Doctors' Prescriptions For Insomnia: What To Expect

Sleep is an essential part of a healthy lifestyle, and insomnia is a common sleep disorder that affects many people. If you are experiencing insomnia, it is important to consult a doctor to determine the underlying cause and explore suitable treatment options. Doctors may initially recommend lifestyle changes and behavioural treatments, such as adopting better sleep habits, improving sleep hygiene, and practising relaxation techniques. In some cases, doctors may prescribe sleeping pills or other medications to help you fall asleep and maintain sleep. It is important to understand the potential side effects, risks, and interactions of any prescribed medication. Additionally, sleeping pills are typically recommended for short-term use and should be used with caution due to the risk of dependence and addiction.

Doctors may recommend lifestyle changes, such as avoiding caffeine and alcohol

Doctors may recommend a variety of lifestyle changes to help those suffering from insomnia or other sleep disorders. One of the most common recommendations is to avoid caffeine, especially later in the day. Caffeine is a stimulant that can keep you alert and make it difficult to fall asleep. It can be found in coffee, tea, energy drinks, and even chocolate, so it's important to be mindful of your consumption throughout the day. Similarly, alcohol can also disrupt your sleep patterns. While a drink or two may make you feel sleepy at first, heavy drinking or drinking too close to bedtime can lead to interrupted sleep or prevent you from getting truly restful sleep.

In addition to avoiding caffeine and alcohol, doctors may suggest adopting healthier sleep habits and routines. This includes maintaining a consistent sleep schedule, even on weekends. Going to bed and waking up at the same time each day helps regulate your body's internal clock and can improve your sleep quality. It is also recommended to avoid napping during the day, as this can disrupt your nighttime sleep. Creating a bedtime routine that helps you relax and wind down can be beneficial. This could include activities such as reading, listening to soothing music, meditation, or deep breathing exercises.

Another important aspect of improving sleep is creating a sleep-conducive environment. Keep your bedroom dark, cool, and quiet. Avoid watching TV, using electronic devices, or engaging in stressful activities in bed. Make sure your bed is comfortable, and consider using earplugs or a fan to block out any noise that might disturb your sleep. It's also important to avoid eating large meals or drinking too much water close to bedtime, as this can cause discomfort or the need to use the bathroom during the night.

In addition to these lifestyle changes, doctors may also recommend cognitive behavioural therapy (CBT) or other forms of talk therapy. CBT can help you identify and change negative thought patterns and behaviours that may be contributing to your sleep difficulties. It can also teach you relaxation techniques and improve your overall sleep hygiene. These lifestyle changes, combined with any prescribed medications, can help improve your sleep quality and duration.

Prescription sleeping pills can be used for short-term relief

Doctors may prescribe sleeping pills to help with sleep problems, including insomnia. Prescription sleeping pills are stronger than over-the-counter pills and are often recommended for short-term use. This is because they are not a cure for insomnia and carry a risk of dependence and addiction.

Prescription sleeping pills can help you fall asleep and stay asleep. They work in different ways, with some causing drowsiness and others silencing the area of the brain that keeps you alert. Benzodiazepines, for example, stimulate a chemical in the brain called GABA, which leads to sedation, muscle relaxation, and reduced anxiety. Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), work by slowing down brain activity.

Sleeping pills can have side effects, including constipation, digestive problems, and worsening snoring and sleep apnea. They can also cause a "hangover effect", with people feeling drowsy, confused, and dizzy the next day, impacting their ability to drive or work.

It's important to note that sleeping pills are not a long-term solution and should be used with caution. Doctors may recommend trying other methods to improve sleep before resorting to sleeping pills, such as cognitive behavioural therapy, changing sleep habits, and avoiding caffeine and large meals before bed.

There are non-drug therapies, such as cognitive behavioural therapy

Doctors may prescribe sleeping pills to treat short-term insomnia. However, medication is typically used in combination with good sleep practices and/or behavioural treatments.

Therapy techniques include stimulus control, sleep restriction, and relaxation training. Stimulus control attempts to change negative associations with the bedroom, reclaiming it as a place for restful sleep. Sleep restriction limits time spent in bed to increase the drive to sleep and temporarily increase daytime fatigue. Sleep compression is a gentler approach, gradually reducing time spent in bed. Relaxation techniques can help reduce racing thoughts and tension, increasing the body's natural relaxation response. These techniques include breathing exercises, progressive muscle relaxation, autogenic training, biofeedback, hypnosis, and meditation.

CBT-I is a collaborative process, and the skills learned in sessions require practice. Homework is often assigned between sessions, such as keeping a sleep diary, practising questioning automatic thoughts, and improving sleep hygiene practices. The majority of patients respond to this treatment fairly quickly, with some experiencing significant changes after only two therapy sessions.

Over-the-counter sleep aids are available, but check with a doctor first

Over-the-counter sleep aids can be helpful for short-term sleep issues, such as jet lag or travel through time zones, but they are not recommended as a long-term solution. It's important to consult a doctor or sleep specialist before taking any sleep aid, even if it is available over the counter. They can advise on the most appropriate course of action and help rule out any underlying problems, such as sleep apnea, stress, or anxiety.

Over-the-counter sleep aids typically fall into two categories: nonprescription medications and dietary supplements. Nonprescription medications usually contain antihistamines as their main active ingredient, such as diphenhydramine (found in Benadryl, Nytol, Sominex, and Unisom) or doxylamine succinate (found in Unisom SleepTabs). These medications work by blocking certain brain chemicals that promote alertness, resulting in a sedating effect. However, they should be used with caution as they can cause side effects such as daytime grogginess, blurred vision, constipation, and dry mouth. Older adults may experience additional side effects, such as confusion and falls.

Dietary supplements, such as melatonin, valerian, and CBD, are also available over the counter. Melatonin is a synthetic version of a naturally occurring hormone that regulates the sleep-wake cycle. While it can be helpful for "night owls" or those with jet lag, it may not be effective for general insomnia. Valerian is an herbal supplement that acts on receptors in the brain to slow down the nervous system and induce drowsiness. CBD, derived from the cannabis plant, is being studied for its potential to treat insomnia due to its anxiety-relieving properties. However, it is important to note that supplements are not strictly regulated by the FDA, so there may be uncertainty about the accuracy of the listed ingredients.

While over-the-counter sleep aids can provide temporary relief, they are not a substitute for addressing the underlying causes of sleep issues. Sleep problems can often be corrected without medication through lifestyle changes, behavioural therapy, or cognitive behavioural therapy. Doctors may recommend a sleep study to evaluate brain waves, movements, and breathing during sleep to identify any underlying issues.

Prescription sleeping pills include benzodiazepines and Z-drugs

If you are experiencing insomnia, your doctor may prescribe you sleeping pills to help you sleep. Sleeping pills are usually prescribed for short-term use and work best in combination with good sleep practices and/or behavioural treatments.

Z-drugs, such as zolpidem (Ambien) and eszopiclone (Lunesta), are another class of medicine that acts similarly to benzodiazepines. They work by slowing down activity in the brain. Z-drugs are usually prescribed for short-term insomnia. It is important to note that Z-drugs carry the rare risk of serious injuries or even death. Complex sleep behaviours can occur while taking Z-drugs, such as sleepwalking, sleep cooking, or taking other medications.

Both benzodiazepines and Z-drugs can be habit-forming if used for more than two to four weeks. Withdrawal symptoms can occur if stopped suddenly, including anxiety, panic attacks, odd sensations, and physical symptoms like sweating, headaches, and nausea. Therefore, it is important to carefully follow the dosing instructions provided by your doctor and not take these medications for longer than directed.

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