Sleep Aids And Stimulants (cont.)
What are non-drug treatments for insomnia?
When you consult a physician about insomnia, he or she may ask to you keep a sleep log for several weeks to monitor your sleep habits. The treatment of insomnia includes not only medications, but often sleep habit and behavioral modifications for optimal long-term results.
Evaluating sleep habits is important in the management of insomnia. In some instances, changing sleep habits may correct the problem without the need for medications. Good sleep habits should include:
- regular sleep times,
- a comfortable bed and quiet room at a comfortable,
temperature,
- appropriate lighting,
- regular exercise but not close to bedtime or late in
the evening,
- a bedroom that is not used for work or other
activities not related to sleep,
- avoidance of stimulants (for example, caffeine, or tobacco),
alcohol, and large meals close to bedtime,
- relaxation techniques such as breathing exercises, and
- avoidance of naps during the day.
What over-the-counter medicines are there for
insomnia?
Self-treatment of insomnia with over-the-counter (OTC) drugs is advisable only for transient or short-term insomnia. OTC sleep aids should only be used for a short period of time in conjunction with changes in sleeping habits. Chronic use of these drugs may result in dependence on them. This creates a situation in which sleep is not possible unless the drug is used. Chronic insomnia should be evaluated by a physician.
Antihistamines
Diphenhydramine (for example, Sominex, Nytol) and doxylamine
(for example, Unisom) are antihistamines that are
currently marketed as OTC sleep aids. Diphenhydramine is
the only agent that is considered to be safe and effective
by the Food and Drug Administration. The safety and
effectiveness of doxylamine has not been evaluated
adequately for FDA approval. Other uses for diphenhydramine include allergy, motion sickness, and cough suppression.
Scientists believe that diphenhydramine and doxylamine
cause sedation by blocking the action of histamine in the
brain, but the exact mechanism of action is not known.
If insomnia is associated with pain, there are numerous
products containing a combination of an antihistamine and
pain reliever. These combination products should not be
used if pain is not present because the added pain reliever
is not necessary.
Pregnancy and Lactation: The effects of diphenhydramine
and doxylamine on the fetus have not been evaluated
adequately. Although the likelihood of an adverse effect on
the fetus is low, these drugs probably should be avoided
during pregnancy. Both agents may decrease lactation
(production of milk). Additionally, these drugs are
secreted into the breast milk, which could affect the
newborn. Therefore, nursing mothers should also avoid both
drugs. Children less than 12 years of age should not use
doxylamine because its use in this in age group has not
been assessed.
Drug Interactions: Diphenhydramine and doxylamine add
to the sedative effects of alcohol and other medications
that cause drowsiness.
Side Effects: Drowsiness is the most frequent side
effect of both diphenhydramine and doxylamine. Therefore,
these agents should not be used in situations (for example,
driving) where mental alertness is required.
Diphenhydramine and doxylamine also cause constipation,
dry
mouth, and difficulty urinating. Both drugs may worsen the
symptoms of glaucoma, asthma, heart problems, and
prostate
gland enlargement. People with these conditions should not
use OTC sleep aids without consulting a physician.
Both drugs may paradoxically cause excitation, resulting
in nervousness and insomnia. This occurs most often in
children and the elderly.
Next: Melatonin »
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