Taking a prescription sleep aid may seem like the simplest solution to a sleepless night - but these types of medications [zolpidem (Ambien), eszopiclone (Lunesta), and others] are not without their drawbacks. Side effects can include next-day grogginess, confusion, delayed reaction times, sleepwalking and sleep-eating, and dependency.
For those reasons, Virtua pulmonologist and sleep specialist,Rohit Malik, MD, only recommends these medications to his patients as a last resort. Before picking up his prescription pad, he suggests the following to those struggling to get a good night’s sleep:
Identify what’s causing your sleeplessness
Several factors can contribute to insomnia: poor sleep habits, caffeine, nicotine use, alcohol use, prescription medications or chronic medical conditions, mood disorders, stress or anxiety to name a few. “In some cases, concurrent sleep disorders (those that exist at the same time), like obstructive sleep apnea or restless legs, might cause or contribute to symptoms of insomnia. Treatment of these disorders is essential for symptoms of sleeplessness to resolve completely,” says Dr. Malik.
Acute adjustment disorder, which occurs when a person is unable to adjust after a stressful life event, can cause symptoms of sleeplessness as well. Most people return to normal sleep patterns in time after the event passes, however, in some cases, psychological counseling and/or prescription medication may be required to help these people get through difficult times.
Practice good "sleep hygiene"
Brushing your teeth and washing your face are not the only ways to be hygienic at bedtime. Dr. Malik offers the following simple steps to clean up your act.
Try Bedroom Best Practices: "Reserve your bedroom only for sleep and sex," says Dr. Malik. This means no computer, no cell phone, no TV. It may take some getting used to but a dark room with no distraction is essential for restful sleep. If you find that a bit of white noise relaxes you, you might consider listening to some relaxation music before going to bed or you might consider hanging a piece of art or photography that induces relaxation.
Watch What Your Drink: "Avoid water 2 hours before bed to reduce nighttime trips to the bathroom and avoid caffeine 6-8 hours before bedtime. It takes about that long for your body to eliminate it from your system," says Dr. Malik. You might also consider avoiding alcohol altogether if sleep is a struggle for you, as alcohol induces sleepiness initially but disrupts your sleep architecture, meaning you will likely wake up in the middle of the night or feel less alert the next morning."
Consider Natural Supplements: One over-the-counter supplement that Dr. Malik recommends for some of his patients is melatonin. "Melatonin is a hormone that is secreted by a gland in the body that modulates sleep. Taking this supplement would have very few side effects," he says. Even though diphenhydramine and doxylamine succinate (the drugs found in products like Benadryl and Nyquil) are packaged and sold as sleep aids, Dr. Malik does not consider them effective, long-term solutions for sleeplessness. These medications lose their effect in some time and might also cause side effects, particularly in elderly patients.
Consider Seeing A Psychologist: “There are several types of therapy that can be very beneficial for patients with insomnia,” says Dr. Malik. These include cognitive behavioral therapy and relaxation therapy, and they can help you work on proven strategies for falling asleep, coping with racing thoughts, and creating positive associations with your bedtime routine.
If you feel you have tried everything and still fail to solve your ongoing sleeplessness, prescription sleep aids might be required in some cases. But remember: "Use of prescription sleep aids must be carefully monitored by a physician," says Dr. Malik. "They should be used only when absolutely needed and not frequently – I would say no more than one to two nights a week for no more than six months to a year to avoid dependency. If you are using prescription sleep aids on a nightly basis over a prolonged period of time, you should seek medical consultation with a sleep specialist," says Dr. Malik.