sleepy businessman yawning

Q. I take zolpidem for insomnia. It helps me fall asleep but not stay asleep, and it gives me a dry mouth.

My doctor suggested I try melatonin instead to prolong the time I stay asleep. Does that sound reasonable?

A. The studies on melatonin are mixed. A recent double-blind French study found no benefit (BMC Complementary and Alternative Medicine, June 22, 2010). It appears to be more useful for jet lag (Current Treatment Options in Neurology, Sept., 2010).

We are sending you our Guide to Getting a Good Night’s Sleep for more information on using melatonin, magnesium and light against insomnia, as well as details on drugs like zolpidem, Sonata and Rozerem.

The FDA recently approved an old drug, doxepin, in a new low-dose long-acting formulation to help people stay asleep. Initial reports are favorable (Expert Opinion on Pharmacotherapeutics, July 2009). You and your doctor may wish to discuss this option, brand-named Silenor, but be forewarned: the drug may be expensive.

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  1. Lee

    I am concerned because my husband has congestive heart failure, a pacemaker -defibrillator is on
    120 mg lasix qd to control the CHF. He was started on melatonin for insomnia, but is finding that
    one pill (5mg) no longer works and has increased it up to 15 mg. What affect will this have on his
    heart problems?

  2. bobby

    I’m 24 years old and I can’t sleep and when I do I’m only out for a couple of hours and then cannot go back to sleep. My doctor gave me ambien today and I was ready to sleep so I took half of one cause I’m not so good with pills they make me fell sick. I didn’t fell anything in the first hour so I took the other half. Still I fell nothing so I took another whole one still nothing so I took a shot of whiskey (not recommended) then I started to get tired I fell asleep. I was only asleep for 3 hours and I woke up unable to fall back asleep. I got up and continued my day its now 8:45pm and I took another one (also not recommended) and I was able to cook dinner and type this up for you on my phone.
    So I’m not sure what I should do I’m going to tell my doctor but I’m not going to be able to see him for awhile cause I’m going on vacation tomorrow morning:( I hope I can figure something out its getting to a point where its affecting the ones around me and the insomnia is starting to get to me I have even thought to admit myself in a pshyc ward..

  3. watchmedye4u

    I have to take two ambiens to sleep every night. The plain white 10 mg ambiens. The red-pin whatever 5mg ambiens give me a harder time. Either I mix it with valium and melatonin or xanax. Ambien is very addictive, and my insurance wouldn’t cover a month supply on Ambien CR, so I wound up paying 86 Dollars. I used to smoke weed when I was younger, wa bing with ambien, and I was out like a light………………

  4. TD

    I work an overnight shift, 5 nights a week. I am home and ready to sleep between 7:30 & 8am. I have found Melatonin (3mg) to be helpful in going into an immediate sleep. I rarely sleep more than 4 hours. I have found that Melatonin seems to have no effect on my nights off, when I try to sleep like a normal person. So I really only use it for day light sleeping, which is substituting for the melotonin that my body is not producing, as it is day-time.

  5. Rx

    A PS to my previous post. I forgot to mention that on nights when I take 50 mg of niacin (the real stuff, not the flush-free) I sleep much better. (Take it with a cookie to decrease flushing.) Last week I changed my melatonin regimen to 6 mg time-release around 8 pm, instead of adding the sublingual, and I’m sleeping better. I find you have to change things around periodically, or you develop tolerance. I use Source Natural Melatonin and it works fairly well.

  6. beau10

    To Susan P: I tried the 20mg at just about the time you mentioned (3 AM). The effect had a slight carry over later in the AM, but it was not incapacitating and not totally unpleasant.
    One thing you might keep in mind if taking melatonin, read the ingredients list on the bottle as one national commercial pharmacy includes 10mg vitamin B-6 (500% daily RDA) w/ each 5mg melatonin tablet. Check-out the side-effects of B-6 toxicity. If I take 4 of these tabs each time for 3 consecutive days, I develop a continuous headache that only disappears with discontinued use.

  7. Jimmy The C

    I take one capsule containing 15mg of the drug Temazepan before bed. I permits me to go off to the first deep REM, but it doesn’t keep me asleep. I wake up about 6 hours after taking same. I should also say that I wear a C-PAP because of medium condition of COPD. Q: Does or could the C-PAP interfere with the ability to continue into the sleep process as the night unfolds? Any answer would be helpful.
    In closing, I was a smoker and also toked about a half a joint before bedtime many years ago, yes It did have a calming effect and put me asleep quickly.

  8. Susan P.

    I have had insomnia all my life, but the older I get the worse it gets. Forty mg of melatonin puts me to sleep but like others, it doesn’t keep me asleep so I have been looking for alternatives. I wonder what would happen if I took 20 mg when I go to bed and 20 mg when I wake up at 3 am. Has anyone tried this?

  9. vrgnia

    I also take 3 mg melatonin every night before bed, I fall asleep easily and sleep well. Originally I was taking it only when I got to bed very late, and found that it helped me fall asleep quickly and get up early without feeling nauseous due to insufficient sleep. No side effects for me.

  10. Rx

    Lifelong insomniac! At night I eat a small cookie (for carbs); 3 mg time-release melatonin around 8pm; before bed, 5 mg sublingual melatonin and 2-5 mg Ambien. This usually puts me out.
    However, I still wake up, and need another ~3 mg of Ambien or 1/2 SL melatonin. I don’t want to build up tolerance, so sometimes I switch out and take Valium instead of Ambien at bedtime. Sometimes 1/2 a Zyrtec helps it last all night. My doctor approves of my regimen. I take as little as possible – depends on the night.
    Decades ago, when I could have a couple puffs of marijuana, I slept a lot better!

  11. Anonymous

    I take 3 mg of melatonin a night on recommendation of my psychiatrist. Works like a charm. I take the pill 30 minutes before I am ready to ride the wave of relaxation into a deep sleep. I never have any side effects from it, as I did when I took Tylenol p.m. But it doesn’t keep me asleep, either.

  12. beau10

    I have tried melatonin for sleep, but it requires 40-60mgs and it does not have a stay-asleep-through-the-night effect. I would be most interested to hear the results of others who have tried it.

  13. Anne T

    I take Doxepin as a generic for Sinequan. It is very cheap!!

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