Sleep Medicine
All insomnia medications should be taken shortly before bed. Do not attempt to drive or perform other activities that require concentration after taking an insomnia medication as the medication will make you sleepy.
Sleep medication pills
Medications should be used in combination with good sleep practices.
Ambien
The original version of Ambien works well at helping you get to sleep, but some people tended to wake up in the middle of the night. Ambien CR is an extended release version. It helps you get to sleep within 15 to 30 minutes, and the new extended release portion helps you stay asleep. You should not take Ambien or Ambien CR unless you are able to get a full night's sleep - at least 7 to 8 hours.
Taking ambien is not advisable if you
Have a history of depression, liver or kidney disease, or respiratory conditions.
Lunesta
Lunesta also helps you fall asleep quickly, and studies show people sleep an average of 7 to 8 hours. Don't take Lunesta unless you are able to get a full night's sleep as it could cause grogginess.
Taking lunesta is not advisable if you
Have a history of drug or alcohol abuse, depression, lung disease, or a condition that affects metabolism.
Rozerem
This is a new sleep medication that works differently than the others. It works by targeting the sleep-wake cycle, not by causing central nervous system depression. It is prescribed for people who have difficulty falling asleep. Rozerem can be prescribed for long-term use and the medication has shown no evidence of abuse and dependence.
Taking rozerem is not advisable if you
Are pregnant or breast-feeding.
Have history of kidney or respiratory problems, sleep apnea, or depression.
Sonata
Of all the new sleeping pills, Sonata stays active in the body for the shortest amount of time. That means you can try to fall asleep on your own. Then, if you're still staring at the clock at 2 a.m., you can take it without feeling drowsy in the morning. However, if you tend to wake during the night, this might not be the best choice for you.
Taking sonata is not advisable if you
- Have severe liver impairment.
- Are pregnant.
- Have a history of depression, liver or kidney disease, or respiratory conditions.
Benzodiazepines
These older sleeping pills (Halcion, Restoril, and others) are useful when you want an insomnia medication that stays in your system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors. However, these drugs may cause you to feel sleepy during the day and can also cause dependence, meaning you may always need the drug to sleep.
Taking benzodiazepines is not advisable if you
- Are pregnant or breast-feeding.
- Have a history of drug abuse, depression or respiratory conditions.
Antidepressants
Insomnia is a common symptom of depression. Thus, some antidepressant drugs, such as trazodone (Desyrel), are particularly effective in treating sleeplessness and anxiety that's caused by depression.
Amitriptyline
One of a class of medications used to treat depression. The tricyclic antidepressants (TCAs) are also used for some forms of anxiety, fibromyalgia, and the control of chronic pain.
Please Note: This brand name drug is no longer available in the US.
Taking amitriptyline is not advisable if you
- Are recovering from a heart attack or using a monoamine oxidase inhibitor (MAOI).
- Have a history of seizures, hyperthyroidism, liver disease, schizophrenia or bipolar disorder.
Nortriptyline (Pamelor)
Nortriptyline is indicated for the relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states.
Taking nortriptyline is not advisable if you
- Are recovering from a heart attack or using a monoamine oxidase inhibitor (MAOI).
- Have a history of glaucoma, seizures or schizophrenia.
Trazodone (Desyrel)
Trazodone is indicated for the treatment of depression. The efficacy of Trazodone has been demonstrated in both inpatient and outpatient settings and for depressed patients with and without prominent anxiety.
Taming trazodone is not advisable if you
Have a history of high blood pressure.
Consider when taking trazodone
Interacts with warfarin (Coumadin) and many herbal supplements.
Over-the-Counter Sleep Aids
Most of these sleeping pills are antihistamines. They generally work well but can cause some drowsiness the next day. They're safe enough to be sold without a prescription. However, if you're taking other drugs that also contain antihistamines -- like cold or allergy medications -- you could inadvertently take too much.
FDA issued warnings for prescription sleep drugs In March 2007, alerting patients that they can cause rare allergic reactions and complex sleep-related behaviors, including "sleep driving."
The FDA's warnings include the following sleep pills
- Ambien/Ambien CR,
- Butisol Sodium,
- Carbrital,
- Dalmane
- Doral,
- Halcion,
- Lunesta
- Placidyl
- Prosom
- Restoril
- Rozerem
- Seconal
- Sonata
Hormones Supplements
Melatonin
Melatonin is a naturally occurring hormone whose levels peak at night. It is triggered by dark and levels remain elevated throughout the night until light decreases it. For this reason, melatonin has been studied for use as a sleep aid. However, most study results have not found it to be beneficial when compared to a sugar pill (placebo). Some positive results have been shown in helping adjustment to jet lag and shift workers who work nights. However, it�s unclear whether simple exposure to light at the right time is more effective, and there is no risk of side effects with light exposure. Long term uses of melatonin are unknown.
Cognitive-Behavioral Therapy
This therapy is intended to reestablish healthy sleep patterns by helping an individual cope with his or her sleep problem. One cognitive-behavioral approach, called paradoxical intention, helps to retrain an individual's fears of sleep by doing the opposite of what is causing the anxiety. For example, a person with insomnia worries long before going to bed about not being able to sleep and the difficulty he or she will have at bedtime. Rather than preparing to go to sleep, therefore, the person prepares to stay awake. Another cognitive-behavioral technique, called thought stopping, allows a person with insomnia a certain period of time to repeatedly and continuously think about going to bed. This technique helps "wear out" the anxiety associated with going to bed, and decreases the likelihood that he or she will obsess about falling asleep at other times.
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