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What To Take For Insomnia

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Should You Take Melatonin For Insomnia

Treating Sleep Problems with Melatonin | Insomnia

Insomnia is a very common medical condition in today’s high-stress world. Aside from prescription drugs, you may have been curious about over-the-counter melatonin supplements. But do they work? Are they safe?

Insomnia is such a prevalent medical condition in this day and age of our fast-paced world. Juggling the hustle and bustle of everyday life, whether it is school, work, parenting, or family, can really do a number on our stress levels. Add a tinge of anxiety and depression, and this can be a recipe for some major sleepless nights.

Medications should never be our first choice when tackling insomnia, however. Most insomnia can be treated well with some behavioral changes, albeit not always easy to accomplish but quite worth the effort. The goal should primarily be to allow your body and mind to learn to fall asleep on its own, chemical free. And then to seek medication if all else fails.

But I know that the reality is that many seek over-the-counter sleep aids as a first step. Aside from antihistamines, melatonin seems to be a popular first choice amongst many.

But does it work? Is it safe? And what is the proper way to take it?

Is Insomnia A Serious Problem

Getting enough sleep is an important part of a healthy lifestyle. Insomnia can affect you mentally and physically. It can make you feel tired, depressed, and irritable. It can also make it hard for you to concentrate or perform tasks during the day. If you have insomnia, you may worry about being able to sleep. Sometimes this can make sleeping harder.

If you dont get enough sleep on a regular basis, youre at increased risk of diseases. These include high blood pressure, heart disease, and diabetes.

Natural Sleep Aids: Home Remedies To Help You Sleep

Are you having trouble drifting into a peaceful, nourishing slumber? Yourenot sitting up at night alone:More than 60 million Americanssuffer from poor sleep quality.

Disturbed sleep is more than an inconvenience that leaves you dragging the next day: it can affect your emotional and physical health. It negatively affects your memory, concentration and mood, and it boosts your risk for depression, obesity, type 2 diabetes, heart disease and high blood pressure.

Happily, there are easy, natural fixes that can improve your sleep, says Charlene Gamaldo, M.D. , medical director of Johns Hopkins Center for Sleep at Howard County General Hospital.

Its not always necessary to get a prescription for a sleep aid, she says. There are natural ways to make adjustments to your sleeping habits.

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How Is Insomnia Diagnosed

Insomnia is diagnosed primarily based on your medical and sleep history. Your doctor may ask you:

  • Questions about your sleep habits, including when you go to bed and when you get up
  • What medicines you take
  • About events or problems in your life that may be upsetting you
  • How long youve been having insomnia
  • If you have any pain, such as from arthritis

If you have a bed partner, your doctor may ask him or her if you snore while you sleep.

If the cause of your insomnia isnt clear, your doctor may order a blood test. He or she also may ask you to wear a small monitor while you sleep. The information may help your doctor determine the cause of your insomnia.

Your doctor may suggest you keep a sleep diary. For a sleep diary, you record:

  • What time you went to bed
  • How long you were in bed before falling asleep
  • How often you woke up during the night
  • What time you got up in the morning
  • How well you slept
  • The time and length of any naps.
  • How you felt during the day
  • What you drank
  • When you exercised

Take your sleep diary to your next doctors appointment. A sleep diary may help you and your doctor identify patterns and conditions that are affecting your sleep. Your doctor may also do a physical exam. This will help him or her rule out other medical problems that could be causing your insomnia.

When To Seek Further Help

Insomnia SymptomsHow to Cure Them

If youve made adjustments to your dosage, schedule, or lifestyle and youre still having trouble sleeping, then insomnia may not be your only worry. Its possible you may have an additional sleep disorder like Obstructive Sleep Apnea .

Its important to get in touch with your doctor or a sleep expert to see what the problem is, and get started with appropriate treatment. If you need help finding accredited sleep specialists or sleep centers near you, I recommend using this tool by the American Academy of Sleep Medicine.

Your overall health and your sleep health go hand in hand taking care of one helps take care of the other. A lot of prescription drugs can cause insomnia or contribute to sleep disorders, but they dont have to. If youre worried that your medication makes it difficult for you to get a good nights sleep, relief can be a single call to your doctor away.

Sweet Dreams,

Michael J. Breus, PhD, FAASM

The Sleep Doctor

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Herbal And Dietary Supplements

Many herbs and dietary supplements have been promoted as sleep aids.19 There is insufficient evidence of benefit except for melatonin and valerian.

Melatonin, a hormone produced by the pineal gland that is involved in sleep regulation, improves insomnia caused by circadian schedule changes .20 Melatonin has been approved by the U.S. Food and Drug Administration to treat circadian rhythm sleep disorder in blind children and adults, but it is unregulated and preparations vary greatly in strength. At higher doses, it causes sleep disruption, daytime fatigue, headache, dizziness, and irritability . Little information is available about the safety of long-term use.

note: CNS stimulation includes insomnia, nervousness, euphoria, irritability, tremors, nightmares, hallucinations, and convulsions. CYPxxx is antagonized or potentiated by inducers and inhibitors of the cytochrome P450 system, isoforms 1A2, 2C9, 2D6, 3A .

