Insomnia Medications and My Experience

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Sleep is essential for our health and well-being, but many people struggle with falling asleep or staying asleep at night. Insomnia, or the inability to sleep well, can affect our mood, energy, concentration, and overall quality of life. Fortunately, there are various medications that can help people with insomnia get some rest. However, these medications are not without risks and side effects, and they should be used with caution and under the guidance of a doctor. In this article, we will review some of the most commonly prescribed sleep aids, their benefits and drawbacks, and their sources.

There are different types of sleep aids that work in different ways to help people sleep. Some of the most common ones are:

• Antidepressants: These are medications that are mainly used to treat depression and anxiety, but some of them can also have sedative effects that can help with insomnia. Examples of antidepressants that can be used as sleep aids are doxepin (Silenor), trazodone (Desyrel), and mirtazapine (Remeron). Antidepressants can help people who have insomnia related to mood disorders or chronic pain. However, they can also cause side effects such as weight gain, dry mouth, drowsiness, and sexual dysfunction. Antidepressants can also interact with other medications and substances, so they should be taken with care 1 2.
• Benzodiazepines: These are medications that belong to a class of drugs called central nervous system (CNS) depressants. They work by enhancing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA), which reduces brain activity and induces relaxation and sleepiness. Examples of benzodiazepines that can be used as sleep aids are temazepam (Restoril), estazolam (Prosom), and triazolam (Halcion). Benzodiazepines can help people who have difficulty falling asleep or staying asleep, especially if they have anxiety or panic disorders. However, they can also cause side effects such as memory impairment, confusion, dizziness, and dependence. Benzodiazepines can also be addictive and cause withdrawal symptoms if stopped abruptly. Therefore, they are usually prescribed for short-term use only 1 2 3 4.
• Z-drugs: These are medications that are similar to benzodiazepines in their mechanism of action, but they have a different chemical structure. They also work by enhancing the activity of GABA in the brain, but they are more selective in targeting the receptors that are involved in sleep regulation. Examples of Z-drugs that can be used as sleep aids are zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta). Z-drugs can help people who have difficulty falling asleep or staying asleep, especially if they have insomnia that is not related to other conditions. However, they can also cause side effects such as headache, nausea, drowsiness, and complex behaviors such as sleepwalking or driving while asleep. Z-drugs can also be habit-forming and cause rebound insomnia if stopped suddenly. Therefore, they are also usually prescribed for short-term use only 1 2 3 5.
• Melatonin receptor agonists: These are medications that mimic the action of a hormone called melatonin, which is produced by the pineal gland in the brain and regulates the circadian rhythm or the body’s internal clock. Melatonin levels rise at night and fall during the day, signaling the body when to sleep and when to wake up. Examples of melatonin receptor agonists that can be used as sleep aids are ramelteon (Rozerem) and lemborexant (Dayvigo). Melatonin receptor agonists can help people who have difficulty falling asleep due to jet lag or shift work disorder. They can also help people who have insomnia related to aging or Alzheimer’s disease. However, they can also cause side effects such as headache, dizziness, fatigue, and nightmares. Melatonin receptor agonists do not seem to cause dependence or withdrawal symptoms, but they may interact with other medications and substances 1 2.
• Orexin receptor antagonists: These are medications that block the action of a neurotransmitter called orexin, which is involved in regulating wakefulness and arousal. Orexin levels are high during the day and low at night, keeping us alert and active during the day and sleepy at night. Examples of orexin receptor antagonists that can be used as sleep aids are suvorexant (Belsomra) and daridorexant (Quviviq). Orexin receptor antagonists can help people who have difficulty staying asleep due to frequent awakenings or early morning awakenings. They can also help people who have insomnia related to narcolepsy or other sleep disorders. However, they can also cause side effects such as headache, drowsiness, abnormal dreams, and sleep paralysis. Orexin receptor antagonists may cause dependence or withdrawal symptoms, but they are less likely to cause rebound insomnia than other sleep aids 1 2.

Sleep aids are not the only solution for insomnia. In fact, they are often not the best solution for long-term insomnia. Sleep aids can mask the underlying causes of insomnia and may lose their effectiveness over time. They can also cause side effects and dependence that can worsen the quality of sleep and health. Therefore, sleep aids should be used as a last resort and only under the supervision of a doctor.

There are other treatments that can help people with insomnia improve their sleep quality and quantity. Some of them are:

• Cognitive behavioral therapy for insomnia (CBT-I): This is a type of psychotherapy that aims to change the thoughts and behaviors that interfere with sleep. CBT-I involves various components such as stimulus control, sleep restriction, relaxation training, cognitive restructuring, and sleep hygiene education. CBT-I can help people identify and modify the factors that contribute to their insomnia and develop healthy habits that promote good sleep. CBT-I has been shown to be effective and durable in treating chronic insomnia 1 2.
• Lifestyle changes: There are many things that people can do to improve their sleep quality and quantity without using medications. Some of them are:
  
  • Maintaining a regular sleep schedule: Going to bed and waking up at the same time every day can help the body establish a consistent circadian rhythm and facilitate falling asleep and staying asleep.
  • Avoiding caffeine, alcohol, nicotine, and other stimulants: These substances can interfere with the production and action of melatonin and orexin in the brain and disrupt the sleep-wake cycle.
  • Avoiding naps during the day: Napping can reduce the sleep pressure at night and make it harder to fall asleep or stay asleep.
  • Exercising regularly: Physical activity can enhance blood circulation and oxygen delivery to the brain, which can support neurogenesis and synaptic plasticity. Exercise can also reduce inflammation and oxidative stress in the brain, which can protect against neuronal damage and degeneration. Exercise can also release endorphins and other neurotransmitters that can improve mood, energy, and well-being.
  • Creating a comfortable and relaxing sleep environment: Making sure that the bedroom is dark, quiet, cool, and comfortable can help reduce external distractions and promote relaxation and sleepiness.
  • Practicing relaxation techniques: Engaging in activities that calm the mind and body before bed can help reduce stress, anxiety, and arousal that can interfere with sleep. Examples of relaxation techniques are meditation, breathing exercises, yoga, progressive muscle relaxation, and guided imagery.

Sleep is vital for our health and well-being, but many people suffer from insomnia or poor sleep quality. There are various medications that can help people with insomnia get some rest, but they are not without risks and side effects. Therefore, they should be used with caution and under the guidance of a doctor. There are also other treatments that can help people with insomnia improve their sleep quality and quantity without using medications. These include cognitive behavioral therapy for insomnia and lifestyle changes that promote good sleep hygiene. By choosing the best treatment for their needs and preferences