctor will switch your medication until you find something that is good for you.
Sleeping pills are grouped into 3 main categories:
Benzodiazepines. These are the older type of sleeping pills and are prescribed by many physicians. They include:
• Ativan
• Xanax
• Halcion
• Restoril
Side effects include respiratory symptoms, daytime drowsiness, memory loss, and some mood changes. These medications should not be used for a long period of time.
Nonbenzodiazepines. These are newer sleeping pills, which have fewer side effects than the benzodiazepines. The drugs in this category include:
• Ambien
• Sonata
• Lunesta
• Imovane
Side effects reported with these drugs include nausea, dizziness, nightmares, agitation, and headache. These medications are more effective in promoting sleep and are safer for long-term nightly use than the benzodiazepines. However, if you use these newer drugs too often, you can become addicted to them, which is a serious problem. You should discuss any possibility of addiction with your physician before taking one of these drugs.
Antidepressants. These medications are usually used for depression, but they can also help people with insomnia when it is associated with depression, or with early-morning awakening. The newer types of antidepressants that can be used for sleep problems include:
• Desyrel
• Serzone
• Paxil
These medications have fewer side effects, and are much less dangerous when taken in overdose, than other anti-insomnia drugs.
New Problems with Sleeping Pills
The Food and Drug Administration (FDA) has recently warned that some sleeping pills can cause side effects that can have serious health risks, including severe allergic reactions and negative behaviors during sleep, such as driving while asleep.
The drugs that have been associated with these side effects include:
Ambien/Ambien CR
Butisol Sodium
Carbrital, Dalmane
Doral, Halcion
Lunesta
Placidyl
ProSom
Restoril
Rozerem
Seconal
Sonataw
Talk with your doctor about these risks if you are taking any of these medications.
The National Sleep Foundation recommends that if you use sleeping pills, you should follow the instructions provided by your physician and included in the package insert. It is important that you tell your doctor about any other drugs you are using, including nonprescription medicines and alcohol. If serious side effects do occur, contact your doctor immediately.
How Long Should You Take Sleep Medication?
Sleep medications are meant to provide temporary relief from insomnia; they are not a long-term solution. The safety of long-term use of sleeping pills has not been established. Changes in your sleep habits and sleep environment, plus behavioral therapies, provide a better long-term solution to insomnia than drug therapy.
If you take sleeping pills, the National Sleep Foundation recommends that you:
• Begin with the lowest possible effective dose
• Use the drugs on a short-term basis, if you use them nightly
• Take the drugs intermittently, if you use them long-term
• Use the drugs only in combination with good sleep hygiene and/or behavioral treatments
Tips for Improving Your Sleep
• Go to bed and get up at the same time each day
• Avoid caffeine, nicotine, and alcohol 4 to 6 hours before bedtime
• Don’t exercise within 2 hours of bedtime
• Don’t eat large meals within 2 hours of bedtime
• Don’t nap later than 3 pm
• Sleep in a dark, quiet room that isn’t too hot or cold for you
• If you can’t fall asleep within 20 minutes, get up and do something quiet
• Wind down in the 30 minutes before bedtime by doing something relaxing
For more information, check these websites: The Food and Drug Administration www.fda.gov. The National Sleep Foundation www.sleepfoundation.org. Helpguide.org www.helpguide.org. Health-Cares.net www.health-cares.net.