Sleeping Pills made me keyed up and anxious (antidepressants, hyper, Benadryl)

[Campaign]

Unfortunately all sleeping pills have one common problem. They are ALL addictive.

Even if they are not prescription medication which are often physically addictive, they are all psychologically habit-forming.

I recommend using a system for taking any sleeping pills that stops them becoming addictive in the first place, no matter what the pill.

It's safer, and stops you lining the drug companies pockets :-)

[groove1]

I actually don't find the melatonin addictive or habit forming. Usually when I take it, it seems to get my melatonin levels up so I don't have to take it again for a while.

[Chris M]

Hello, I find that diphenhydramine works well. Within an hour or so, it puts me to sleep. I buy mine at Walmart or Target for $4.00 for 32 liquid filled soft gels. These are strictly diphenhydramine soft gels. I would purchase these rather than Tylenol pm if you take them regularly.

[GreenMachine]

Originally Posted by Campaign

Unfortunately all sleeping pills have one common problem. They are ALL addictive.

Not true. Some are, some aren't...

[Mattie Jo]

Chris, it is true that things like Benadryl work, if that is what you are referring to. I hate the stuff though. I feel lousy the next day even though I cut the dosage down, which helps by the way. And they are so drying to the system.

[GLS]

Insomnia is NOT a disease state. It is a SYMPTOM of an underlying problem, which may or may not be a disease. In selecting an appropriate treatment, which should be both efficacious and safe, the primary determinant is accuracy of diagnosis. For example, you would not automatically use an antibiotic to treat a fever. A fever is the symptom, but the underlying problem may or may not be an infection. If the fever is caused by something other than an infection, then the antibiotic will be both ineffective AND subject you to unnecessary side effects. Similarly, choosing "sleeping pills" without taking the time to establish a working diagnosis is "trial and error". This gets you a mix of anecdotal testimonial "success" (which doesn't apply to other people), possible exacerbation of the real underlying cause, and an increased risk of side effects which may include paradoxical reactions.

The advice to seek a sleep study is valid because it underscores the above point in establishing a diagnosis. For example, it is essential to rule out the cause of your insomnia being sleep apnea. Simply put, people with sleep apnea stop breathing during the sleep process, sometimes for a minute at a time. Usually a drop in oxygen jolts the person awake. This process may repeat itself multiple times during the night. The next day the person is tired and the lay interpretation is "I'm having trouble sleeping. Maybe I should take a sleeping pill." At this point let's return to the prescribing guideline that a sleeping pill (or any medication) should be both effective and safe.

Sleep apnea is usually classified into one of three types: obstructive, central, and mixed. Obstructive (the most common) is caused by a blockage of the airway by soft tissue at the back of the throat. The point is that you can see that a "sleeping pill" is an inappropriate and ineffective treatment for a problem that is a physical blockage. In the "central" type of sleep apnea the brain fails to signal the muscles to breathe. This illustrates the safety risk. Many sleeping medications, i.e. benzodiazepines are central nervous system depressants. These blunt brain function and further add to the cause of the insomnia if it is "central" sleep apnea". Remember that sleep apnea can be fatal, and the use of sedative/hynotics adds to the risk of death by further compromising brain function.

[Wisteria]

Jessaka: ....it is true that things like Benadryl work, if that is what you are referring to. I hate the stuff though. I feel lousy the next day even though I cut the dosage down, which helps by the way. And they are so drying to the system.

But things like Benadryl won't work for people like me and others who get hyped up from antihistamines. An antihistamine effect is what is in antidepressants -- and they can make someone feel like they are on speed -- but if they are truly depressed, I guess they get them revved up enough that it feels okay for them.

Most of my immediate family has an adverse reaction to antihistamines -- we do not get sleepy at all -- in fact, we'll be up for days with them! That's why I don't take them, even for colds -- I never sleep on them. It really depends on the body type, and that is not what drug manufacturers do. They just take the general "average" person, and design for them. But there is another portion of the population that has those paradoxical effects, and we get the opposite reaction to medications prescribed for a particular thing -- we don't get sleepy on those "sleep" medications!

If there's anyone out there who also has paradoxical effects and has found something that works for sleep, please share. Thanks!

[GLS]

I ran out of room on the above post and it's the first time that happened to me. Sorry. I'll skip over much of the detail, with the caveat that none of this post is intended to substitute for a good discussion with your physician or pharmacist. However, I am driven to share some of this because reading the posts illustrates that most of you have skipped the health care discussion and gone immediately to some creative and dangerous self-medication.

Although sleep studies are important for people with chronic insomnia, they are expensive and inconvenient, and we know most people aren't going to do this. If you are dragging your feet, at least start a sleep diary. Do you have trouble falling asleep, or do you fall asleep easily , wake up , then have trouble falling asleep again? Record how many hours of sleep you get a night. Do you sleep in the day? The data over a period of a few weeks will help you and your physician determine a pattern, which provides clues to pursue an accurate diagnosis.