FDA = U.S. Food and Drug Administration CNS = central nervous system SSRI = selective serotonin reuptake inhibitor.

*Prices for monthly starting dosages. Estimated cost to the pharmacist based on average wholesale prices in Red Book. Montvale, N.J.: Medical Economics Data, 2007. Cost to the patient will be higher, depending on prescription filling fee. Prices are rounded to the nearest dollar.

Common adverse effects of nonbenzodiazepine hypnotics: headache, dizziness, and nausea use caution with narcotics additive effects with alcohol and CNS depressants.

Taking Steps To Manage Stress

If you consistently find yourself lying in bed with your mind racing, stress could be stealing your ability to fall asleep. In fact, nearly 40% of Americans say that they often feel tired or fatigued because of stress, according to a2013 American Psychological Association poll.Verified SourceAmerican Academy of Pediatrics Professional society for pediatricians that aims to improve childrens health everywhere.View source

Nearly 40% of Americans say that they often feel tired or fatigued because of stress.

And it gets worse. When youre wiped out during the day from not getting enough sleep, you tend to feel even more stressed, anxious, and irritable. Over time, the whole stress-sleep thing can turn into a vicious cycle. Which is why taking steps to manage your stress is so critical for achieving deeper, more restful sleep.

So should you start sitting cross-legged and singing Kumbaya before bed? Well, sure, if you want to. But if thats not your style, dont worry. There are plenty of other effective ways to ease feelings of stress and promote feelings of relaxation. A few to try:

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Treatment Of Chronic Insomnia

The treatment of chronic insomnia consists of initially diagnosing and treating the underlying medical or psychological problems. The identification of behaviors that may worsen insomnia follows and stopping them would help eliminate insomnia. Next, a possible trial of pharmacology can be tried, although the long-term use of drugs for chronic insomnia is controversial. This is in spite of the fact that the US FDA has approved three medications for the treatment of insomnia with no limitation on the duration of their use. A trial of behavioral techniques to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning, is however useful. Behavioral intervention combined with pharmacologic agents may be more effective than either approach alone.

Challenging The Worries And Thoughts That Fuel Insomnia

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Its also helpful to challenge the negative attitudes about sleep and your insomnia problem that youve developed over time. The key is to recognize self-defeating thoughts and replace them with more realistic ones.

Challenging self-defeating thoughts that fuel insomnia
Self-defeating thought:Sleep-promoting comeback:
Unrealistic expectations: I should be able to sleep well every night like a normal person. I shouldnt have a problem!Lots of people struggle with sleep from time to time. I will be able to sleep with the right techniques.
Exaggeration: Its the same every single night, another night of sleepless misery.Not every night is the same. Some nights I do sleep better than others.
Catastrophizing: If I dont get some sleep, Ill tank my presentation and jeopardize my job.I can get through the presentation even if Im tired. I can still rest and relax tonight, even if I cant sleep.
Hopelessness: Im never going to be able to sleep well. Its out of my control.Insomnia can be cured. If I stop worrying so much and focus on positive solutions, I can beat it.
Fortune telling: Its going to take me at least an hour to get to sleep tonight. I just know it.I dont know what will happen tonight. Maybe Ill get to sleep quickly if I use the strategies Ive learned.

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The Body’s Internal Clock

The sleep-wake cycle is controlled by the body’s internal clock. Many other bodily functions also wax and wane cyclically in response to the 24-hour circadian rhythm. For example, normal body temperature is lowest at about 5 a.m., when it averages 97° F, and highest at about 5 p.m., when it averages 99.4° F. Similarly, sodium excretion and urine output are normally higher during the day than at night. Hormone levels also fluctuate cortisol secretion is highest during the morning. Testosterone production peaks in the morning, growth hormone at night. Melatonin, the “dark hormone,” is produced by the brain’s pineal gland during the night.

The daily cycles of light and darkness help set the body’s internal clock. Disturbances in the normal coordination of light and darkness with wakefulness and sleep account for the temporary sleep disturbance of jet lag or the chronic disorders experienced by many shift workers. Travel is a common cause of disturbed sleep today, but similar disturbances originated long before the jet age Robert Burton got it right way back in 1628 when he said, “Our body is like a clock, if one wheel is amiss, all the rest are disordered… with such admirable art and harmony is a man composed.”

Are Sleeping Pills Or Sleep Aids Right For You

Its the middle of the night, and youre staring at the ceiling, thinking about work, or bills, or the kids. When sleep just wont come, its tempting to turn to a sleeping pill or sleep aid for relief. And you may get it in the moment. But if you regularly have trouble sleeping, thats a red flag that somethings wrong. It could be something as simple as too much caffeine or viewing TV, your phone, or other screens late at night. Or it may be a symptom of an underlying medical or psychological problem. But whatever it is, it wont be cured with sleeping pills. At best, sleeping pills are a temporary band aid. At worst, theyre an addictive crutch that can make insomnia worse in the long run.

