Have you ever wondered how would it feel to have a good night’s sleep? I think we are all deprived of good night sleep, waking up tired and exhausted. Sleep is a complex process and it has a direct impact on a variety of health conditions. Although there is no consensus of what constitutes enough sleep and individual needs will vary, the National Heart, Lung, and Blood Institute and the National Sleep Foundation have recommended that most adults get 7 to 8 hours of sleep a night. About 10-20% of the adult population suffers from insomnia and 60 million prescriptions are written each year for insomnia. Patients often approach pharmacists for questions and recommendations requests for OTC products to treat insomnia. As a pharmacist, it is our first recommendation to offer non-pharmacological interventions and behavior changes such as
regular sleep schedule
adjusting bedtime environment
avoiding alcohol and nicotine usage near bedtime,
caffeine usage afternoon
daytime naps
avoiding electronics usage in bed
There are few OTC products available to address insomnia and sleep irregularities; however, they are not meant to be used long term. Antihistamines, such as diphenhydramine (Benadryl) and doxylamine (Unisom) are available to help with insomnia by promoting sedation. Those products need to be used with caution and not in combination with other products that contain the same active ingredient. Also, patients need to be aware of their side effects such as sedation, decrease in cognitive function, and development of tolerance. Another OTC production is a naturally occurring hormone called Melatonin. This agent is not regulated by the FDA because it considers a dietary supplement. Melatonin helps insomnia by balancing the circadian rhythm and pretty benign. Another herbal product is Valerian which has been used centuries treating nervous system, stress, and sleep disorders. Valerian is generally very safe.
People who suffer from insomnia become very irritable and anxious throughout the day. Often they need medication to regulate their cycle, however there are times that we are able to help them by assessing their daily routines and offering them non-pharmacological advice.