Monday, January 16, 2012

Non-Canine Sleep Aids (NCSAs)

When I wrote my first post on sleep, I was initially surprised to find out how many of you also suffer from insomnia. It is such an isolating affliction, it always surprises me to hear from others who go through the same thing.

But of course, many people go through it. Insomnia is the most common sleep affliction and affects 35% of the adult population in any given year. 


I've had it for as long as I can remember, so I've had some time to think about and try lots of different treatments. 


In graduate school, I even did a cross-cultural comparison of sleep remedies in Traditional Chinese Medicine and in the herbal medicine practiced by the Dominican curanderos who practiced out of the botanicas near where I lived in New York City while I was at Columbia. 


Maybe some of these ideas will be helpful to you. 
1. Valerian. Made into a strong tea--you have to simmer the root for 5 minutes or so--it smells absolutely horrific but does induce drowsiness. A couple of times, its been enough to make me sleep. You can make it taste and smell more bearable by mixing with mint, catnip, chamomile, alfalfa, or other calming herbs. 
2. St. John's Wort. You can buy the tincture or buy the bulk herb and make tea, or make your own tincture. Never has been enough to conquer my insomnia demons but does replace mild anxiety with a nice feeling of well-being.
3. Xiao Yao Wan (Free and Easy Wanderer). Chinese herbal patent formula that corrects liver imbalance. I tried this years ago, in powder form mixed with hot water. It did induce a pleasant drowsiness that led to sleep.
4. Diphenhydramine hydrochloride (Benadryl, Tylenol PM). I discovered this when I was in Guatemala and taking Dramamine for the crazy bus rides; the related compound in Dramamine made me very sleepy. Sometimes, one of these is enough by itself. 

There are many other remedies that others have apparently used to good effect, that haven't done much for me. These include Melatonin and many herbs such as chamomile, spearmint, catnip, passionflower, hops, and kava kava. 

Then there are the allopathic remedies that most doctors don't like to prescribe because they are reputed to make things worse if you ever go off them and to require higher and higher doses to be effective. I have not found this to be the case. I've been taking one prescription pharmaceutical or the other for sleep since about 2003, and have not--as many doctors have warned me I would--had to increase my dose or found that the medication no longer worked over time. 


I have realized, especially after reading the excellent book Insomniac by Gayle Greene, that most doctors don't know a darn thing about insomnia. A common allopathic pattern seems to be to refuse the few medications that actually are specific to insomnia, and instead to try to get patients on an antidepressant. This is because most doctors do not consider insomnia to be a primary ailment, but secondary to some other psychological or medical complaint.


After doing battle with countless practitioners who tried to convince me that I was depressed or had an anxiety disorder, I am happy to finally have gone to a sleep specialist who understood that I'm fine in every respect except that I just can't sleep. Even this doctor didn't talk to me much about the underlying causes of insomnia, which Greene discusses in Insomniac--the possible overproduction of cortisol, the hormonal imbalances--but, with a seeming sense of resignation that echoed my own, he did prescribe some things that have been helpful.
1. Alprazolam (Xanax). An antianxiety drug that I got over the counter when I went to Mexico in 2003 and used for most of that year and the next. A low dose made my mind just shut down, in a good way.
2. Zolpidem tartrate (Ambien). I was first prescribed Ambien in 2002, have been taking it in small doses fairly regularly since 2005 when I started graduate school. I take a lower dose than I started with and have only increased it during stressful times. Just lets things shut down. 
3. Ambien CR. This is for when Ambien gets you to sleep, but doesn't keep you asleep. Didn't make a huge difference for me.
4. Gabapentin. Tashi took this for her arthritis so I was surprised when the sleep specialist prescribed it for me. It's also used to control seizures in epileptics. Sometimes it gets me to sleep by itself, other times I have to take a bit of Ambien too. When it works, I wake up so rested and pain-free I think at first that I slept on a different mattress. When I slept without any prescription for a few weeks recently, it was after taking Gabapentin and no Ambien for a night. I felt so relaxed the next evening that I decided to try sleeping without a pill, and succeeded, and kept on succeeding until I got a cold and lost that sleep mojo.


It feels strange to divulge the full extent of my sleep problem, and especially to discuss at length the prescription meds I take to manage it. I sound like a wacko and a druggie.


But the stigma and the misconceptions about insomnia are the reason I'm writing this. The perception that it isn't a real ailment, is only secondary to some sort of other disorder and that if I would only stop drinking coffee (which I don't drink) or alcohol (which I drink only occasionally) or get more exercise (I ride my bicycle about 40 miles a week and walk the dogs easily 10 miles a week) or treated my anxiety and depression (I'm generally pretty happy and only a little anxious) or ate meat (don't even start), I'd sleep.  


So I'm writing this for any of you bloggers who look at your blissfully snoring canines with envy, and feel like a bit of a freak that you can't just join them wherever they go when they snooze off. If you had diabetes or high cholesterol or any number of other chronic conditions, you'd take your meds in order to function and not beat yourself up about it. I do believe that insomnia is a primary physical ailment resulting from some sort of chemical thing going on in the brain and nervous system--too much of something that makes us alert or too little of something that makes us able to shut down--and that some of us need outside help in getting those things to balance.

