Thursday night was a rough night!
I crawled between the bed covers looking forward to drifting off to sleep to the sound of rain. Sleep was close, but then sirens were blaring. And then more sirens. Now that I was wide awake, I checked the local news—a stolen car had crashed and been set on fire not far from my front door.
Ok, I thought, no flooding, no evacuations, back to sleep.
As I felt my body drifting toward dreams, I heard a crash, a bang, and a whole lot of swearing. I didn’t bother to get out of bed again but found out the next day that a car slid off the road and into a tree in front of where I live. I put the pillow over my head but my brain was racing and would not cooperate with plan.
Since I was born I have loved to sleep. I was one of those children who actually looked forward to bedtime, and that trait continued well in to adulthood. For me, sleep is the reset button. No matter how bad the day, slipping into slumber shuts out the “noise” and clears the system for the new day.
Lately, though, sleep has been elusive. Politics and weather are probably the main culprits.
My friend suggested I take an over the counter (OTC) sleep aid such as Tylenol PM. I am not a fan of those kinds of medications because, on the rare occasion when I have, I sleep strangely and move through the next day feeling very disconnected to my body.
I actually prefer feeling sleep deprived, rather than drugged. But I decided I’d look into the options and was very surprised by what I found. In spite of all the reassurances from the commercials, OTC sleep medication seems to be addictive, and abuse is on the rise.
The type of sleep aids that you can buy in the store without a prescription include Advil PM, Nytol, Sominex, Tylenol PM, and Unisom. The problem with these medications is that they should only be used short term, two weeks tops. Unsurprisingly, people use them much longer than that, increasing the dosage when they become less effective.
Most OTC sleep aids use antihistamines to cause drowsiness. Antihistamines are what we take for allergies; they block the histamines that your body produces in response to pollen, for example. The main side effect of antihistamines is drowsiness, so drug companies figured they’d harness the power of that side effect and offer up a way to help people sleep.
There are several problems with taking OTC sleep aids. The scariest is drug and alcohol interactions. If you drink alcohol and then take high doses of antihistamines you can sedate yourself to the point of not being able to wake up. Accidental death from OTC sleeping pills is not uncommon when combined with other substances, such as alcohol and recreational drugs.
If you take medication everyday for an on going medical condition, talk to your doctor about your sleep issues. Over the counter sleep aids may have a negative impact on your condition or an interaction with your medication that could cause illness or a worsening of symptoms.
Another problem with OTC sleep aids is, the more often you take them, the less well they work. Anyone who has taken antihistamines for allergies knows that you become less drowsy and better able to function after a week or so of using antihistamines. When used for sleep, people typically have to increase their dose over time to achieve the same effect.
If you are having a period of difficulty sleeping that lasts more than a night or two, you need to figure out the root cause rather than just medicate yourself to sleep.
When I worked for the Salt Lake City School district with families who were having a hard difficulty getting their children to school on time, I developed a sleep hygiene protocol. When parents actually used these guidelines on a regular basis, everyone in the family slept better.
- No electronic equipment in the bedroom, i.e. gaming, television, phones.
- Turn off all electronics at least 30 minutes (preferably 60 minutes) before going to bed. The way that your brain is stimulated by electronic information makes it very difficult to sleep.
- Exercise everyday but not within a few hours of going to bed.
- Get plenty of sunlight during the day.
- Create an atmosphere in your bedroom that is quiet, dark, and free of clutter.
- Daytime naps are an excellent way to make up for missed z’s at night but limit them to 30 minutes and don’t nap after 3 p.m.
- Avoid foods after lunch that have a stimulating effect, such as caffeine and chocolate.
- Avoid foods all together that might give you indigestion such as spicy dishes, citrus and carbonated drinks.
- Establish a regular bedtime routine (for example, turn off television, have a cup of herbal tea, and read a book for 30 minutes).
Create your personal routine, whatever it is that works for you, and then — stick to it!
As we age, we tend to sleep less soundly and for fewer uninterrupted hours. There are several reasons for this. A decrease in exercise, certain medications, pain or restlessness from chronic conditions and a change in our hormones that regulate sleep all have the potential to interfere with a solid eight hours of slumber. The sleep hygiene protocol can be helpful in older adults as well.
No solution is perfect. When I work with clients around issues of sleep I challenge them to start thinking about sleep in a different way. I know we all want a solid 6-8 hours every night but this might be unrealistic.
Perhaps looking at your sleeping and waking cycles a little differently might remove the angst that we often feel at not being able to fall asleep. I have written on this topic before: Uninterrupted Sleep Or Wee-Hour Awakenings?
If you take any kind of sleep medication, whether over the counter, prescription or herbal remedies, you know you are addicted if you:
- have tried to stop taking them but weren’t able to
- have doubled the dose and it’s still not working
- have been taking them longer than recommended (usually 2 weeks)
- crave sleeping meds
- combine them alcohol
If you think you have a problem, don’t discount that it is “only” OTC medication. It can still cause havoc with kidneys and liver function and there have been plenty of cases of “accidental” overdosing with OTCs.
Talk to your doctor, use the sleep hygiene techniques and start thinking about other lifestyle changes to support your sleep habits.