Tuesday, May 06, 2008

To Cut Risks of Sleeping Pills


Don't take them.

Melinda Beck, in today's Wall Street Journal, suggests hiding car keys, unplugging the phone, preparing for impending disaster. That's if you must take the new-generation of sleeping pills.

She's referring to the NBZs the nonbenzodizepines, especially Zolpidem (Ambien). Ambien knocks most people out like a 2 x 4 at the back of the head. But some people, under the influence, do things they regret.

There are documented cases like this one: A person takes a pill, has a beer, then decides to go out for cigarets, forgetting to open the garage door before backing out the car.

So we might suggest, too, as Ms. Beck does, don't use these drugs with alcohol.

Obviously some people need sleep medications and I'll be the first to suggest a medication evaluation from a medical doctor. When I say, (above) Don't take them, it's really you, initially, who has to determine if you're in the Some People Really Do Need Them category. If you think you are, a medical doctor still has to agree with you.

It's a medical decision, prescribing medicine.

I would still urge you first to try Ms. Beck's alternative advice before you nag your pri-care for a script.

She recommends, on the front page of WSJ's Personal Journal, First try exercise, stress reduction, and avoiding caffeine.

I'd add,

And for sure, get therapy.

As long as we're adding, let's go for it.

Develop an evening wind-down routine. No more eating or drinking after dinner, except for a cup of tea or another hot liquid, maybe soup, but nothing too creamy. Sugar arouses us and everything we eat breaks down into sugars.

Call your mother, father, sister, brother. Or friends.

Undress, bathe. Read. Learn something. Create something. Creating really tires you out.

Watch television, the great soporific, but not too late.

If you go out, don't stay out to late.

Dispatch anything work related to the recycle bin. Oh. Can't do that?

Have sex.* Make love. Discuss love. Embellish the meaning of love.

And if you're still unable to sleep, plan a cat-nap on your coffee break the next day. And skip the coffee altogether, if possible. Maybe, since that may be impossible, unfeasible, a ridiculous suggestion, strategically plan one cup. And eat really light.

You'll make it through the day.

yawn.

therapydoc

*Sex, as you know from previous posts, (did I post on this?) is the natural tranquilizer.

19 comments:

shaya g said...

I have found the fastest way to get me to fall asleep - and i'm talking seconds here (don't worry, I'll keep it clean) is....

shower and get ready for bed, crawl in and take a breath, and then...have my wife start telling me about her day. BAM, out like a light! :)

therapydoc said...

I'm thinking stand-up, Shaya, seriously.

Tigermom said...

Thank you for that post!

Holly Schwendiman said...

I'm all for the natural tranquilizer myself. *snicker*

Hugs,
Holly

Chana said...

You're famous!!

You're linked from CNN.com!

Woohoo!!

Psychomom said...

Hello,
I found your blog today through the article "Your blog can be group therapy" on CNN. I liked your advice on sleeping pills and I'm looking forward to reading the archives.

Clara

therapydoc said...

Thanks all. I think my pulse is up to 62 now.

Barfly said...

Didn't you once say in this blog that sleep is overrated?

Anonymous said...

It's not going to work, cat napping. Not everyone can wake up from a cat nap.

Anonymous said...

It's very easy for you to say do all these things, but many people have night shifts and when you finish work it's like daytime. Not so simple to get to sleep when it's light outside.

therapydoc said...

ANON 1: Yeah, I know. I'm sorry for minimizing this topic. I knew I would be.

ANON 2: Ditto on the minimizing. Night shift does create a whole new set of issues. We'll have to talk about it.

therapydoc said...

BARFLY: Maybe. Maybe I said sleep is over-rated. That's because people generally freak out when they feel they haven't had enough.

It's a form of anticipatory anxiety.

Usually you can forget you haven't had enough and can get through the day on a lot less than you thought. It is a head thing, an attitude, and your teachers and parents, for whom it was convenient, you sleeping (keeps you quiet) have done a nice job hypnotizing you to think you need a square 8, for sure.

Six is nice. Delicious, for many of us, horribly unsatisfying for others.

People are different.

Midwife with a Knife said...

Great post. Although I will take some Ambien here and there for various reasons (not the least of which is that sleepless nights are miserable), there isn't good evidence that sleep aids actually improve the amount of sleep by very much (I remember a study about Lunesta, I think, increasing sleep by 15 minutes on average) and there's some fairly decent evidence that they do disrupt sleep architecture (thereby causing a problem with sleep quality). So, sleeping without meds is much better.

I find attempting to do something creative too stimulating to be good around bedtime, but definately good a few hours before. Exercise (not too close to bedtime) is a great insomnia fighter. I also recommend (at risk of sounding too new-agey, which I'm definately not) progressive muscle relaxation and directed imagery. It seldom fails for me.

therapydoc said...

MWAK, thanks. I completely forgot about the sleep structure thing. I think it interrupts REM sleep, too, never a good thing.

We need to dream.

benjamin said...

it's weird but I think brushing my teeth before bed makes it easier for me to fall asleep. That fluoride taste is like a little lullaby to my brain, telling it, "good night, little brain, it's time to go to sleep now."

Miriam L said...

I find crossword puzzles are a good just-before-bedtime relaxer. There's something both enjoyable and yet profoundly boring about them, for me.

SeaSpray said...
This comment has been removed by the author.
therapydoc said...

You know I can't answer these personal things. But I'll tell you one thing. Every lucid day. Every day that a person can use his or her intellect in one way or another, every stroke-free, Alzheimer's free day, is a good day.

Relatively.

Cognitive health is another way of saying, mental health.

lostonthefloor said...

Yes, the ubiquitous night shift is a problem and we do endure with the sleep disruptions related to it. I will use the occasional Ambien to help me flip over from a night schedule to a day schedule (in the case of multiple days off). Only problem I ever have is the munchies.