Sleeping Pills and Potions - What works and what doesn't

 You're at the end of your rope, so you head to the pharmacy for the help you so desperately need to sleep. But wait, you aren't sure if it's safe, if it works, and if there's a better way.  Stay tuned to learn about the benefits, side effects, and risk of sleep aids. 

 I'm Dr.Vickie Petz Kasper. If you're ready to take control of your health, you're in the right  place. I'll give you practical steps to start your own journey toward better health because healthy looks great on you.

 This is episode 159, Sleeping Pills and Potions. What works and what doesn't. You know that poor sleep is associated with heart disease, cancer, diabetes, obesity, immune dysfunction, high blood pressure, anxiety, depression, fatigue, irritability, and good grief, I could go on and on. So, taking something to help you sleep sounds like a good idea, right?  Today, we'll discuss what you need to know before you go and get a prescription, supplement, or over the counter sleeping aid.

Look, we have to sleep. Our very lives and health depend on it. But the struggle is real. Insomnia is one of the most common symptoms people go to the doctor or health care provider for treatment.  

And what if I told you that good sleep is possible without medications? Well, it is. In fact, the first line treatment recommended to treat insomnia is not medication. The standard recommendation for managing insomnia is to eliminate things that go bump in the night and keep you awake.  Or, to treat underlying diseases that disrupt sleep. It's not recommended to start with behavioral therapy or medications until these other things are maximized.

Ha! But good luck with that. If you go to your primary care provider and you don't get a prescription, I'll buy you a cup of coffee and we can both stay awake.  And, if you think you need to see a specialist, then you'll probably get to spend the night in a sleep lab hotel hooked up to a bunch of wires and you may get answers, like, a CPAP, and that's important if you have sleep apnea, but if not, you might not even hear from them. No wonder you're looking for a good solution to sleep.  And though medications are not the first line recommendation, that is the topic of today's episode. So let's get to it. We're going to start with prescription medications, then we'll talk about over the counter medications and wrap up with supplements. 

There are three classes of drugs approved to treat insomnia. Benzodiazepine receptor agonist, histamine receptor antagonist, and melatonin receptor agonist. Listening to all that medical jargon may be sufficient to put you to sleep. But wait, let me explain. You'll understand more after we go to mini medical school today and learn about receptors. 

These are made up of proteins and they receive chemical signals that produce a response.  Let me give you this analogy. You've got a lamp sitting on an end table, but it's not plugged in, so there's no light. And when you stick those two prongs into the socket, behold, now you can sit and read. And that's kind of how a receptor works.

The plug fits into the plug in. So an agonist is like the plug. It fits. It turns it on. It lets the electricity flow.  But, if you had a toddler in the house, you might want to plug in one of those little plastic things so he doesn't stick a butter knife in there and get shocked. So that would be an antagonist. 

Okay, now wake up and pay attention. We've got three classes of drugs to look at. Benzo receptor agonist and melatonin agonist. That plug in and histamine receptor antagonist that block the plugin. And then there's another category called other. We'll just call that the clapper, you know, clap, clap. And the light comes on, clap, clap, and the light goes off. 

There are eight drugs in the benzodiazepine receptor agonist family. And the first five are about my age, you know, born in the 60s. They are Estazolam, which is Prosom, Florazepam, which is D