Thursday, March 28, 2013

So, you can't sleep...

I fill and dispense Zolpidem (the generic for Ambien) by the truckload. We keep a 1,000 count bottle on our "fast mover" shelf. It is our top ten list of most-filled drugs. The generic is fairly inexpensive now and it is prescribed heavily. And while Zolpidem is the most popular, we do see a high number of other medications prescribed as sleep-inducing agents.

Unfortunately, Zolpidem is a controlled substance and has addictive properties. And based on the number of people that scream and shout when they're out of refills, I have no doubt that it is addictive. I have one female patient taking 20mg of Zolpidem (prescribed by HER doctor), and I suspect she's taking 10mg of HER HUSBAND's Zolpidem prescription and HER DOG's Tramadol, every single night. I've never seen someone go so panicky when one of the family is out of their medication.

Here's some recent articles which you may find interesting. Some of them obviously have the "duh, right" factor, but you'd be surprised how many people don't know the basics.

It’s important to develop healthy sleep habits and stick to them each night.

The National Sleep Foundation recommends these healthy sleep habits to help you wake up rested each morning:

* Establish a regular bedtime and wake-time schedule and follow it every day, even on weekends.

* Create a consistent and relaxing bedtime routine, and make sure your bedroom is comfortable, dark and quiet.

* Invest in a comfortable mattress and pillows.

* Don’t eat within two to three hours of bedtime, and avoid caffeine, alcohol and tobacco before going to sleep.

* Exercise regularly, but try to schedule your workout well before bedtime.

If you are inactive, adding a 10 minute walk every day could improve your likelihood of a good night's sleep. Making this small change and gradually working your way up to more intense activities like running or swimming could help you sleep better.

You have a wake-up alarm. How about a go-to-sleep alarm? LINK: The secret to getting enough sleep

Your alarm is set for 6 a.m., but every morning you hear it blaring and hit snooze. Nine minutes later, you hit snooze again, and again, until your back-up alarm goes off and you get out of bed a bit after 6:40, groggy and pretty sure that planned workout isn't going to happen before you need to leave the house by 7:15. Is there any way to break this cycle?

The key is to realize that if you really can't pull yourself out of bed at the time you intend to get up, you're probably not getting enough sleep. So you sleep in -- but not in a way that's helpful (snooze button sleep is pretty much useless). If you want to get up at a certain time, then getting adequate sleep means you need to stretch your sleep back earlier in the night. That means going to bed on time. And that means setting a bedtime alarm.

Finally, check out the infographic Sleep or Die for other important stuff you may not have known about sleep.


Unknown said...

Not to mention the side effects of that stuff. Wowza, sleep driving? Holy moly, no no no. Sorry, too scary for me.

ChelleEve said...

Oh, ambien, you were great... for about six weeks. After that things got weird. When I woke up smearing peanut butter on my kitchen counter (cat was licking it up as I went) that wasn't too bad. Calling my sister in law and explaining that I've never wanted to have sex with her? That was the deal breaker.

Insomnia is my lifelong enemy, and you'd probably punch your monitor if you had any idea how many sedating meds I'm on, though only one is a controlled substance and it's no help. Wonder if it's safe to cold turkey off 1mg per day clonazepam. I'll ask my night worker pharmacist. He sings about junkies when he thinks no one can hear, and is the greatest.