Monday, May 21, 2012

Insomnia part 3: Sleep Medications can cause Harm and Rebound Insomnia

May is National Better Sleep Month





Related Insomnia blog posts in this series:

Insomnia:  Sleep Medications can Cause Harm and Rebound Insomnia
When you have poor sleep, sleep deprivation, or insomnia, first rule out any obvious causes of your sleep problem.  Check your sleep/wake routine and your sleep hygiene.  If your sleep problems are not temporary and are affecting daily living, see your physician.  There are many things you can do to help manage your sleep bring your body's sleep/wake rhythms back into balance without prescription medications.  Talk with your physician about them.  These include (but are not limited to):
ClipArt: tired
  • Adjusting your sleep/wake cycle
  • Improving your Sleep Hygiene
  • Improving/Changing your Mattress
  • Exercise
  • CAM therapies
    • Traditional Chinese Medicine (includes acupuncture, tai chi, qi gong, Chinese herbal medicine, etc.)
    • Yoga
    • Meditation
    • Massage therapy, craniosacral therapy
    • Reiki
    • OMT (osteopathic manipulative therapy)
    • Chiropractic
  • Cognitive Behavioral Therapy
 Prescription Sleep Medications should NOT be a First-line "Fix" to Insomnia or Poor Sleep
Prescription Sleep Medications do not encourage your body's natural ability to heal itself.  They force the body into a new pattern.  While useful for severe cases in the short-term, they are not a long-term fix.  The goal is not to depend on a pill for your body to be able to sleep every night for the rest of your life, is it?

Many prescription sleep medications can cause dependence (yes, that it drug-dependence) such as benzodiazepines [lorazepam (Ativan) or flurazepam (Dalmane)].  Coming off or dosing down from such medications requires physician supervision or direction and sometimes rehabilitation (acupuncture is regularly used in addiction clinics to help the body-mind have an easier time coming off of drugs and medications.  For more on acupuncture for addiction, please see the NADA website.)

Some prescription sleep medications, such as Ambien and Lunesta cause people to do things while they sleep they do not remember later such as driving a car or similar sleep-walking activities.

Antihistamines for Sleep
According to mayoclinic.com, this is a common ingredient in over-the-counter sleep aids.  The anti-histamine causes drowsiness and is only effective for a couple days before the body develops a tolerance to it.  This is not an ideal way to treat insomnia.  Start with the list above (sleep hygiene, etc).

General Side Effects of Prescription Sleep Medications
Rebound Insomnia
Addiction, often cited as "habit-forming"
Interact with Alcohol and grapefruit
Cause weight gain
Are less-effective over time
sleep-driving
sleep-eating
dizziness
headaches
nausea
vomiting
indigestion
gas, bloating
prolonged drowsiness--do not operate a vehicle or machinery while taking most of these medications
severe allergic reaction
Memory problems, memory loss
dry mouth
irregular heartbeat
Interact with other medications
Stopping Prescription Sleep Medications without the help of a Physician can Cause . . .
Anxiety (greater than before starting medication)
Withdrawal symptoms
Rebound Insomnia (ability to sleep worse than before starting medication)
Nightmares
Vomiting


Medications that can cause or worsen symptoms of insomnia
Check with your primary care provider if the medication you take for the following is aggravating your insomnia.Your physician may be able to find a similar medication for you that does not contribute to sleep problems.DO NOT STOP your medications without the supervision of your physician.Many of these medications, if not tapered properly can cause severe rebound insomnia and other more serious issues.

Medications prescribed for:
High blood pressure
High cholesterol
Sinus congestion (colds or allergies)
Pain medications (like opioids)
Anxiety and depression
Birth control



The Melatonin Factor
According to Mayoclinic.com, melatonin may help insomnia that is related to a change in your sleeping routine, such as changing time zones.  Melatonin helps your body reset to a normal circadian (follow the sun) cycle.  Melatonin can interact with certain prescription medications which include blood thinners, immunosuppressants, diabetes medications, and birth control medications.

How to Improve Your Sleep without Prescription Medications
See the previous Insomnia Blog posts on:

Cognitive Behavioral Therapy for Improving Sleep, is a successful alternative to prescription
medications for insomnia.  

Sources
"Prescription Sleeping Pills:  What's right for you?" by Mayo Clinic staff.   www.mayoclinic.com
"Ambien:  Is dependence a concern?" by Eric J. Olsen, MD.  www.mayoclinic.com
"Sleep Aids:  Could antihistamine help me sleep?" by Timothy Morgenthaler, MD.  mayoclinic.com
"Sleep Aids:  Understand over-the-counter options" by Mayo Clinic staff.  www.mayoclinic.com
"Melatonin side effects:  What are the risks?" by Brent A. Bauer, MD.  www.mayoclinic.com
"Sleep and Diabetes" by Nancy Klobassa Davidson, RN and Peggy Moreland, RN.  Living with Diabetes Blog,  mayoclinic.com

NADA (National Acupuncture Detoxification Association) website

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