To Sleep, Perchance to Sleep Soundly (cont.)
Benzodiazepines: These older sleeping pills (Valium, Halcion, and others) are useful when you want a drug that stays in your system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors, says Arand. "The biggest problem with these is daytime sleepiness, although you also have to monitor them more closely for dependence as well," she says. (Dependence means that you always need the drug to go to sleep.)
Antidepressants: Insomnia is a common symptom of depression. Thus, some antidepressant drugs, such as Serzone, are particularly effective in treating sleeplessness and anxiety that's caused by depression. "In those cases, the antidepressant helps treat the sleep problem but is really treating the underlying cause," says Arand.
Over-the-Counter Sleep Aids: Most of these sleeping pills, such as Sleep-Eze, are antihistamines. This means they're somewhat sedating and can cause some drowsiness the next day. They're safe enough to be sold without a prescription, but if you're taking other drugs that have similar effects -- like cold or allergy medications -- you could inadvertently take too much.
Combining Medicine With Good Sleep Habits
Roth suggests that it's time to start thinking about insomnia as a chronic disorder -- which he notes that it is in at least 10% of the population -- and treating it that way. "For people who have high cholesterol, you don't just give them a drug to lower their cholesterol and that's the end of it," he says. "You also work with them on other factors in their life that may be elevating their cholesterol."
Similarly, he says, sleep medications for insomnia should not be used in isolation. "You want to use them in conjunction with good sleep practices, good behavioral therapies, and treating accompanying conditions," he says. That means, among other things, practicing "good sleep hygiene:"
Studies have also found that cognitive behavioral therapy (CBT) can be a very effective treatment for insomnia, making it easier to fall asleep more quickly and stay asleep longer. "In fact, some research shows that medications aren't as effective in the long term as behavioral treatment of the insomnia problem," says Arand. "Changing behavior can have a greater impact and longer duration of effectiveness. But that doesn't mean you can't use these remedies in combination."
Published February 2005.
SOURCES: Donna Arand, clinical director, Kettering Sleep Disorders Center, Kettering, Ohio. Thomas Roth, MD, director, Sleep Disorders and Research Center, Henry Ford Health System, Detroit. National Sleep Foundation.
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