22 June 2015

GUEST POST: Thoughts on over-the-counter sleep aids, by Amy Korn-Reavis RRT, RST

Is there an Easy Answer to Insomnia?
by Amy Korn-Reavis RRT, RST

We are all looking for that easy solution to staring at the ceiling at night. A pill that will allow you to fall asleep as soon as your head hits the pillow. 

We have also heard about the issues with the prescription medications that are prescribed. Some physicians are refusing to prescribe sleep aids and some insurance companies are unwilling to pay for them. 

We then turn to over-the-counter medications to help us get to sleep.

The most common ones are ones that contain antihistamines. You know the ones that have 'sleep' or 'zzzz' or 'som' in their names. They use two very common antihistamines mixed with nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to help reduce pain. They are used because drowsiness is a common side effect. 

The issues with these are multiple. You can build up a tolerance to the medication, and an increased dose will cause other health issues such as liver damage, increased sinus swelling, and sensitivity to the medications. 

Another issue is known as rebound. You take yourself off the medication and the insomnia you were worried about increases as soon as you stop taking the medication. 

If you are going to use any of these medications, please follow the directions. Be aware: you should never use these medications for more than 3 days consecutively; you most likely will experience rebound after you take it, then stop using it.

Melatonin is another popular over-the-counter sleep aid. It is a natural hormone that our brain makes when we are exposed to darkness. As we get older we produce less of this hormone. Does it work? That depends. It might help you, unless you are on a medication that blocks melatonin production, or if you do not turn out the lights before bedtime. If you are going to take it, you need to take it and then turn off the lights and go to sleep. It works best when you take it sublingually (under your tongue). You should also start with a low dose such as 1 mg; you should not go higher than 3 mg unless your physician prescribes it for you. There is not enough research on melatonin to show it is safe to use at higher doses.

Teas that help you sleep, such as chamomile tea, are thought to help you relax. The heat of the tea alone can be relaxing for some people. The chamomile herb itself is also believed to help; however, there is little research to support his.   

Supplements that help with sleep--such as L-theanine, CoQ10 or manganese--are thought to help people to relax and fall asleep. While this may be true for some people, it is not true for everyone. Usually it works if you happen to have a low level of the supplement in your system. If you are an average healthy person, then these supplements will not change your sleep onset.  

There is no such thing as an easy answer when it comes to sleep problems. The newest research has found that changes in behavior, with the help of a good counselor who specializes in sleep disorders, appears to be the best help for insomnia. 

We need to remember that achieving quality sleep depends upon relaxing, getting that exposure to quiet and darknes, and getting a little exercise in the morning, all things that will help you best achieve a good night sleep every night.  

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Amy Korn-Reavis is a registered repiratory therapist (RRT) and registered registered sleep technologist (RST) who has worked in the health field since 1986. She is also the coordinator of the Polysomnography program at Valencia College, where she helps to instruct the next generation of sleep technicians. She is also the founding president of the Florida Association of Sleep Technologists. She currently manages the sleep lab at Emery Medical Solutions in Orlando, Florida.