Nodding off on the “L?”
Feeling sleepy at your desk?
You’re not alone.
Most of us aren’t getting the eight hours of sleep a night recommended by doctors to keep us healthy and mentally alert. We fall asleep too late, wake up too early and try to raise our energy level with caffeine jolts from Starbucks.
Desperate for rest, millions of people are turning to prescription sleep aids.
According to a survey from the National Sleep Foundation, more than 70 percent of adults don’t get the eight hours of weeknight sleep recommended by experts. Last year, 43.1 million prescriptions for Ambien, Lunesta and other sleep aids–$2.8 billion in sales–were filled in the U.S., according to IMS Health, a pharmaceutical information and consulting company.
“It’s beyond frustrating,” said Matt Zumbach, a 25-year-old financial analyst who has problems falling asleep and averages four to five hours of sleep on weeknights. “It drives you nuts. And the more you get frustrated, the harder it is to go to sleep.”
A few nights each month, Zumbach, who lives in River North, can’t fall asleep at all and lies in bed watching the clock. The next day, he’s drowsy and has difficulty concentrating. He tries to catch up on sleep on weekends.
Dr. Ramadevi Gourineni, a neurologist at Northwestern Hospital’s Sleep Disorder Center, says getting more sleep should be simple, but it’s not. The patients she sees push themselves so much with work, family and social obligations that they sacrifice sleep to get it all done.
Gourineni encourages patients to make behavior or lifestyle changes to help them relax or find time to sleep. She suggests listening to music or talking on the telephone at night and avoiding emotionally taxing activities such as paying bills right before bed.
“I tell my patients, ‘I wish I could give you a prescription for eight hours of sleep at night, but that really depends on you and what you’re willing to do to feel better,’ ” Gourineni said.
Zumbach says he’s always had a tough time falling asleep, even as a kid. In high school, a doctor suggested he try an over-the-counter sleep aid such as Tylenol PM, then told him to stop when he couldn’t fall asleep without using it. He did, and he’s learned to live with his sleeplessness without taking medication, he said.
Tylenol PM also was a temporary fix for Jenny Koppy.
The 32-year-old teacher from Northville, Mich., started seeing a doctor for her insomnia two years ago, when she turned 30 and the Tylenol PM she had been taking for a year no longer was working. The doctor put her on prescription Ambien, which she quickly felt dependent on, she said.
“Pretty soon I had to take it every night to fall asleep,” Koppy said. She started taking one pill a night, then one and a half, then two.
Knowing Ambien was not intended for long-term use, Koppy stopped taking the drug. She didn’t sleep for three nights. Then she had the prescription refilled.
In the past few years, more and more people have turned to prescription drugs to sleep.
In 2004, more than 8.5 million people were prescribed sleeping aids, up from 5.5 million in 2000, according to Medco Health Solutions, which manages prescription drug benefit programs. For people ages 20 to 44, the number of prescriptions for sleep aids doubled during that time.
Northwestern’s Dr. Gourineni says people often turn to sleeping pills for a fast solution to insomnia, rather than working through the issues that are causing the sleeplessness.
“It just becomes more and more common for people to want a quick fix,” she said.
For Koppy, Ambien was just the beginning of a long and trying search for something to help her sleep. She already was doing what doctors recommend: avoiding caffeine late in the day, exercising regularly and watching her diet. She tried sleep CDs but found them too corny to be relaxing.
Her doctor tried a series of other drugs, including anti-anxiety medications, but they didn’t work or produced unpleasant side effects. Now, she’s on a low dose of a drug used to treat psychosis that her doctor believes can slowly be reduced, she said.
“I eventually think I can get off it,” said Koppy, who now can fall asleep and stay asleep with the medication. Side effects have been a 15-pound weight gain and bad dreams. “It’s a long process for me,” she said.
Dr. Esra Tasali, who works at the University of Chicago’s Sleep Research Laboratory, only recommends sleep aids as a last resort for people with insomnia. Most of her patients already have tried them without success by the time they come to see her.
“It’s certainly a temporary solution,” she said. “One should be very careful with them on a long-term basis.”
At Hazelden drug and alcohol rehab center in Minnesota, there has been an increase in the number of people being treated for addiction to sleep medicines in the past several years, said Dr. Marvin Seppala, chief medical director. Many of those people also are addicted to alcohol or cocaine and take sleeping aids to counteract the effects of those drugs, he said.
People can get lulled into thinking that because sleeping pills are advertised or because a doctor prescribes them, there’s nothing to worry about, he said.
“It’s easy for people to see them as extremely safe,” Seppala said. “They aren’t as safe as they may seem to be.”
Patricia Skaja, a 47-year-old librarian from Lakeview, said she was uncomfortable taking prescription sleeping pills even though they helped with the insomnia she’s had since her 20s.
“Just the thought of having to take something in my 40s that I would have to take the rest of my life–I wasn’t comfortable with it,” she said.
Now, she takes Simply Sleep, an over-the-counter sleep aid made by Tylenol. With it, she can sleep for four hours a night. Without it, she sleeps for only two.
“There’s nothing worse than lying in bed thinking it’s almost time to get up and [discovering] it’s 1 o’clock in the morning,” Skaja said.
She hasn’t been to a sleep disorder center, such as the one at Northwestern, because she doesn’t think there’s anything they could do for her.
“I would like to keep it as a last resort,” Skaja said. “As long as I can get enough sleep with Simply Sleep, I’m happy.”
The latest problem: driving under Ambien
Ambien, the best-selling prescription sleeping pill in the U.S., is showing up as a factor in traffic arrests, sometimes involving drivers who later say they were sleep-driving and have no memory of taking the wheel after taking the drug, The New York Times reported.
In some state toxicology labs, Ambien makes the top 10 list of drugs found in impaired drivers.
As more people are taking the drug–there were 26.5 million prescriptions in the U.S. last year–there are signs that Ambien-related driving arrests are on the rise: In Washington state, officials counted 78 impaired-driving arrests in which Ambien was a factor last year, up from 56 in 2004.
Ambien’s maker, Sanofi-Aventis, says the drug’s record after 13 years of use in the U.S. shows it is safe when taken as directed, the Times reported.
A spokeswoman for the FDA said the drug’s label warnings, which say it should not be used with alcohol and in some cases could cause sleepwalking or hallucinations, are adequate, the newspaper reported.
– – –
8 tips for getting a good night’s sleep
Suggestions if you’re having trouble sleeping, from the National Sleep
Foundation:
— Maintain a regular sleep and wake schedule, even during weekends.
— Do something relaxing before bed, such as listening to music, soaking in a bath or reading. Avoid high-stress activities such as paying bills or working right before bed.
— Make sure your bedroom is dark, quiet and cool.
— Use your bedroom only for sleep and sex. Do not engage in activities there that make you anxious.
— Exercise regularly, but do not work out several hours before bedtime.
— Avoid eating two to three hours before going to bed.
— Avoid alcohol and nicotine close to bedtime. Alcohol can disrupt sleep patterns, causing a restless sleep.
— Avoid caffeine after the afternoon. Avoiding caffeine six to eight hours before bedtime can improve sleep.
For more tips and information, go to sleepfoundation.org
———-
TALK BACK
What’s your secret for getting a good night of sleep? E-mail us at ritaredeye@tribune.com. Include your full name, age and neighborhood.
kmasterson@tribune.com
