New Research on Sleep Medications in Women

Jun 29, 2021 | Dona Locke | @DrDonaLocke | Comments (55)

Why Sleep?

In the HABIT program, one of our topics is addressing sleep quality because of the importance of quality sleep on daily cognitive function. We discuss identifying sleep disorders, such as sleep apnea (you can see our posts here and here about addressing sleep apnea and adjusting to CPAP therapy). But one of the biggest issues is really sleep disturbance (e.g., trouble staying asleep) rather than a medical sleep disorder. It is common for medical providers to provide prescription medication to help with sleep disturbances, which have been shown to have short-term sleep benefits. However, some patients end up on sleep medications on more of a long term basis. There is new research suggesting that sleep medications may not be as effective in the long term.

The Research:

The Study of Women's Health Across the Nation (SWAN) is a long-term cohort study of a diverse sample women living in the USA. From this sample, the researchers compared the self-rated sleep quality of middle aged women who started a prescription sleep medication to that of another group of middle aged women who did not start a sleep medication. At the start of the study, each group reported similar sleep ratings. After 1 year and 2 years the sleep ratings for medication users were not improved and remained similar to the non-medication group.  You can read the full study here if you wish. In this news release on the research, a Neurologist working in a Sleep Disorders Center was quoted, "The problem with using medication to control insomnia symptoms is it provides patients with some relief but the sleep they get on medication is more sedation than sleep."

The Conclusions:

With these results suggesting the lack of long term benefit of prescription sleep medications on sleep quality in middle aged women and the fact that these medications can have side effects (cognitive being one class of side effects), we'd encourage you to discuss your sleep prescription use with your physician to see if you have other options. We've discussed healthy sleep HABITs in this blog before and that may be a start, but habits for healthy sleep can take some time to develop if there is significant insomnia present. Cognitive-behavioral therapy for insomnia (CBT-i) with a trained provider may be an important part of a sleep treatment plan with your physician. To search for a provider, one option is Psychology Today, an online resource with detailed listings for professionals in the US.

We hope this might stimulate a discussion with your physician about sleep and sleep medications and get you on your way to better quality sleep--for your brain health, your emotional health, and your physical health!

Interested in more newsfeed posts like this? Go to the Living with Mild Cognitive Impairment (MCI) blog.

Please share how one might find CBT-i in a specific location. I am in a large metropolitan area with access to and insure coverage for four large medical networks. None is familiar with this therapy.
Sue

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@sueinmn

Please share how one might find CBT-i in a specific location. I am in a large metropolitan area with access to and insure coverage for four large medical networks. None is familiar with this therapy.
Sue

Jump to this post

Hi @sueinmn

In the last part of the post, there is a link embedded in the Psychology Today recommendation that should open a tab for a search by location for a CBT-I provider. So, if you click on Psychology Today above, does that link open for you? Let me know if that doesn't work.

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@DrDonaLocke

Hi @sueinmn

In the last part of the post, there is a link embedded in the Psychology Today recommendation that should open a tab for a search by location for a CBT-I provider. So, if you click on Psychology Today above, does that link open for you? Let me know if that doesn't work.

Jump to this post

Thanks, I found it.
Sue

REPLY

Discussions with my physicians did not result into much! I religiously use CPAP units for more than 20 years, but still cannot sleep more than 4 to 5 hours per night. All those standard things like quiet environment (I live in the middle of a forest, our a dark room (mine is pitch black), seem not to do t for me. But none of my Mayo providers did go any deeper in with my sleep problems. I have a PhD in Biomedical Sciences, and started to do a bit of research, and came up with taking progesterone at night (with fatty foods, to prevent the first path through the liver). Progesterone extended my sleep by an hour or if I am lucky, by two hours per night. I monitor my sleep, and get hardly any deep sleep, and some nights I have no deep sleep at all. That leaves me pretty tired the next day. But luckily, I can take afternoon naps when I am to tired, but i rather sleep during the night, and don't want to waste my daytime hours with sleeping.
What is your recommendation for a person like I to get a decent night sleep in, as I said, talking to my Mayo providers has not done any good for me.

