by George H. Glade, MC, MN, ARNP* –
Patients come to me frequently with this question, “Can you give me a pill with no side effects that will let me sleep through the night, lose weight and get rid of my stress and depression?” I wish I could. Unfortunately, such a pill does not exist. What I can give my patients, though, is a system through which they’re able to accomplish their goals. Before I tell you about that, let me share a few secrets about sleeping pills, especially prescription ones.
Can I get addicted to them?
Yes, in two major ways: behaviorally and physically. Ugly, dramatic drug withdrawals are rare, but the behavioral conditioning of “Pill Equal Sleep” affects tens of millions who are habituated to the belief that they need a pill to sleep. One Detroit study gave people who were hooked on sleeping pills for an average of ten years the choice of blue or orange sleeping pills – the pill they were on and the placebo. The result was that they took equal amounts of the old pill and placebo, since what mattered to the brain was getting that pill, even if nothing was inside.
Do they work?
Yes, though not for as long as many think. Sleeping pills are particularly good at knocking out people so they don’t wait around for sleep. The actual sleep pills produce is different from natural sleep, with varying amounts of deep sleep and REM.
How long does it take to become addicted?
Physically, it can take months of high doses of standard sleeping pills, the valium-like drugs called benzodiazepines. Behaviorally, people can get hooked in days to weeks – but also unhooked very quickly.
Can they kill you?
If you’re driving, using machinery, having suicidal thoughts, or falling asleep in unusual places, then yes. Several large-scale population studies correlate sleeping pill use with higher death rates, especially in the elderly. A recent Canadian Journal of Psychiatry paper declared sleeping pill and anti-anxiety pill users have an overall increased death rate of 36%. The reasons may have to do with why those people were taking the pills rather than the effect of pills
Do over-the-counter pills work?
Somewhat, but usually only for short periods of time. Melatonin, antihistamines like Benadryl, and ancient drugs like valerian all have fans. However, they usually only work temporarily and can have negative side effects.
Why do people want sleeping pills so much?
Because they don’t see rest as regeneration but as distraction. They want to get to sleep fast every night. Sleeping pills promise the quick fix we crave. However, lots of folks on pills wake up in the middle of the night, especially with newer pills like Ambien (zolpidem) that use their fast action as a marketing pitch. A fast-acting sleeping pill won’t help you much, though, if you still wake up early and can’t sleep through the night. Details like bizarre sleepwalking and sleep eating generated by these drugs sometimes get left out of promotional materials.
Are there good reasons to use sleeping pills?
Insomnia treatments, times of stress (such as a relative’s death or a cancer diagnosis) and situations with significant sleep distortion like jet lag or shift work are all appropriate reasons for sleeping pill treatment. It is, however, crucial to be diagnosed correctly and to maintain the following best practices for getting good rest whether or not you are using sleeping pills.
So How Do I Get Sleep Without Sleeping Pills?
Recognize three things: (1) sleeping pills often work through conditioning, which you can do effectively without pills; (2) what you do during the day strongly affects what happens to you during the night; and (3) your body is built to rest in very effective but very particular ways.
- Conditioning. You have to calm down and rest before you sleep. Creating a routine for works great for this. The simple acts of flossing, brushing your teeth, setting the alarm, putting out your clothes for the next day, and reading a book you should have read in high school (or as some patients tell me, one of my books) all send signals to your brain that say, “It’s time to sleep.”
- Listen to Your Body. Use your body the way it’s built. To create a holistic health routine for yourself, go FAR (Food, Activity, and Rest) throughout the day. Creating a system of healthy eating, regular exercise, and designated times for rest will help you sleep well, lose weight, look younger, and gain more peak experiences. The key is to use a cycle that works best for your body.
- Rest is Regeneration. Rest is not the laziness that some people ascribe to it. Resting right, which means using active rest techniques, can increase your chances of a long, healthy life. So try to sleep naturally. Let rest do what it does so well: improve your mood and memory, prevent heart disease and stroke, reset your immune system, and give you a renewed, rewired brain in the morning. Most Americans no longer know what it’s like to feel awake, alert, and aware in the morning. It’s time to really wake up – and enjoy.
*George H. Glade, MC, MN, ARNP, was named one of Seattle’s Top Doctors and Nurses in Seattle Metropolitan Magazine in 2012. Glade is a Member of the Board of Directors of ADD Resources and is the author of Eating for Cognitive Performance and The Stimulus Driven Brain: The Essential Guide for the ADD/ADHD College Student. Currently, he is developing the Coaching Access Project, which is due to be released Summer 2015.
Reviewed by ADDR March 31, 2015 (mm)