I'd certainly prefer not to patronize the drug companies that profit from my imbalance, and to find a way to sleep that is more in keeping with my "natural" groovy crunchy way of life. But sleeping sure does make life easier, and for those nights when a tiny snoring foster piglet is not enough, I'm glad there are other options.

10 comments:

  1. I don't suffer from insomnia, but I do have fibromyalgia, so I understand the frustrations of a chronic issue with no "cure." I also struggle with how much prescription medication I should take and have attempted to go a more natural route...and I'm pretty miserable. Sometimes our bodies just need a little bit more. You have a good point, if you had diabetes or arthritis, you wouldn't beat yourself up about the meds. And you shouldn't for insomnia! Sleep is SO important to our mental clarity and ability to function day to day. Good luck with your health and medications. It sounds like you are on the right path. And I can definitely relate to being jealous of those doggies...I have two pits who just LOVE to snore the day away! :-)

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  2. Thanks for sharing! I too like to follow a natural, holistic path when I can but there are just times when the herbs don't cut it and pills are necessary to treat what you got. I have nowhere near chronic insomnia but I do experience what I call "stress insomnia" where I wake up in the middle of the night and can't get back to sleep. This mostly occurs when I am stressed about something. I found that reading or watching something boring, like headline news repeating itself every 15 minutes, was usually enough to shut off my brain and help me fall back asleep. Leaving my stressful job and starting my own business (where I'm in control!) really helped. I went from not being able to sleep several times per week towards the end of my last job to rarely experiencing it now. For me, it was more about lifestyle change and making myself happy during the day - then I could sleep at night.

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  3. I love the "read something boring" strategy. It really does work sometimes!

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  4. Hi Kirsten, I'm going to show my mom your post today. She can sleep but wakes up a lot throughout the night. My dad sleeps just fine with an extremely low dose of Melatonin. He just doesn't seem to be able to stitch together enough hours for sleep. And us "kids" - we do just fine.

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  5. OH I soo badly wanted to comment here last night but it just would not go through my mobile device! Also, I don;t know if anyone's told you, but your post title is coming up different from your post?

    Anyway, insomnia! I don;t have it, certainly nothing like yours. I've always been a light sleeper, but I seem to be needing less and less sleep these days. About 3-4 hours at a go, then I'm awake. However, I crash in the daytime. Seriously CRASH! I can fall asleep while eating or while holding my coffee. I've spoken to my GP about this but he says it's not anything exciting like narcolepsy. It might just be another damn sign of ageing! Or I might have some sleep apnea.

    This is horrible news as The Other Half looks like Darth Vader on his res med [diagnosed a couple years back] and I'm determind not to make it a double act!

    I use a lot of incense and aromatherapy oils. Valerian - as I recall, smells rather like cat poo ;p I gagged the first time I opened a bottle and had a sniff! Almost everyone who comes to the house says it feels very peaceful. They often fall asleep. Our dogs seem to get just as sleepy. I often wonder if it's the incense and aromatherapy! Have you tried them yourself? You sound like you might know your oils :)

    That last picture is gorgeous. Is it Sandy? What a beatific smile!

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  6. Georgia, I do use oils and they make me very happy, but not sleepy :) I use an aromatherapy diffuser and put essential oils in the humidifier, which all makes for a relaxing and happy environment.

    That's amazing that you fall asleep just like that! Is that dangerous? Actually, come to think of it, I do that too sometimes--mostly at my desk at work:) Once I even fell asleep briefly when stopped at a stop light, and slid gently into the car in front of me! Almost very scary! I can usually take a nap in the daytime no problem; the struggle comes when it's time to go to bed at night.

    That is Sandy--she is such a little snoring snorty puppy.

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    1. That was a micro-sleep you had. That's what we call it here. Dangerous! Lucky I don't drive. I've fallen asleep and woken up with chocolate melting in my fingers and the coffee mug slipping. Nothing like sliding into another car!

      What oils do you use? Some that I like for relaxing are rosewood, palmarosa, frankincense, sandalwood and lavender. I mix them with a citrus blend for happy happy :)

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  7. Thanks for this post. I like reading what you say, but this one covered new territory for me. Important too. Thank you.

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  8. Very nice blog, Kirsten--sums it up nicely!
    thanks for the mention.
    Love the photos!
    Gayle

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  9. Coming to you from Something Wagging This Way Comes! I'm not insomniac but I work night shifts; they do not well lend themselves to good sleep. When my shift is done and I have clocked out, my body shuts down - I only have 9 miles to drive home but sometimes I need to take a nap in our cafeteria! Once, I was so tired on the way home, I pulled over into a side area (for some reason, left the car running) and went to sleep to find two police cars and a firetruck. Someone was concerned and called the authorities - I was just napping! Hmmm...this sounds like I sleep well which isn't true; this morning hour or two is often all I get before going back to the hospital while the dogs snooze like the ones (gorgeous) in your photos! When I am on a day schedule for several days, I do take Melatonin occasionally to sleep at night; once I'm out, I'm out - it's getting there.
    Kudos to you for sharing about your insomnia - just because we can't SEE a disorder doesn't mean it doesn't exist! Your posts are lovely - plan to be back.

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