Banner Health McKee Medical Center

SPR 2017

Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.

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19 medication only occasionally and for a short period of time. But there's no one size fits all when it comes to sleeping aids. "Some sleep medication helps you fall asleep, and others work on both falling asleep and staying asleep," says Dr. Raskin. Rather than heading straight to an over-the-counter remedy, choosing the best medication should involve a conversation with your primary care physician and maybe even a sleep specialist to discuss your symptoms. He or she can help rule out an underlying medical condition, such as sleep apnea, a common yet serious sleep disorder that causes you to stop breathing momentarily during sleep, says Dr. Raskin. At the doctor's visit, you'll need to describe your specific problem. It is falling asleep or staying asleep? Is it early morning awakening? Is it that you think you slept, but you wake up feeling exhausted? If falling asleep is the issue, your healthcare provider may recommend melatonin, a natural hormone made by your pineal gland to induce sleepiness (usually around 9 p.m.), and sold as an over-the-counter supplement. If you have trouble staying asleep, the remedy may be doxylamine succinate (Unisom) or diphenhydramine (Benadryl), which works by blocking histamine, a brain neurotransmitter, to help you fall asleep and stay asleep. Sleep Rx Prescription medication can also be helpful, such as zolpidem (Ambien) and eszopiclone (Lunesta), which induce sleep by causing the brain to release more gamma-aminobutyric acid (GABA), a sleep-inducing chemical. However, both drugs have the potential to impair memory and lead to dementia with long-term use, says Dr. Raskin. Sleep tweaks Another prescription medication, doxepin (Silenor), has no addiction potential. Like non-prescription diphenhydramine, it works on the brain's histamine receptors to help you stay asleep. A newer prescription sleep aid, suvorexant (Belsomra), works by blocking orexin, a brain chemical that causes alertness. "It turns off the brain's alertness signals and may be effective for people who say they can't fall asleep because their brain is so activated," says Dr. Raskin. Be aware that any sleep medication has side effects and may even cause rebound insomnia: When you stop the drug, the insomnia can be worse than when you started. Overall, Dr. Raskin recommends using sleep medication for as short a time as possible, as advised by your health care provider. "I try to find the right drug for the right patients, if they need drugs at all," says Dr. Raskin. S Before heading to the doctor about your sleep problem, do a little homework, say the experts. "Analyze your life, your priorities and your schedule," says Terry Cralle, RN, co-author of "Sleeping Your Way to the Top: How to Get the Sleep You Need to Succeed" (Sterling, 2016). "There could be some simple natural fixes that will help with your sleep and avoid the need for medication." Try these strategies to help say goodnight to insomnia: • Darken your bedroom. Light is alerting. Invest in room-darkening shades that block moonlight and early morning sun. If you get up during the night, use a nightlight to find the way rather than turning on a bright light. • Wear yourself out. "Exercise is incredibly helpful for sleep," Cralle says. It helps you fall asleep faster and stay asleep longer. If you can't get to the gym, take a 10-minute walk at lunch or opt for the stairs instead of the elevator. • Cut back on caffeine. A stimulant like caffeine is a sleep stealer. If sleep is a problem, try avoiding caffeine after lunch. "I have patients who do 4:30 p.m. Starbucks runs, and they wonder why they can't sleep," Cralle says. • Power down. The light from your computer and smartphone can interfere with your brain's melatonin production. At least an hour before bed, turn off your devices. "Do something relaxing that doesn't require an electronic," Cralle says, such as taking a bath, having a cup of chamomile tea or coloring in an adult coloring book. "It's all about putting sleep first and making it a priority." Why sleep matters Sleep is the ultimate fatigue fighter— and it's also the cornerstone of your health and wellbeing. "Sleep is as important as eating right and exercising regularly," says Dr. Damon Raskin, a sleep medicine specialist affiliated with Concierge Choice Physicians in Pacific Palisades, Calif. Regularly missing out on nightly rest, in fact, can increase your risk of chronic conditions such as high blood pressure, obesity, diabetes and even cancer, according to the Centers for Disease Control and Prevention. "A lack of sleep can also worsen the pain of arthritis and fibromyalgia," says Dr. Raskin, and put you at increased risk for anxiety and depression.

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