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Sleeping Well Without Pills

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Q. I am 64 and nearing retirement, but with the stress of the economic downturn, I'm having a difficult time sleeping. I have a high deductible so I have to pay for my prescription medications out of pocket. Sleeping pills like Ambien or Lunesta cost more than $160 a month, which I cannot afford. What can you recommend for me so I can sleep at night and stay sharp on the job?

A. Ambien is available as an inexpensive generic, zolpidem. It has some adverse effects, though: some people sleep-walk or even sleep-drive while on this drug and many readers report some generic formulations don't work as well as Ambien.

Melatonin or a hot bath 30 minutes before retiring may help promote sleep. We have many more non-drug approaches as well as a discussion of the pros and cons of sleeping pills in our Guide to Getting a Good Night's Sleep.

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Here are some more suggestions that may help-These are some other prescription meds that are inexpensive too. One is Clonazepam the generic for Klonopin. Another is Temazapam, the generic for Restoril. If you feel your sleeping problems are a temporary thing, or you don't think you would need to use them every night, these would be an especially good choice, as they can lead to dependence if used each night for an extended period of time. There are other generics of this family of meds that your Dr. may prefer.

I had been having sleep problems for years but was very reluctant to use a prescription. I have no trouble falling asleep but would wake up around 2:00 or 4:00 a.m. and be up for hours. Many days I got by on less than 4 hours sleep. I had a note in my bag that I carried around for years in which Andrew Weil recommended Melatonin as a safe sleep aid.

I bought a $5.99 bottle of Melatonin Plus in Costco and it has improved my sleep quality immensely. I take it at 10:30 and am ready for sleep by 11:00. I've been getting 6-6 1/2 hours of uninterrupted sleep most nights. I think it is certainly worth a try.

I have tried every drug there is and go to a sleep professional. What works for me has been the simplest and least expensive solution...

12 mg generic elavil (1/2 of a 25 mg amitriptyline) along with 1 mg generic Ativan (lorazepam) taken at about 6 pm. I can't tell I've taken anything and I read myself to sleep in about 30 minutes at 10 or 11.

The generic ambien was not good for me and the real ambien seemed to make me moody in both extremes. Generic restoril is fine but I hated taking it every day.

This has been an easy and inexpensive, not to mention successful, way to handle lifelong insomnia. The bath and a quiet evening without bright overhead lights are also requirements but melatonin has not helped me.

Sleep can be a problem for me too, but my physiology background has prompted me to look for healthy options. A warm bath, combined with slow yoga-like stretching takes away most of my tension. In addition, at 65, I find that little aches and pains can make me tense as I try to fall asleep. A couple of mild pain killers handle that. A softer bed does wonders too, as does a proper set of pillows. People who say melatonin doesn't work for them are usually taking too little. I find that between 5 and 10 mg will put me out, even on a transpacific jet. Another useful natural sleep aid is valerian. And when my joints are achy, 1500 IU of Vitamin D3 is a superb cure and safe up to once a day.

Not to make light of the economic downturn and the amount of stress that it would cause to contribute to a difficult time sleeping, but I (age 58) have found that taking liquid calcium with a hand-full of walnuts right before bed has left me sleeping like a baby. Be sure to take before brushing your teeth because walnuts stain.

It has helped me to pay attention to what I take in from TV viewing in the evening. I decided to stop watching TV programs that for me produce anxiety or feelings of helplessness. I can now go to bed and sleep hours before I used to and get back to sleep easily after waking in the night.

I have used the melatonin for about 5 years. I only take it when I really need it. Less is more. I also take my calcium, (liquid) at night on the recommendation of a pharmacist. She told me it would help me to sleep.

I have found 200mg of 5HTP about 30 min before bedtime is helpful, also no computers after about 8pm and don't sit close to the TV, these both emit enough blue light that they alter ones melatonin levels.

Try magnesium - it cured my insomnia.

I'm 64 too. I have recently started taking 15,000 IU of Vitamin D3 daily. I've been very impressed with how much longer and sounder my sleep has been, as well as my urine flow. If you are afraid of overdoing it, you should get your "serum 25(OH)Vitamin D3" level checked by your doctor. Most people are deficient. An excellent web resource on Vitamin D is the outstanding multi-session seminar on Vitamin D presented on: www.youtube.com, search for: "UCSD Vitamin D" without the quotes, by UCSD (University of California at San Diego). Your eyes will be opened! I've always had the feeling that this or that nutrient was valuable, but there was something missing. I now believe that Vitamin D is that missing something.

Sincerely,

Russ

PEOPLE'S PHARMACY RESPONSE: DR. HOLICK'S LECTURE IS INTERESTING, AND HE IS A LEADING EXPERT ON VITAMIN D. BUT THE DOSE YOU ARE TAKING IS SIGNIFICANTLY HIGHER THAN THE USUAL RECOMMENDATION.

re: getting to sleep and STAYING asleep. I had that problem for years. I found that what I watched on tv before bedtime DID affect me. WHEN I began watching a series this past year (where it was continued as a clock counting down the minutes and seconds...) I just could not go to sleep! for hours!!! I learned my lesson!

YEARS ago I read a hint in a famous "hints" column; the hint was: do NOT look at a clock when you go to bed NOR ANY time thereafter during the night or early morning; I turned my clock face away, and covered the front of the stereo/satellite tv receiver with the little "pilot light".

I used to wake up many times like at maybe 2:30 am look at my clock and then start to think...it's 2:30; I get up in 3 hours.....CAN I get back to sleep? probably not. (THE SECOND that a person looks at a clock and sees the time, the brain section that handles waking up/etc. DOES wake up. ) THIS HINT TAKES PRACTICE!!!! But, after I stopped looking at the clock at bedtime or during the night, (I found that I could even wake up at 5:20 am and quickly go BACK to sleep! as long as I did not KNOW what time it was....) (MY husband later told me that I had awakened at that time. He gets up early.

AND I take 500 to 700 mg magnesium along with my calcium; I try to always use the citrate form. I would not have believed it if I had not trained and tried this: do not look at the clock from bedtime on....(IF you have to set an alarm, go ahead.)

PEOPLE'S PHARMACY RESPONSE: DR. HOLICK'S LECTURE IS INTERESTING, AND HE IS A LEADING EXPERT ON VITAMIN D. BUT THE DOSE YOU ARE TAKING IS SIGNIFICANTLY HIGHER THAN THE USUAL RECOMMENDATION.

The reason for my high dose is that I want to get my Vitamin D level up to 60ng/ml, which is still far below the level of lifeguards, at 100ng/ml. Guessing that my starting level is 25ng/ml, I will only be taking 15,000iu for a month and then get my serum 25(OH)D level checked. Professor Robert Heaney, in the UCSD lecture on youtube titled: "What's a Vitamin D Deficiency", reports that no adverse effects have been reported in the literature below a continuous dose of 30,000iu/d. He also reported that the body uses 4,000iu/d; so my excess of 11,000iu, which will actually increase by body's stores of Vitamin D, is only equivalent to 11 minutes of sun exposure at it's maximum of 1,000iu/minute. I live in Ontario, Canada, so I wont be getting any Vitamin D from the sun as it is too low in the sky now.
Sincerely, Russ

I'm 62 years old. My 20 year struggle with sleep issues ended about a month ago when I began taking 5-HTP. I understand it helps the body normalize serotonin and melatonin levels. I've been taking 100 mg capsules every morning.

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