Apr 1, 2014

By Sam Smith Pharmacy Student at the Dauphin Clinic Pharmacy

After a few restless nights and failed attempts at getting a good nights sleep, most people will turn to a health care professional for help. Your pharmacist can be that helpful person. Unfortunately, 1 in 3 people will experience insomnia at some point in their lives. Often insomnia coincides with impaired daily functioning such as feeling tired, sluggish, moody and lacking the ability to concentrate. Although insomnia is more common in the aging population as well as an increased incidence in females, insomnia can affect anyone. It can last anywhere from days, months to years.

Talking to your pharmacist can be the first step in improving your sleep. Certain drugs can make sleeping more difficult and fixing the problem may be as simple as moving the dose to bedtime. Some of these medications are prescription drugs such as antidepressents, blood pressure medications and steroids. However, over the counter medications can also affect sleep. For example many cough and cold medications contain stimulants that could be keeping you awake.

If we cannot find a drug that is causing insomnia, perhaps it is being caused by a medical condition that is not being optimally controlled. Your pharmacist can work with your doctor to make sure that you are taking all of the right medications and using them optimally to control your ailments.

Although pharmacists are the medication experts, the first thing we often recommend for insomnia is something called sleep hygiene which does not involve medications at all. Some of the most effective suggestions we make are to:

  • Avoid watching the clock and turn it away from you
  • Set consistent bedtimes and wake times even on weekends
  • And avoid daytime naps

Other things to avoid include:

  • Drinking large amounts of liquid before bedtime and avoiding caffeine and alcohol late in the day

Although exercising 30-40 minutes at least 4 times week can improve sleep, exercise should be avoided right before bed.

Even though watching TV and reading in bed can be appealing, it can also keep you awake so it may be a good idea to move all electronics out of the bedroom. The bed should be used only for sleep and intimacy.

There are also behavioral adjustments that can be made to improve sleep such as deep breathing techniques. Often people find it beneficial to use a sleep diary to keep track of the amount of sleep they are getting.

Although, sleep hygiene is effective in 75% of people, sometimes medications are needed.

Products such as SleepEEZ or Unisom can be purchased Over the counter and are commonly tried first. However, you should be aware that tolerance to these products can develop if used them for more than 3 consecutive nights. If you have been using them for more than two weeks it is recommended that you speak with your physician. Some people have certain conditions such as asthma or glaucoma and should not be taking these over the counter sleep aids. It is important to speak with your pharmacist or physician to make sure that they are okay for you to take and that they will not interact with any of your medications.

Some find the herbal supplement melatonin helpful for sleeping and a pharmacist would be happy to give you more information on it.

There are also prescription therapies available to treat insomnia. Most commonly people are given a benzodiapepine or zopiclone. It is important to remember that although effective, these medications can be habit forming and ideally should not be used for more than 3 nights per week. Commonly they are prescribed for a 2-4 week trial and then discontinued. Often when people stop using their sleep medications they will have a few days of troubled sleep until they adjust. It is important to continue using sleep hygiene techniques even when you are taking medications!

It is also important to remember that our goal is not to make you sleep for 8 hours a night. The goal is to reduce your difficulty falling asleep, increase your ability to stay asleep and to wake up feeling rested. Your pharmacist would be happy to help you with whatever questions or concerns you may have!

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Insomnia - Dauphin Clinic Pharmacy


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