There are a variety of reasons why we might have trouble sleeping. It might be a recent issue such as a trip where you travelled across different time zones. Or it might be related to a work project or personal issue that’s causing you stress. In these scenarios, poor sleep is temporary and may resolve on its own relatively quickly. Poor sleep becomes a bigger problem if it has been at least 3 months of poor sleep (occurring at least 3 nights a week) that also affects your daytime activities and ability to function. This is called insomnia which is a medical condition that could also affect your physical and mental health.
Finding out the cause
It’s important to find out what might be causing poor sleep. Your doctor can help determine if your insomnia is related to another medical condition such as sleep apnea, pain, restless leg syndrome, issues with your bladder or urinating, depression or anxiety. By treating the underlying medical condition, the symptoms of insomnia often resolve as well.
Insomnia may also be caused by certain medications and having your pharmacist review your medications would be helpful. There are a number of over-the-counter products that might interfere with sleep such as decongestants (eg. Sudafed) and medications containing caffeine (eg. Tylenol Migraine). Prescription medications can also affect sleep especially if taken at the wrong time of day and some examples include stimulants (medications for ADHD) and antidepressants. Your pharmacist can help identify these medications and recommend potential solutions.
Sleep aids
There are many sleep aids on the market that include both prescription, over-the-counter, and natural/herbal options.
Melatonin – Your body normally makes melatonin to help regulate your sleep. Taking melatonin as a herbal supplement provides an extra “boost” of melatonin at night. Most of the evidence for it’s benefits are for jet lag. In these cases a dose of 1-3 mg is usually taken at bedtime until your body becomes accustomed to the new time. For sleep higher doses around 3mg are used to try and cause drowsiness.
Tryptophan – Ever heard of the myth around Thanksgiving that eating Turkey makes you sleepy? That’s because turkey contains tryptophan which is considered a “hypnotic” meaning that it works on the brain to make you fall asleep. Although turkey does not have enough tryptophan to actually cause this, a natural supplement with high amounts of tryptophan can make you feel sleepy. The evidence for this is mixed meaning it might work for some people while it may not work for others.
Diphenhydramine-based products (eg. Sleep-eze) – Many over-the-counter products marketed for sleep contain diphenhydramine which is the same ingredient in Benadryl that is used for allergies. Benadryl as a side-effect often causes drowsiness so these over-the-counter sleep aids take advantage of Benadryl’s side-effect profile along with some cleaver marketing. We often do not recommend these products as a sleep aid since they may also cause daytime grogginess.
Prescription sleep aids – There are a number of sleep aids available by prescription and speaking about each individual one is beyond the scope of this blog. The bottom line with these medications is that although these are more effective than over-the -counter and herbal remedies, there are also risks of using these such as addiction, dependency and side-effect.
Other than medications, there are also other strategies that you can do to improve sleep. Here are some rules to getting a better night’s rest.
Sleep rules:
- Set a consistent sleep schedule. That means waking up at the same time every day and going to bed at the same time every night. We need to learn from the best sleepers…babies. That’s because they have consistent schedules that sets their internal body clock.
- No napping. Period. This can really throw off your body’s schedule. Many people think that naps are good to help “catch up” on sleep that they missed the night before. In fact, this works against getting a good night rest and can aggravate the problem.
- Bedroom = sleep. This means no watching TV, working on your computer, or using tablets/phones. Not only does the light emitted from these electronic devices affect your ability to sleep but it can also create negative associations for sleep.
- Avoid caffeine and alcohol. Or at least try to minimize these and try not to have any caffeine or alcohol within 4 hours of your bed time. Although alcohol can make you sleepy, it tends to disrupt your sleep later in the evening
- Exercise. Physical activity for at least 30 minutes on a regular basis will help build up your ability
- Consider quitting smoking. Or at least reducing cigarette intake.
If you’re interested in reviewing your medications to see if any of them are affecting your sleep then speak to us today and we’re more than happy to help.
Want to learn more and see how we can help? Whether it’s reviewing your medications or answering your questions about sleep aids, visit us today!
References:
Insomnia. Canadian Sleep Society https://css-scs.ca/resources/brochures/insomnia (Accessed Dec 7, 2018)
Holbrook, AM et al. The diagnosis and management of insomnia in clinical practice: a practical evidence-based approach. CMAJ 2000; 162(2): 216-220.