Sleep Medication

MEDICATION

Sleep-Aid medication should be a last resort.
Over-the-counter sleep medicines can have side-effects, including a “hangover” effect the next morning.
If these fail, you may want to ask you health care provider to recommend other options.
Avoid all sedatives, including the benzodiazepines, during pregnancy.

Call your health provider if:

* A sleeping problem becomes persistent and unbearable, despite home treatment
* A sleeping problem occurs more than 3 nights per week for more than 1 month
The insomnia is accompanied by other worrisome symptoms, such as chest pain or shortness of breath

What to Expect at Your Office Visit

Your provider will perform a physical examination. To help better understand your sleeping problems, he or she may ask the following:

* Do you have difficulty falling asleep or staying asleep (insomnia)?
* Do you awaken from sleep not feeling rested?
* How often do you awaken at night?
* How long have you had the problem?
* Have you taken any over-the-counter sleeping products?
* What medications do you take?
* Do you take any herbal supplements or alternative medicine remedies?
* Do you drink much coffee or alcohol? Have you recently cut down on your coffee or alcohol?
* Do you have any excessive stress or anxiety?
* How much do you normally sleep? What hours?
* What do you do during the few hours before you go to bed?
* Do your sleep schedule change frequently? (shift work)
* Do you fall asleep at inappropriate times or places?
* Does your sleep schedule change drastically on weekends?
* Do you worry excessively about sleep?
* Do you have breath-holding spells or do you snore?
* Do you have any aches or pains that prevent you from sleeping?

In some cases, the following tests may be recommended:

* Sleep log record
* Psychological tests
* Thyroid tests (TSH, T3, T4)
* At home Sleep Study

In some rare cases, your health care provider may want you to see a sleep medicine specialist who will perform a sleep study (polysomnography)

MEDICATIONS

In most cases, sleep aid medication will not be necessary. Your health care provider can explore with you the possibility of using prescribed medications if everything else has failed.


Some antidepressants such as Elavil (amitriptyline) can be used at bedtime as a sleep aid because they are sedating. These sleep aids require a prescription. If insomnia is caused by depression, proper treatment of the depression with other appropriate medications or therapy should solve the problem. Benzodiazepines such as Valium (diazepam) or Ativan (lorazepam) are anti-anxiety medications that can also help induce sleep. They must be used with caution because they can be addictive. They too require a prescription.

Newer sleep medicines help reduce the time it takes you to fall asleep. They are less likely to be addictive than benzodiazepines. Two examples are the prescription medicines Ambien (zolpidem) and Sonata (zaleplon).

WARNING: The FDA has asked manufacturers of sedative-hypnotic sleep medicines to put stronger warning labels on their products so that consumers are more aware of the potential risks. Possible risks while taking such medicines include severe allergic reactions and dangerous sleep-related behaviors, including sleep-driving.