March 14, 2013

Ditching the Sleeping Pills: Not Easy But Worth It

As I reported yesterday, using sleeping pills -- prescribed or OTC -- for more than a week or two is a bad idea, and a hard habit to stop.

I know from my own experience. But overcoming this addiction has enhanced my well-being almost as much as my getting rid of  nicotine and alcohol.

Eliminating Sleep Aids
I recounted my history with insomnia and sleeping pills yesterday. I'll just add a few details today, the final chapter in the story.


I was a long-time occasional user of Tylenol PM, but I began using it almost daily on my many trips to Nepal from 2001 to 2009. I also got a prescription for Ambien to use on jet lag days. Since the effectiveness of Tylenol PM began to lessen, I'd add half an Ambien.

On my May 2006 trip to Nepal, I used Tylenol PM every night and often added the Ambien kicker. I continued the pattern when I got home, as "jet lag therapy." By the end of that week, I was hit with anxiety attacks, depression and continued insomnia. I stopped using the Tylenol PM and Ambien, since I felt they were causing the craziness.

Thus began what I dubbed "The Summer from Hell." I sought help from several doctors and sleep professionals. I told them I was sure my problems stemmed from abusing sleeping pills. They reacted by getting out their pads and prescribing yet MORE meds.

Over the course of that summer, I was prescribed trazodone, Remeron, Lunesta, Rozerem, Lexapro, and clonazepam. None of them worked, and most made a bad situation worse. Finally, my pill shrink said it was time to scrap the pills. Instead, he suggested I seek a holistic approach.

I tried hypnosis. I even went to NYC where a doctor created a personalized sleep music CD from my brain waves! Actually that CD helped a little... certainly more than the pills.

The real breakthrough came when I stumbled upon a book (no longer in print) that touted meditation-like exercises to deal with insomnia. One that involved a "secret handshake" actually began to help. Something else, too, seemed to help me: a minimal bedtime dose of the OTC supplement 5-HTP, a serotonin booster.

By the end of the year, I was falling asleep easily. When I awoke in the middle of the night, I'd use the "secret handshake" meditation, and go back to sleep. That pattern continues to work for me, and is even enhanced by having two sleeps, before and after my 4am "joy of quiet" hour. (See Monday's post.)

That's my story. Here's some good advice I found in the December 2012 issue of the Harvard Health Letter.

How To Discontinue Sleeping Pills
If you've been taking sleep meds for a long time and you're not sleeping well, Dr. Lawrence Epstein of the Harvard Medical School says it's time to seek other treatments.

He is not a fan of supplements like the hormone melatonin or the herb valerian root. He says there is little evidence they help. (He doesn't say anything about my 5-HTP.)  He does recommend  behavior therapies with the help of a sleep specialist or a psychologist, such as:
  • Sleep restriction, a method of actually cutting down the amount of time in bed to create more consolidated sleep.
  • Stimulus control, improving sleep hygiene by looking at your sleep habits and environment. (This might have saved me years of insomnia if I'd realized I needed bedroom blackout curtains to shut out the light from the street lamp.)
  • Cognitive therapy, which teaches you to adjust your thoughts or anxiety about sleep. (In my case, revising my thoughts about needing a "solid seven hours" of sleep and accepting as natural my two sleeps, before and after my 4am "joy of quiet" hour.
Sometimes it works to combine sleep therapy and gradual reduction in meds. Epstein advises working with your doctor and watching for withdrawal symptoms.

Most of all, he adds, be patient. "Insomnia and chronic sleep problems can be fixed."

And I say: Amen to that.

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