That doesnt mean that you should never use medication, but its important to weigh the benefits against the risks. In general, sleeping pills and sleep aids are most effective when used sparingly for short-term situations, such as traveling across time zones or recovering from a medical procedure. If you choose to take sleeping pills over the long term, it is best to use them only on an infrequent, as needed basis to avoid dependence and tolerance.

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Dietary Supplements For Insomnia

There are many dietary and herbal supplements marketed for their sleep-promoting effects. Although they may be described as natural, be aware that sleep remedies can still have side effects and interfere with other medications or vitamins youre taking. For more information, talk to your doctor or pharmacist.

When Should A Person Use Sleeping Pills

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The best time to take melatonin will depend on the nature of the sleep problem:

  • Sleeping pills for insomnia: A person with insomnia should take a sleeping aid, which includes valerian and sedative antihistamines, just before or at bedtime.
  • Sleeping pills for jet lag: Melatonin is a good option if tackling jet lag. Take melatonin several hours before the intended bedtime every day throughout the trip and a few days afterward.
  • Sleeping pills for shift work: Melatonin may also be the best option for people managing shift work. Taking melatonin at the end of a shift can help prepare the body for bed.

People taking sedating antihistamines should follow the directions on the medication or the advice of a medical professional.

When to take valerian depends on the type a person uses. Generally, people can take valerian an hour before going to bed. People should follow the recommended dosage for supplements.

Learn more about valerian dosage here.

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What Are The Types Of Over

Any adult can buy OTC sleep medications at a store. OTC sleep aids often contain an antihistamine. This drug treats allergies, but it can also make you drowsy.

Some people take melatonin or valerian supplements to help them sleep. Melatonin is a hormone your body naturally produces that promotes sleep. Valerian is an herb that supposedly aids relaxation and sleep.

Although these sleep aids are easily accessible, you should check with your healthcare provider before taking them. Drugs in over-the-counter sleep aids can interfere with other medications or make health conditions worse.

When To Take A Sleeping Pill For Insomnia

Sleeping pills can be an effective treatment for chronic insomnia. But like any other drug, sleep medications can have side effects. One potential side effect of sleeping pills is daytime drowsiness.

Sleep medications are powerful hypnotics. They can be helpful because they cause a strong urge to sleep. But you dont want this sleepiness to persist after you wake up.

One way to minimize the risk of daytime drowsiness is to take a sleeping pill at the right time of night. Most sleeping pills such as Ambien or Lunesta should be taken right before you get in bed.

You should only take these sleeping pills when you are able to get a full night of sleep. This means that you should take the medication at least seven to eight hours before you need to wake up.

But a new study shows that many people are taking sleeping pills in the middle of the night. The researchers surveyed nearly 2,000 people who have a prescription for sleeping pills.

Results show that 20 percent of respondents reported using a sleep medication in the middle of the night. Some of them even reported taking a sleeping pill twice in the same night.

Taking a sleeping pill in the middle of the night greatly increases the risk of daytime drowsiness. It also raises the risk that you will get out of bed without being fully awake. This may lead to problems such as sleep driving.

Many people with insomnia wake up in the middle of the night and struggle to go back to sleep. This is called sleep maintenance insomnia.

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Tips For Safer Use Of Sleeping Pills

If you decide to try sleeping pills or sleep aids, keep the following safety guidelines in mind.

Never mix sleeping pills with alcohol or other sedative drugs. Alcohol not only disrupts sleep quality, but it increases the sedative effects of sleeping pills. The combination can be quite dangerouseven deadly.

Only take a sleeping pill when you will have enough time for at least seven to eight hours of sleep. Otherwise you may feel very drowsy the next day.

Dont take a second dose in the middle of the night. It can be dangerous to double up on your dosage, and with less time for the medication to clear your system it may be difficult to get up the next morning and shake off grogginess.

Start with the lowest recommended dose. See how the medication affects you and the types of side effects you experience.

Avoid frequent use. To avoid dependency and minimize adverse effects, try to save sleeping pills for emergencies, rather than nightly use.

Never drive a car or operate machinery after taking a sleeping pill. This tip is especially important when you start using a new sleep aid, as you may not know how it will affect you.

Before taking sleeping pills

Talk to your doctor or pharmacist about:

What You Can Do About It

Why Dr. Serpe Doesn’t Recommend Melatonin for Insomnia

There are a number of things you can try to help yourself get a good night’s sleep if you have insomnia.

These include:

  • setting regular times for going to bed and waking up
  • relaxing before bed time try taking a warm bath or listening to calming music
  • using thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise
  • avoiding caffeine, nicotine, alcohol, heavy meals and exercise for a few hours before going to bed
  • not watching TV or using phones, tablets or computers shortly before going to bed
  • not napping during the day
  • writing a list of your worries, and any ideas about how to solve them, before going to bed to help you forget about them until the morning

Some people find over-the-counter sleeping tablets helpful, but they don’t address the underlying problem and can have troublesome side effects.

Read more self-help tips for insomnia

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