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Insomnia and the Danger of Prescription Sleep Aids

Picara Vassallo

Last week, insomnia was the complaint of half of my patientsHalf!  Usually, this is problem that gets worse for people at Spring time, but with the unseasonably warm spring like weather we’re having, it’s starting early.

In addition, last week this article in the LA Times about prescription sleep aids came out and rightly scared some people, causing them to reach out to me for help.  Why?  Well, here are the highlights that struck me:

"A new study suggests that the 6% to 10% of Americans who use prescription sleep medications such as zolpidem (Ambien), temazepam (Restoril), eszopiclone (Lunesta) and zaleplon (Sonata), are more likely to develop cancer, and far more likely to die prematurely, than those who take no sleep aids."

"Compared with patients with no record of taking prescription sleeping pills, the study says, those who were the heaviest users of prescription sleep aids were 35% more likely to be diagnosed with cancer during the study period."

YIKES!

If this wasn’t bad enough, I’ve had patients on Ambien tell me that they have done all sorts of strange things while on the drug including making purchases online, eating, and having conversations that they don’t remember.  Some have even told me they have hallucinated and almost injured themselves while on this drug with no recollection later as to what happened.

So, what are our alternatives if we aren’t interested in putting ourselves at greater risk for cancer, early death, hallucinations and sleep walking?

Here are a few ideas you can implement today:

1. Create a bedtime ritual

This doesn’t have to be complicated, just create a routine before going to bed.  An hour before you want to go to sleep, turn the lights down and reduce any noise.  Make sure that your bedroom is at a cool temperature as well.  Move any electronic items away from the bed, this includes your alarm clock and cell phone, both of which can be plugged in across the room to diminish light by your head as well as electricity.  A half an hour before bed, turn off the tv and make sure your lap top is closed and put away.  Make sure that there is no light coming in from windows or other sources.  You want the room to be as dark as possible, even if that means you have to use black out curtains or a sleep mask.  Once in bed, keep activities outside of sleep and sex to a minimum.  Nothing else should be going on in your bed - not work, not phone calls, not eating.

2. Take a bath or shower

If you have time, take a hot bath about an hour and a half before bedtime.  Your body temperature will increase during the bath and then slowly decrease when you get out.  As your body cools, it will become more tired.  Another idea comes from Tim Ferriss and involves ice baths an hour before bed.  Now, I’ve done this and it was a miserable experience submerging myself in ice water for 10 minutes.  But, it does seem to work.  My version is to submerge only your feet in ice water.  I’ve found the benefits for sleep are still there and the rest of me isn't chilled and feeling awful.

3. Balance your blood sugar

Another recommendation from Tim Ferriss is to have about 200 calories before bedtime to prevent insomnia and to help you feel more energized in the morning.  Preferred snack foods should be consumed just before going to bed and should be in small quantities and have a low glycemic index.  Good examples are nuts and a small pear or apple, two tablespoons of nut butter (straight from the jar is great!), or low fat/high protein yogurt (like Greek yogurt).  He also recommends taking a tablespoon of flax seed oil with your bedtime snack to help your system work to repair itself as you sleep.  Otherwise, you want to make sure your last major meal was 3 to 4 hours before you plan on going to bed.   Also, you want to be careful about exercising too close to bed as that can also effect your blood sugar so make sure your workout is 3 hours before your scheduled bedtime.  You also want to make sure that you eliminate all caffeine from your system 5 hours before going to sleep, this includes coffee, tea, chocolate, energy drinks. 

3. Supplements

Chinese herbal remedies for insomnia have helped many of my clients.  You will want to see a certified Chinese herbalist who will make sure you get the right combination of herbs for you.  Unlike prescription drugs, Chinese herbs are not addictive and do not have the same side effects as drugs like Ambien.   They work well in conjunction with acupuncture or alone.  Other supplements that seem to help people are melatonin, which is what your body naturally releases when it’s time to sleep.  Usually a low dose (around 2mg) helps many people.  Check with your doctor before taking any supplements or making any changes to your medications.  Stopping or starting any new supplements or your prescriptions should be a decision between you and your MD.

4. Reset your internal clock

When you wake up in the morning, get sunlight as soon as possible and if you can, get outside around noon each day.  This helps your natural clock understand what time it is.  It gets very confusing for our body with all of the unnatural light sources we experience all day.  Sunlight helps us to adjust so that we will start producing the right chemicals in our body to promote sleep at night.

This list was inspired by Dr. Erin Shannon and Tim Ferriss