Expert Advice for Women on Sleeping Pill Safety, Side Effects, and More

Chances are, someone you know takes a sleeping pill. One in four Americans takes a sleep aid every year, according to the National Sleep Foundation, and the numbers are even higher for women—one in three uses some sort of sleep medication a few times a week.

Why do women have such trouble sleeping? The reasons are as numerous as the passel of pills on the market: anxiety, depression, chronic illness, restless legs syndrome, sleep apnea, everyday exhaustion...the list goes on and on. No wonder so many sleep aids are available.

But sleeping pills, while often quite helpful, are largely misunderstood. Many stop working after a few hours, for instance, and most should never be mixed with other meds. So if you take one of these drugs now—or plan to in the future—there are important questions you need to ask. Here, the answers.

Q: Should I try over-the-counter drugs before a prescription pill?

A: Many sleep experts arent fans of OTC sleep aids because the meds dont usually help people with significant insomnia. And many—like Nytol, Simply Sleep, Sominex, and Unisom—contain antihistamines (similar to the allergy medicine Benadryl) that can have side effects like dry mouth and eyes and next-day grogginess, says Donna Arand, PhD, clinical director of the Kettering Sleep Disorders Center in Kettering, Ohio. OTC sleep aids are best for people who have occasional sleep problems. Note: Women who breast-feed should avoid them, as should the elderly, who sometimes are more sensitive to the effects of antihistamines.

Q: How do I know if I need a sleeping pill?

A: More than a third of Americans experience occasional insomnia, which is defined as a few nights of restlessness, poor sleep, or trouble falling asleep. The general rule of thumb: If insomnia lasts a month and doesnt get better, talk to your doctor, says Frisca L. Yan-Go, MD, director of the Sleep Disorders Center at Santa Monica–University of California, Los Angeles, Medical Center and Orthopaedic Hospital. She may recommend a pill for a short period, but dont be surprised if she suggests some tests or other nondrug treatment options first.

For starters, your doc may have you visit a sleep specialist to rule out sleep apnea, a common breathing disorder that wakes sufferers several times a night, sometimes without them even knowing it. If you have apnea, you may need a sleeping device that gently forces air into your windpipe.

If you dont have apnea, some docs recommend cognitive behavioral therapy (CBT): You work with a trained therapist to change how you think about sleep and learn sleep-inducing techniques (like how to set up your sleep space and what to do before bedtime). Some studies say CBT is as effective as pills—if not more—and has no side effects.

"Often people attribute everything bad that happens to them, including being angry and crabby, to lack of sleep," says Dr. Arand. "It puts such a burden on sleep that not sleeping gets blown out of proportion." CBT changes that kind of distorted thinking and in some cases is prescribed along with a pill.

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Lead writer: Rachel Grumman
Last Updated: September 03, 2008

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