LindeS

REPLY

Boy can I relate to that! That was my problem and for several years during this challenge I had very little to no restorative sleep. I was exhausted. I did talk with my docs and tried some sleep meds, and had an allergic reaction. That's when I started the melatonin that I'm now questioning. I self medicated with that, and never discussed it with my doc. I wasn't hiding it from him, but I just thought it was so harmless that it didn't require discussion. I think we need to be careful of those so called harmless OTC drugs. Finally I just decided on my own to stop it, and I'm so glad that I did. One of the things that you said that jumped out at me was the daytime napping. I was doing the same thing. I couldn't help it. I was exhausted all of the time. When I sat I just fell asleep. I'm guessing that because of how you described yourself that you have a million thoughts going through your head all night long as you try to fall asleep. Two hours of sleep a night was my normal. The primary thing that I have regained from not taking the melatonin is the mental clarity. The brain fog was horrible. I couldn't do anything. I said earlier that I was a crafter, and I am, but I'm a hobby crafter, and do it because I love it and it helps me to express myself creatively. I was actually a social worker in my career, and could hold countless details accurately in my mind. During this period of brain fog I couldn't hold a clear thought. I also believe that I was in denial about my illness. I was so healthy and never believed that I would ever get sick. So when I began to recover I noticed one day that the curtains in my bedroom were too thin to give me much privacy, and I was keeping the shades pulled a lot. I decided that I needed bottom curtains to give me more privacy during the day when the room was light so I could walk around the house w/o pulling the shades closed all of the time. Hang with me because there is a reason that I'm telling this story. During this 4 1/2 years I did absolutely no crafting, and being retired I wasn't in a job. So one day I decided that I would make those lower curtains because I knew exactly what I wanted them to be like, and I knew that I could make nicer custom curtains than I'd buy anyplace. One day I had my husband drive me to the store to buy material for these curtains. By then over a period of several weeks I had measured everything and I knew what I needed. I got the material, brought it home, and it set on my dining room table for weeks and weeks. I was terrified to cut that fabric. I measured and remeasured. I couldn't cut the fabric. Finally in those weeks I admitted to myself what I refused to accept. I was terrified, and so unsure of myself after several years if having very limit activity. When I saw my doc one day after that I recall asking him…"What is this? Is it a syndrome, Is it an illness? Is it a disease?" He said "it's a disease", and my world came crushing down over me. I couldn't deny it any longer but I was able to take an active role in my recovery. Shortly after that I got out the material, measured for the last time, and cut the damn fabric. I now have 4 beautiful bedroom curtains and each morning I open the shades and light comes streaming in. It was the brain fog. I used to hear people use those words, and I had no concept of they meant, none, but now I know what they are talking about. I no longer nap during the day. I'm up at 5:00, and I'm in bed about 10:30. I fall right to sleep, and I'm reclaiming my life. I feel like I'm the luckiest person alive. I'm doing some amazing projects, and I'm regaining a sense of balance again at age 84. I wish this for all of you. Not that you are 84 (ha ha), but that you can regain a sense of balance in your lives.The problem though is that we're all different, and what works for one of us won't work for another. Just don't give up. Keep on searching until you find the "get out of jail free card".

REPLY
@lindes

Discussions with my physicians did not result into much! I religiously use CPAP units for more than 20 years, but still cannot sleep more than 4 to 5 hours per night. All those standard things like quiet environment (I live in the middle of a forest, our a dark room (mine is pitch black), seem not to do t for me. But none of my Mayo providers did go any deeper in with my sleep problems. I have a PhD in Biomedical Sciences, and started to do a bit of research, and came up with taking progesterone at night (with fatty foods, to prevent the first path through the liver). Progesterone extended my sleep by an hour or if I am lucky, by two hours per night. I monitor my sleep, and get hardly any deep sleep, and some nights I have no deep sleep at all. That leaves me pretty tired the next day. But luckily, I can take afternoon naps when I am to tired, but i rather sleep during the night, and don't want to waste my daytime hours with sleeping.
What is your recommendation for a person like I to get a decent night sleep in, as I said, talking to my Mayo providers has not done any good for me.

LindeS

Jump to this post

Have you read the book No More Sleepless Nights by Peter Hauri? I am a patient of Mayo Clinic sleep department. They instructed me to read this book. The sleep department and following the book has helped me tremendously. I highly recommend both.

REPLY
@lizzier

Boy can I relate to that! That was my problem and for several years during this challenge I had very little to no restorative sleep. I was exhausted. I did talk with my docs and tried some sleep meds, and had an allergic reaction. That's when I started the melatonin that I'm now questioning. I self medicated with that, and never discussed it with my doc. I wasn't hiding it from him, but I just thought it was so harmless that it didn't require discussion. I think we need to be careful of those so called harmless OTC drugs. Finally I just decided on my own to stop it, and I'm so glad that I did. One of the things that you said that jumped out at me was the daytime napping. I was doing the same thing. I couldn't help it. I was exhausted all of the time. When I sat I just fell asleep. I'm guessing that because of how you described yourself that you have a million thoughts going through your head all night long as you try to fall asleep. Two hours of sleep a night was my normal. The primary thing that I have regained from not taking the melatonin is the mental clarity. The brain fog was horrible. I couldn't do anything. I said earlier that I was a crafter, and I am, but I'm a hobby crafter, and do it because I love it and it helps me to express myself creatively. I was actually a social worker in my career, and could hold countless details accurately in my mind. During this period of brain fog I couldn't hold a clear thought. I also believe that I was in denial about my illness. I was so healthy and never believed that I would ever get sick. So when I began to recover I noticed one day that the curtains in my bedroom were too thin to give me much privacy, and I was keeping the shades pulled a lot. I decided that I needed bottom curtains to give me more privacy during the day when the room was light so I could walk around the house w/o pulling the shades closed all of the time. Hang with me because there is a reason that I'm telling this story. During this 4 1/2 years I did absolutely no crafting, and being retired I wasn't in a job. So one day I decided that I would make those lower curtains because I knew exactly what I wanted them to be like, and I knew that I could make nicer custom curtains than I'd buy anyplace. One day I had my husband drive me to the store to buy material for these curtains. By then over a period of several weeks I had measured everything and I knew what I needed. I got the material, brought it home, and it set on my dining room table for weeks and weeks. I was terrified to cut that fabric. I measured and remeasured. I couldn't cut the fabric. Finally in those weeks I admitted to myself what I refused to accept. I was terrified, and so unsure of myself after several years if having very limit activity. When I saw my doc one day after that I recall asking him…"What is this? Is it a syndrome, Is it an illness? Is it a disease?" He said "it's a disease", and my world came crushing down over me. I couldn't deny it any longer but I was able to take an active role in my recovery. Shortly after that I got out the material, measured for the last time, and cut the damn fabric. I now have 4 beautiful bedroom curtains and each morning I open the shades and light comes streaming in. It was the brain fog. I used to hear people use those words, and I had no concept of they meant, none, but now I know what they are talking about. I no longer nap during the day. I'm up at 5:00, and I'm in bed about 10:30. I fall right to sleep, and I'm reclaiming my life. I feel like I'm the luckiest person alive. I'm doing some amazing projects, and I'm regaining a sense of balance again at age 84. I wish this for all of you. Not that you are 84 (ha ha), but that you can regain a sense of balance in your lives.The problem though is that we're all different, and what works for one of us won't work for another. Just don't give up. Keep on searching until you find the "get out of jail free card".

