Alternatives for Sleeping Problems

The following excerpt comes from “Sleeping Pills and Tranquilizers” on WorstPills.org.

Experts in sleep and aging have stated, “It’s extraordinarily rare to find an old person who actually requires [sleeping pills].”

If the cause of the sleeping prob­lem is depression, the depression should be addressed rather than simply treating the symptom by prescribing sleeping medication. If the cause is a medical condition, with pain as one of the components, the pain has to be treated rather than using a sleeping pill to induce sleep despite the pain. In the case of senile brain disease, such as Alzheimer’s, the sleep disturbance will probably not respond to sleeping medications.

Drugs can produce stimulating effects and a chemically induced anxiety, making sleep more difficult:

• Over-the-counter (OTC) drugs: Sleeplessness can be caused by caffeine, found in aspirin and caffeine (ANACIN) and other drugs; the stimulants found in triprolidine and pseudoephedrine (ACTIFED); pseudoephedrine (SUDAFED) and other deconges­tant products; and the ingredients in many asthma drugs.
• Prescription drugs: Sleeping prob­lems may be caused by asthma drugs containing theophylline (SLO-BID) or aminophylline (SOMOPHYLLIN), amphet­amines such as dextroamphet­amine (DEXEDRINE) and diet pills, steroids such as cortisone and prednisone, thyroid drugs, and the withdrawal from the use of sleep­ing pills, tranquilizers and antide­pressants.

If you have a sleeping problem and use one of these drugs, or if the problem began when you started using another drug, talk to your doctor about all the drugs (OTC and prescription) you are taking. It might be possible to change the drug or lower the dosage to help you sleep. Returning to sleeping pills to get past withdrawal effects will only place you in a vicious cycle.

An excellent review of nonphar­macologic approaches to managing insomnia offers suggestions far more sensible, less dangerous and less ex­pensive than reliance on prescription drugs. As the authors of this review stated, “Nonpharmacological treat­ments not only cause fewer side ef­fects, but they can sustain long-term improvements more successfully than pharmacological treatments.”

We list some of the suggestions from this review below:

Stimulus Control

Instructions given to patients for this treatment include the following:

1. Go to bed only when you feel tired.
2. Use the bed and bedroom for sleep and sex. For example, do not read books or magazines, watch TV, eat, or worry while in bed.
3. Leave the room if you do not fall asleep within 15-20 minutes. Remain in the other room for as long as you wish or need. Return to bed only when you feel sleepy again.
4. If you still cannot sleep, repeat step 3. Do this as often as neces­sary throughout the night.
5. Get up at the same time every morning regardless of how much sleep you obtained the night before (use an alarm clock if necessary).
6. Avoid napping.

Sleep Hygiene Education

1. Avoid the use of caffeine-con­taining products (including tea, coffee and chocolate), nicotine and alcohol, especially later in the day.
2. Avoid heavy meals within two hours of bedtime.
3. Avoid drinking fluids after sup­per to prevent frequent night­time urination.
4. Avoid environments that will make you really active after 5 p.m. (i.e., avoid noisy environ­ments).
5. Only use your bed for sleep. Sit in your chair when you just want to relax.
6. Avoid watching television in bed (i.e., watch it in your chair).
7. Establish a routine for getting ready to go to bed.
8. Set time aside to relax before bed, and utilize relaxation tech­niques.
9. Create an atmosphere condu­cive to sleep: Keep yourself at a comfortable temperature by modifying the number of blankets you use. Use earplugs if it is too noisy. Make the room darker if there is too much light (e.g., close the door). Put an extra mattress on your bed if it is uncomfortable.
10. When in bed, relax and think pleasant thoughts to help you fall asleep.
11. Get up at the same time every day, including weekends. Use an alarm clock if it will help.
12. Avoid taking daytime naps. If you have to take them, make sure you do so before 3 p.m. and that the total time napping does not exceed one hour.
13. Pursue regular physical activity, such as walking or gardening, but avoid vigorous exercise too close to bedtime.