Everyone enjoys a good night sleep. Unfortunately, most of don't sleep like babies as we age.
Sleep difficulties first require evaluation and accurate diagnosis. Insomnia often represents the warning light going off on your body’s dashboard indicating a problem that needs attention. Taking a sleeping pill without first identifying the cause is like disconnecting the flashing red warning light on your car’s dashboard without fixing the problem. Some sleep problems can be life threatening (such as sleep apnea) while others, like stress, are more common but not life threatening.
Sleep hygiene should always be instituted and maintained. Suggestions for sleep hygiene include going to bed and getting up at the same time each night, avoiding stimulants and caffeine late in the afternoon and keeping the sleeping temperature cool.
Over the counter sleep aids such as Sominex, Unisom, Benadryl and Melatonin often help. These medications can result in drowsiness the following day.
For chronic insomnia, I often recommend Trazadone, a mild antidepressant, as a prescription medication to help with sleep since it is safe and not habit forming. The usual dose is 50mg to be taken 2 hours prior to bedtime. The dose may be increased up to 300mg although such high doses are rarely used for sleep.
Insomnia may be an early indicator of life stress or depression that needs specific treatment.
· I do use prescription sleep medications (such as Ambien, Restoril, Prosom, etc.) for stress related insomnia. These medications should be used in the lowest effective dose for the shortest period of time, never more than 30 times in a 6 month period. If you are requiring more than this amount of medication for sleep, you have a problem that warrants a more comprehensive evaluation by a sleep specialist.
If you are currently dependent on prescription sleep medication, I will help you change to a non-addictive medication or refer you for a sleep evaluation.
Habit forming prescription sleep medications can be hazardous, especially in the elderly where they are sometimes associated with memory problems and an increased risk of falling. They may also mask or worsen depression or dementia.