Better Sleep Articles >> Good Sleep TipsOvercoming Roadblocks to SleepPOSTED: July 22, 2007 12:15 pm  Like a headache or fever, insomnia may be a symptom of another problem. It can result from something as simple as anticipating a stressful event, like a test or meeting, or from a longer-lasting stressful circumstance, such as a sick child or troubled marriage. Even worrying about having a tough time falling asleep may itself prevent a person from drifting off.
Other common causes of nighttime wakefulness include environmental disturbances, such as noise from traffic or television, an uncomfortable temperature, or light from the sun or other source; use of alcohol or stimulants, such as caffeine or nicotine; and erratic hours, like those of shift workers and people whose air travel takes them across time zones.
Sometimes short-term insomnia may go away on its own or with simple changes in daytime or sleep-time habits. (See "Wooing Sleep.") If these lifestyle changes don't work, the careful use of sleeping pills approved by the Food and Drug Administration may help provide temporary relief from insomnia.
A doctor can help choose an appropriate medicine. One factor to consider is the drug's half-life, or the time it takes to be cleared from the body. Drugs with shorter half-lives are less likely to have carry-over sedation that affects daytime functioning.
A second factor is the drug's toxicity. Because of their lower risk of overdose, the newer benzodiazepines and benzodiazepine-like drugs are used more often to treat insomnia than barbiturates and other older drugs. Among the most commonly prescribed benzodiazepine sleep-aids are flurazepam (Dalmane), estazolam (ProSom), quazepam (Doral), temazepam (Restoril), and triazolam (Halcion). The prescription sleep-aid zolpidem (Ambien) is in the imidazopyridine class of drugs.
As a rule, these sleeping pills should be used only for short periods because of the risk of developing dependency and withdrawal symptoms when the drugs are stopped. So, while they may help with short-term insomnia induced by jet lag, shift work schedule changes, or short-term stress, they should generally not be used for chronic insomnia because of their potential addictiveness and because they can mask underlying medical problems.
Some other sleep-aids are available without a prescription, including diphenhydramine (in Nytol, Sleep-Eze, and Sominex) and doxylamine (in Unisom Nighttime). These products contain a sedating antihistamine and, like prescription drugs, must be used with care. Even if taken at night, they can cause daytime drowsiness, which can make driving and other tasks risky.
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