Patients come to me frequently with this question: "Do you have a pill that will let me sleep through the night, lose weight, get rid of my stress and depression and not have side effects?"
No, I don't have that pill, but something better - a way for you to accomplish these goals and create your own personal health insurance no one can take away from you. But before I tell you about that here's some secrets about sleeping pills, especially prescription ones:
1. Can I get addicted to them? Yes - in two major ways - behaviorally and physically. Ugly movie style drug withdrawals are rare, but the behavioral conditioning of Pill=Sleep affects tens of millions, habituated to the belief that I need a pill to sleep. One Detroit study gave people hooked an average of ten years the choice of blue or orange sleeping pills - the pill they were on, or placebo. The result - they took equal amounts of the old pill and placebo, since what mattered to the brain was getting that pill, even if nothing was inside.
2. Do they work? Yes, though not for as long as many think. Sleeping pills are particularly good at knocking out people so they don't wait around for sleep. The sleep they produce is different from natural sleep, with varying amounts of deep sleep and REM.
3. How long does it take to become addicted? Physically it can take months of high doses of standard sleeping pills, the valium like drugs called benzodiazepines. Behaviorally, people can get hooked in days to weeks - but also unhooked very quickly.
4. Can they kill you? If you're driving, using machinery, have any tendency to falls or suicide attempts, you bet. Several large scale population studies correlate sleeping pill use with higher death rates, especially in the elderly, and a recent Canadian Journal of Psychiatry paper declared sleeping pill and anti-anxiety pill users increased the overall death rate 36% - but the reasons may have to do with why those people were taking the pills.
5. Do over-the-counter pills work? Somewhat, for short periods of time. Melatonin, antihistamines like Benadryl, and ancient drugs like valerian all have fans. However, they usually only work for a few days and can have mean side effects.
6. Why do people want sleeping pills so much? Because they don't see rest as regeneration and have cut off so much bed time that they have to get sleep fast, every night. Sleeping pills promise the quick fix we crave. However, lots of folks on pills wake in the middle of the night, especially with newer pills like ambien (zolpidem,) which use their short action as a marketing pitch - nonsense if you wake early and can't sleep through the night. Details like bizarre sleepwalking and sleep eating generated by these drugs sometimes get left out of promotional materials.
7. Are there good reasons to use sleeping pills? Absolutely, particularly in times of stress, like the death of a spouse or a cancer diagnosis, when trying to first treat mental illness or insomnia, or when willfully ignoring biological clocks, as in shift work and jet lag.
So How Do I Get Sleep Without Sleeping Pills?
Recognize three things - that sleeping pills often work through conditioning, which you can do well without pills; that what you do during the day strongly impacts what happens to you during the night; and that your body is built to rest in very effective, very particular ways.
Point 1 - Conditioning - you have to calm down and rest before you sleep, and the simple acts of flossing and brushing your teeth, putting out your clothes for the next day, reading a book you should have read in high school (or as some patients tell me, one of my books) and hiding the clock can make everything work.
Point 2 - Use your body the way it's built. To get your own private health insurance, go FAR - set a pattern of Food, followed by Activity and then Rest, throughout the day. Going FAR may quickly and without seeming effort get you to sleep well, lose weight, look younger and gain more peak experiences, simply by using a cycle that fits the way your body's built.
Point 3 - Rest is regeneration, biologically opposite to the laziness people ascribe to rest. Resting right, which means using active rest techniques, can increase your chances of a long, healthy life. If you essentially get a new heart in three days, you want to use that power of rest for yourself.
So try to sleep naturally - letting rest do what it does so well, improve your mood and memory, prevent heart disease and stroke, reset your immune system, and give you a renewed, rewired brain come morning. Most Americans no longer know what it's like to feel awake, alert, and aware. It's time to really wake up - and enjoy.