Jump to this post

You said your doctor said it's a disease. What disease? Please clarify. Was it the melatonin? Were you cured because you stopped taking melatonin?

REPLY

When my doc told me that Polymyalgia Rheumatica was a disease I was finally able to accept it. I wondered if it was Rheumatoid Arthritis, and I couldn't wrap my head around all of these changes in my body. I couldn't turn over in bed, and was sleeping in a recliner about 2 hours a night. Prior to that I was, as one person on this feed said, in a malaise and depressed. But when I asked him that and got an answer it felt like I knew what I was up against. I could keep on going as I was, or I could try to improve my life. I had stopped taking the melatonin by then, and I was beginning to feel better. Nothing changed physically, but my mental clarity was coming back. It was the brain fog that lifted for me. I was able to ask clear questions. I'm not saying that no one should take melatonin, I'm saying for me, and possibly in combination with prednisone, it wasn't working. There was a course offered in the local school system put on by a healthcare program, and I signed up for it. It was called Living Well With Chronic Pain, and it helped me a lot. I began to formulate questions for my doctors, I began looking for local resources. I began to do the simple 26 exercises in the book, I began to cook healthy meals, and when I was in a lot of pain, I would refocus. I'd look out the window and watch the birds at my feeders, or turn my attention to my flower gardens that were overrun with weeds. I began to think about crafting again. I can no longer do stairs so I had to figure out how to get my sewing room moved to the first floor. These were monumental tasks, and I got them done by asking people for help. I never said I was cured, but I can see such an improvement over where I was even just this past winter. I'm in the process of doing a pretty complex project that I designed, and am bringing to completion. So for me my quality of life has improved. Prior to that I was going to my medical appt., doing what the doc said, and fumbling through life. Now I've taken control of my life. I'm not free of pain, but I'm better than I was. I walk without my walking stick when I can, and I'm living a productive life. My husband has a wife again.

REPLY
@grillgirl

Have you read the book No More Sleepless Nights by Peter Hauri? I am a patient of Mayo Clinic sleep department. They instructed me to read this book. The sleep department and following the book has helped me tremendously. I highly recommend both.

Jump to this post

I will definitely read this book. Thank you so much. One comment from another contributor was that genetically some people simply need less sleep. I was always an 8 hr. a night gal. Get in bed, fall asleep, wake up 8 hrs. later. My sleep rhythms were definitely not my normal. Last night I slept 6 1/2 hours, and for me I'm satisfied. I can accept an hour or 2 difference, but the 2 hours that I was getting a night is not good for me, it leaves no room for restorative sleep. I do believe that when I'm in balance, and I am much more so now, then my normal sleep pattern will return.

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I am 61 years old and can count on 1 hand the number of nights that I have slept all night and felt refreshed the next day. I have tried everything out there. Melatonin does nothing. Prescribed drugs either don't work at all or give me horrific nightmares! I have tried calming herbal teas, OTC medicine, yoga for sleep, calming sleep apps, black out curtains, did a sleep study (which resulted in no sleep apnea but no other answers either), a sleep schedule, eating protein before I go to bed or later in the night. Nothing works and my brain never shuts up. When I was in college, I would lay awake and write my papers in my head. Having hypothyroidism, celiac disease, great stress and anxiety ( I am a special education teacher and caregiver for my husband) does not help. I have learned that praying myself to sleep is the only thing that works. Not sleeping is frustrating and then I feel sluggish and get migraines!
Good luck to y'all!

REPLY
@grillgirl

Have you read the book No More Sleepless Nights by Peter Hauri? I am a patient of Mayo Clinic sleep department. They instructed me to read this book. The sleep department and following the book has helped me tremendously. I highly recommend both.

Jump to this post

Funny, I am a patient of that department for many years already, and nobody ever mentioned this book to me!

REPLY
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