Coming to the Clinic, Part 11 - The Elusive Good Night’s Sleep

     On one of my blog post’s last week, I lamented about my lack of sleep. At the time, I realized that some of you would be willing to offer me advice on how to get a good night’s sleep, or probably more likely, you all wanted to share in my angst. It dawned on me that I should be offering solutions here, so I present to you, after over a year off, a new episode of “coming to the clinic”.

Here is the long list of solutions which insomniacs have at their disposal. (Disclaimer: Even though everything I’m writing about can have merit, don’t consider anything here as medical advice, talk to your personal health care provider for help with this or any other problems you have.)

     1)     Prescription medications. The number one drug prescribed for sleep is probably Zolpidem, the generic for Ambien. Others include Rozerem, Belsomra and Sonata. All of these are available by prescription only because they have long lists of side effects, should be taken with caution, and are not usually meant to be taken every night. Even though you might get a good night’s sleep, you could still be sleepy the next day. Other side effects include dizziness, imbalance, memory issues, and addiction.

     2)     Over the counter sleep aids. Diphenhydramine (Benadryl) and Doxylamine succinate (Unisom SleepTabs) are probably the oldest non-prescription sleeping pills. As with the prescriptions, they can also cause daytime sleepiness. Melatonin is the one I see most recommended by health providers as being the safest to take, which means it is pretty mild and may not get everyone who takes it to sleep.

     3)     Self-medicating. The distinction I’m making between these and OTC meds is that by “self-medicating” I mean taking something to help you sleep that wasn’t designed to do that. Such as drinking alcohol or smoking pot. Sure, you’ll be relaxed and possibly fall asleep, but really? Do you really want to do that to yourself?

I’m also going to put in this category benzodiazepines (aka “benzos”), which include Alprazolam (Xanax), Diazepam (Valium) and Lorazepam (Ativan). These are mostly prescribed for anxiety, but also for a wide range of other things, from relaxing muscles to controlling seizures to lessening the effects of alcohol withdrawal. And even though they can be prescribed for sleep, they are highly addictive and should only be used very occasionally for sleep. (OK, I should fess up at this point. Alprazolam is the one thing that helps me get the best sleep [and I’ve tried everything!], but my 30-pill prescription lasts me an entire year. I will go for two or three nights with very little sleep before I resort to taking a half a pill.)

     4)     Oils. I include essential oils and CBD (Cannabidiol) oil here. This would be a long discussion and more research than I am up to right now. But just so you know, these are options, but you really need to look into them for yourself. Proponents of both essential oils and CBD oil will say they can cure everything, but I just can’t bring myself to believe that.

     5)     Non-medication alternatives. These are the best option. There’s very little danger in any of these, they are mostly all natural, you can’t get addicted, some are free and others are still inexpensive. I’d love to go into the whole list in detail (and sometime I probably will), but here they are:

a.     Meditation and/or other relaxation techniques

b.     Guided imagery (this works well for me sometimes and other times, not so much)

c.      Massage therapy (if only my massage therapist could come to my house and tuck me in bed when she’s done)

d.     Physical therapy (again, you can’t do it right before bed, but it can help to relax those achy muscles, in case that is what’s keeping you awake)

e.     Chiropractor (I know that some people swear by chiropractors and some think they are witch doctors, but they can help with sleep for the same reasons as c and d can)

f.       Aroma therapy (probably part of the essential oil discussion)

g.     White noise, such as a fan on low or soft music

     6)     Lastly, Sleep Hygiene. This always throws me off because I see the word “hygiene” and think to myself, “but I brush my teeth every night”. But the definition of hygiene is conditions or practices conducive to maintaining health and preventing disease. So this can apply to things other than cleanliness.

These are things you can get into the habit of doing which are conducive to a good night’s sleep:

a.     Go to bed and get up at the same time, even on your day off

b.     Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature

c.      Don’t watch TV or use your computer, phone or other electronics in the bedroom or just before going to bed

d.     Don’t consume large meals, sweets or caffeine before bedtime

e.     Get enough exercises throughout the day

f.       Decrease areas of stress in your life (yea, right, like this is going to happen)

So those are some of my thoughts on the subject of sleep. And none of them are concrete answers. No single thing is going to work safely for everyone or work for any individual all the time. And I should know. It’s way past my bedtime already.  

Example of poor sleep hygiene - too many dogs in the bed.

Better sleep hygiene, only one dog in bed.