Sleepy in Seattle: Sleep Aids from Behavioral Therapy to Rozerem
Last time, I wrote about the causes of sleep deprivation, which so many of us go through during cancer treatment, and sometimes for years afterwards. Worry, a distressed body, age, menopause, all contribute to sleeplessness. Surprisingly, many women don’t report sleep issues to their doctors; apparently figuring it’s just “part of the deal” of cancer treatment and aging, they choose to suffer silently.
Maybe that’s not such a smart choice. Many large hospitals have sleep centers that deal specifically with sleeplessness, inefficient sleep, and other night-time issues key to our bodies’ health. Sleep, when the muscles rest and the brain “reboots,” is every bit as important as food and water. Deprive a person of sleep, and she’ll soon exhibit mental deterioration, to say nothing of a compromised immune system and a host of other problems.
Bottom line: you may be able to get along on very little sleep, but “getting along” isn’t nearly as healthy as a good, solid six hours or so of shut-eye.
What should you do, if you can’t fall asleep (insomnia), or sleep and wake in quick cycles all night long? First, tell your doctor. He or she most likely has dealt with this issue before, and knows some protocols to try. There are two basic paths leading to more restful sleep: behavioral and cognitive therapy, and drugs.
Behavioral and Cognitive Sleep Therapies:
A recent report in the Journal of the American Medical Association indicated that six weeks of behavioral therapy–learning new pre-bedtime routines designed to invite sleep back into your life–is more effective than a prescription sleep aid. Behavioral therapy can include such things as changing your daytime activities, and/or your evening schedule, to better prepare you for sleep.
Cognitive therapy involves talking yourself out of the fact that bedtime automatically means insomnia. A negative attitude, developed after many nights of sleep challenges, can be turned positive, with some education and work. In addition, complementary therapies such as relaxation techniques, Reiki, meditation, yoga, and exercise all promote a better night of sleep. If your health care center has an area specializing in sleep problems, ask to be referred. It may take several months to rework your habits, but you’ll probably find some relief.
Prescription drugs are often prescribed for short-term sleep issues, in hopes the body will revert back to its usual healthy sleep pattern, given some relief from constant wakefulness. I have a friend who swears by Tylenol PM for her occasional insomnia, but there are other, stronger drugs available if you need them.
In the past, doctors routinely described a class of drugs called benzodiazepines, which included Halcion® and Ativan®, However, since these drugs can be habit-forming, they were only available short-term. Newer drugs, with less risk of creating dependence, include Ambien, Sonata®, and Lunesta ®. Each works slightly differently: Ambien is best for those who awaken early in the night; Sonata for those who can’t fall asleep, and Lunesta is an all-purpose sleep aid.
None of these drugs promotes REM (rapid eye movement) sleep, which is critical; thus, even though you’re asleep longer, you may not feel fully rested.
A new drug on the market, approved in the summer of 2005, is Rozerem®, which works completely differently than any previous sleep aids. Unlike older drugs, which bond to a particular sleep-inducing neurotransmitter in the brain and enhance its effects, Rozerem acts like melatonin, the hormone that tells your body it’s time to go to bed. It’s thought to be a more “natural,” and thus more effective path to a good night’s sleep. While it takes a few months to work up to its optimum effectiveness, it’s not habit-forming, making it a good choice for anyone with long-term sleep problems.
Next time: A clinical study puts me back on the road to sound sleep.