How Can I Treat Insomnia?
October 21, 2011 in Sleep Disorders
How can I treat insomnia without medications?
The first step toward treating insomnia is improving your sleeping habits. Many cases of insomnia are actually caused by poor sleeping habits. Consider the following tips:
- Avoid caffeine, tobacco and alcohol. It can take up to 8 hours for the effects of caffeine to wear off. Although alcohol can help you fall asleep, it causes you to sleep lighter (not deep sleep) and causes you to awaken easier.
- Work with your doctor and pharmacist to remove any medications that may be causing insomnia. Remember, over-the-counter medications and “natural” herbal supplements can cause insomnia, too.
- Stick with a routine. Go to bed and wake up at the same time every day, even on weekends.
- Relax before bedtime (with a warm bath or listening to music).
- Do not exercise, eat heavy meals or drink a lot before bedtime.
- Make sure your bedroom is dark, cool and comfortable.
- Do not use your bed for watching television or reading.
How can I treat insomnia with over-the-counter medications?
The most commonly used over-the-counter (OTC) medication for sleep is actually Benadryl® (diphenydramine). Benadryl® (diphenhydramine) is the main ingredient in most OTC sleep aids like Tylenol PM® and Excedrin PM®. Benadryl® is an antihistamine used to treat allergies, but its major side-effect is sedation or sleepiness. These OTC sleep aids should not be used by people over the age of 65. As you age, you become more sensitive to the side-effects of the OTC sleep aids, which include constipation, impaired memory, dry mouth, blurred vision and difficulty urinating.
Several “natural” or herbal sleep aids are also popular. Melatonin is a substance produced in your brain that helps control the sleep cycle. OTC melatonin supplements for sleep are available; however, how effective they are is still in question. A prescription drug that is similar to melatonin has been approved, but it appears to only be modestly effective. A herbal product called valerian has also become popular for insomnia, but evidence supporting its use is also lacking. If you choose to try herbal supplements for insomnia, remember that “natural” does not mean safe. St. John’s Wort became popular as a sleep aid for a period of time; however, it was later learned that it could cause liver failure, death, and interact with various prescription medications. All herbal supplements can cause side-effects. Talk with your doctor or pharmacist before using a herbal supplement (also check out our Self-Care section for additional information).
What prescriptions are available for treating insomnia?
Several prescription products are available for treating insomnia (see the chart below).
| Drug | Comments |
| “Benzodiazepines” – Ativan® (lorazepam), Restoril® (temazepam), Serax® (oxazepam), Xanax® (alprazolam |
This group of drugs contains about 10 different medications. They were initially considered the drugs of choice for insomnia until Ambien® was developed. Like other prescription sleep aids, these drugs can be “addictive”. They are all very inexpensive at less than $10 per month. For insomnia, try to avoid Valium® (diazepam), Dalmane® (flurazepam), and to a lesser extent, Klonopin® (clonazepam). These three drugs stay in the body longer and can give you a “hangover” effect that will leave you tired the next day. The best choices may be Ativan® (lorazepam) or Restoril® (temazepam). |
| Ambien® (zolpidem) | Ambien® represents the most prescribed drug for insomnia. It is now available in a low-cost generic (less than $10 per month). Again, this drug can be addictive and is generally recommended for short-term treatment (less than 2 weeks). The new version Ambien CR® appears to offer few, if any, advantages over Ambien® and it is significantly more expensive (about $100 more per month). |
| Lunesta® (eszopiclone) | Lunesta® is very similar to Ambien®, but also significantly more expensive (about $100 more per month). Lunesta® can also cause an unpleasant taste in your mouth after taking it. Sonata® (zaleplon) Sonata®, which is now available as a generic product, is also very similar to Ambien® and Lunesta®. The main difference between these drugs is that Sonata’s® effects do not last as long. This can be good and bad. If you feel “hungover” in the morning after taking Ambien®, Sonata® may not cause the same feeling. On the other hand, your Sonata® may not last long enough to provide you with a full nights rest. |
| Rozerem® (ramelteon) | Rozerem® is one of the few prescription sleep aids that is not considered addictive. However, it only appears to be modestly effective. It reduces the time you need to go to sleep by about 10 minutes and helps you sleep about 15 minutes longer than normal. |
| Other Medications | Although not FDA-approved for treating insomnia, several other medications are sometimes used for sleep. Some examples include Elavil® (amitriptyline), Deseryl® (trazodone) and Remeron® (mirtazapine). |
