LITTLE ROCK — Insomnia is one of the most common symptoms affecting us. Almost daily, my patients complain they cannot sleep, and the request is invariably the same — “Please, doctor, I must have a sleeping pill.” And most of us take the path of least resistance and prescribe something — a mistake!
Many people have tried Tylenol PM. The active ingredient is the antihistamine Benadryl. Both over-thecounter sleep aids and prescription sleeping pills can have side effects, including daytime drowsiness, shorter reaction times that increase risk of motor vehicle wrecks, depression, gastrointestinal upsets and blood pressure abnormalities. In older people, sedatives can cause memory loss. Sadly, the disadvantages of these drugs outweigh any perceived benefit.
And if these side effects are not enough, new research published in the British Medical Journal shows that taking the most common prescription sleeping pills, such as Ambien, Sonata and Restoril, can shorten life expectancy. Remarkably, taking as few as 18 sleeping pills annually was associated with an increased risk of death, and those taking them daily were five times more likely to die than those who were not, according to the study.
This information is preliminary, and many other factors could contribute to death rates in insomniacs taking sleeping pills. Nevertheless, if the information is true, sleeping pills are more dangerous than cigarettes.
Medication treatment for insomnia must be the last resort. First, attempt to identify and resolve the cause. Most commonly, lifestyle and stress precipitate the problem. Too much caffeine, alcohol, jobor family-related stress, burning the candle at both ends and worrying about sleep difficulties all contribute to insomnia. Many medications, including antidepressants, cholesterol-lowering drugs and decongestants can cause poor sleep.
Sometimes a sleep disorder can be the culprit. The most common include sleep apnea, in which breathing stops for short periods of time during sleep, and restless leg syndrome, in which excessive leg movement affects sleep quality.
The key to preventing insomnia is improving sleep habits. Avoid anything that interferes with quality sleep. Limit caffeine after noon, avoid too much alcohol, and stop drinking fluids of any kind three hours before bedtime. Sometimes merely switching medications to the morning makes a difference.
Good sleep habits occur in happy and healthy people. Depression and stress, which can manifest with severe insomnia, are readily improved by therapy.
Lack of exposure to sufficient sunlight can affect the body’s metabolic rhythms and make it difficult to sense night from day. Spending too much time indoors leads to daytime napping and nighttime insomnia. A general rule is to spend four hours daily in sunlight. If that is not possible, consider a specialized sun lamp that mimics sunlight and ultimately improves sleep.
For optimum function, it is better to exercise vigorously in the morning and take a leisurely stroll before dinner. This raises the body temperature subtly and helps lower it as night approaches — a message that tells your body it is bedtime. A snack an hour before bedtime may help with sleep. The release of digestive hormones following eating contributes to drowsiness. A snack also raises brain concentrations of serotonin, which promotes sleep.
Improved sleep hygiene can be very beneficial. Time in bed should be limited to sleep. The bedroom and bed should generally be restricted to sleep — no radio, television, music or long discussions. Do not have a strict time to go to sleep, and only go to bed when sleepy. Never try to go to sleep, as this can cause you to become anxious and aggravate insomnia. Don’t toss and turn. If you are unable to sleep, consider getting out of bed and going elsewhere to watch television or read. Return to bed only when you feel sleepy.
Avoid alarm clocks if possible. This creates pressures that can make nighttime awakening frequent. Experts in the field recommend waking up at the same time every morning, irrespective of how late you went to bed or how much difficulty you had falling asleep.
Developing good sleep habits by removing the root cause is the best way to overcome sleeplessness. Should insomnia persist, consider a study in a sleep laboratory to help identify the cause. Take sleep medications for only a very short time. Long-term use causes much more harm than good.
Dr. David Lipschitz is a gerontologist in Little Rock. More information is available at:
drdavidhealth.com
High Profile, Pages 35 on 03/18/2012