During my early years in practice, I freely prescribed sleeping pills. The evidence available during the 80s and 90s looked great. Sleeping pills appeared highly effective and safe. As the years passed, I started to see more and more problems with sleepers. By 2010, I dreaded using sleepers. Sleepers can cause drowsiness, lethargy, drugged feelings, depression, memory problems and a multitude of other problems.
During the last decade of my practice, I had large numbers of middle-aged patients who couldn’t sleep without their magic pills. Despite my admonishments about the risk of sleepers and their addictive potential, patient persisted in requesting/demanding them. In the last 3 years of my practice, I started getting my patients off of Ambien and other sleepers.
Unfortunately, I still have patients who insist they need Ambien. I talked to one yesterday. She’s retired and has trouble staying asleep. I explained that I can’t stay asleep either. My sleep cycle is screwy! I go to bed at 10:30 and sleep until 3 am. At 3 o’clock in the morning, I go to the computer and write. I watch a little TV or listen to a book. By 7 am, my eyes start to close and I nap until Renee comes down at 10:30. I nap again in the afternoon and after dinner.
Since surgery and retirement, the above pattern has become my new normal. I have two choices. Choice number one is to ask my doc to prescribe a sleeper. If I start on a sleeper, I can “normalize” my sleep cycle but will be on a pill the rest of my life.
Choice number two is to accept my new sleep cycle and live with it. I chose to live with it. If I had to work at a 9 to 5 job, choice number 2 would not be good, but I don’t have a work schedule. Anything I can do during the day can be done at night or during the very early morning hours.
After 40 years of practice, I advise that you accept your sleep cycle as normal for you and learn to live with it. So, what do you do if you have a sleep abnormal sleep cycle and have a fixed schedule that does not work with your sleep cycle? Meditation is your best bet and while we are all sheltering in place, it’s a good time to learn how to meditate.
Dr Belle Ruth Naperstak has some excellent material used to teach you to meditate through the use of guided imagery available at Health Journeys.com. The Center for Sleep Medicine, in Libertyville, has a great program for treating Insomnia through behavior modification. They can also assess if sleep apnea plays a role in your sleep architecture. There are several easy screening assessments you can use at home to help diagnose sleep apnea. Please look under the “For Patient” tab for those screeners.
If you must take a pill, melatonin seems to be the least harmful. Unfortunately, the nutraceutical market is full of questionable products. If you can, look for melatonin made by Douglas Labs, Metagenics or OrthoMolecular.
If all else fails, see your MD. Well, it’s time for my morning nap.