It also will empower you to implement non-pharmacological interventions that focus on good sleep hygiene. For example, can you cut your caffeine or alcohol intake? Is your bedroom temperature too hot or too cold? Can you reduce noise levels in your sleeping environment? Do you refrain from eating or exercising one to two hours before retiring? Improving "sleep hygiene" is within your control, inexpensive, and has no risk of drug side effects. For example, the cause of your insomnia MAY be another medication you take on a daily basis. Examples include: pseudoephedrine, bronchodilators, antidepressants, thyroid medication, and MANY others. The point is, do you really want to treat "insomnia" by adding a second drug (a sleeping pill), when the solution may be as simple as adjusting the dose or time of administration of the first drug? For example, if you are taking thyroid medications and your TSH is too low, the physician may decide to lower your thyroid dose and the insomnia may resolve. Also, for those posts advocating benzodiazepines such as clonazepam (Klonopin) and diazepam (Valium), when the body develops tolerance to them, or you cut the dose abruptly, they may be the CAUSE of your insomnia. This is one reason physicians are hesitant to prescribe them for long periods. It becomes hard to tell if the drug is still effective or if it is part of the problem. Oh no. Out of space again.....

[GLS]

Here are some final thoughts, with apologies to oversimplification.

1. You are not alone and it IS important to treat insomnia. Approximately one-third of adults report trouble sleeping and approximately one in ten report chronic sleep difficulties. The consequences of untreated insomnia include memory difficulties, concentration problems, psychomotor impairment, degraded mood, daytime drowsiness, problems with relationships, increased potential for accidents, poor work performance, etc, etc.

2. Treatment without an effort towards determining cause is inadvisable.
The efficiacy and safety of the treatment will only be as good as the
accuracy of the diagnosis.

3. When a physician does initiate treatment with a drug, the lowest
effective dose is recommended. I worry about all the posts on this
thread and no one has specified a dose. The risk of side effects
increases with dose, and if you are unlucky enough to have a
paradoxical reaction, the SEVERITY of side effects increases with higher
doses. When you are "nibbling" on medications prescribed for a friend or
relative, they may have already safely reacted to Ambien 5mg before
they were advanced to Ambien 10mg. Taking a half tablet may have
been a higher dose than your physician would have started you on.
Drugs such as Restoril come in multiple strengths such as 7.5mg, 15mg &
30mg. Starting with the highest dose, especially in the elderly can be
dangerous.

4. Most sedative/hypnotics are safe in low doses, used intermittently, for
limited periods of time. IF you insist on self-medicating, one guideline is
to not use any sleeping aid for longer than seven to ten days. Tolerance
develops quickly. The Center for Medicare & Medicaid Services uses a
10 day duration for sedatives as a guideline for Nursing home patients
in the pharmacists' monthly medication review. Risk of side effects
increases at this point.

4. "Sleeping pills" cause side effects that may be worse than the insomnia.
Benzodiazepines increase fall risk and injuries such as hip fractures. Less
dramatic , but equally important in some patient populations is the
"drying" side effect mentioned in one post. Antihistamine use can lead to
constipation and in rare cases bowel perforation.

5. If "sleeping pills" are the ONLY medication you are taking you can skip
this point. However, demographics suggest that most people take multiple
medications. What drug interactions are occurring when your sleeping pill
is added to your arthritis medication? congestive heart drug?
antihypertensive?antidepressant or other psychoactive medication?
Are you on clonidine of atomoxetine for adult ADHD? Not only may these
be causing your insomnia, but the sleeping sedative may counteract the
primary medication, making your ADHD worse, which further interferes
with your sleep cycle, and now you are "roller-coastering" between
multiple medications.

6. An informative discourse on herbal remedies is beyond this post.
However, herbal remedies are not regulated as "drugs" by the FDA.
As such, they are not subjected to the same quality assurance
standards or "good manufacturing practices" as medications. Although
they may contain an active ingredient, the AMOUNT may vary from
brand to brand and even batch to batch. Also, other impurities can be
contained that have pharmacological action. Without over-generalizing,
the clinical response and potential side effects many herbal remedies
are UNPREDICTABLE. Obviously this is unacceptable in treating
insomnia since discovering the cause depends upon predictability of
sleep patterns and the response to specific treatments.

As a caveat, let me emphasize that I am NOT anti-herbal remedy. I AM
against uncontrolled, indiscriminate, self-medication with herbs. To
illustrate, consider one of the herbs mentioned in a post: Kava Kava.
Please supplement you knowledge by reviewing the National Institutes
of Health website. There are numerous cases of Kava causing liver
damage, and Kava has been implicated in lawsuits where unsupervised
use has led to death.



Sorry. I'm running out of room again. Exit stage left. I hope this post helps those of you seeking information on the subject. I have given you a very abbreviated overview that I hope will be a catalyst for further discussion with your physician or pharmacist. The subject is much more complex than any of the posts indicate, and your health is much too important to risk by self-medicating without an expanded knowledge base.


PS: If you awoken by noise on your roof tonight, don't take a sleeping pill. Smile and try to gently drift back to sleep. It's just Santa. Merry Christmas.

[groove1]

Originally Posted by jessaka

Chris, it is true that things like Benadryl work, if that is what you are referring to. I hate the stuff though. I feel lousy the next day even though I cut the dosage down, which helps by the way. And they are so drying to the system.

Problem with dipenhydramine is that it doesn't give you the sleep you need to feel rested, the REM or "Rapid Eye Movement" sleep.