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When Counting Sheep Fails: The Latest Sleep Medications

Is the new generation of sleeping pills the answer for insomnia?
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A Tour of Today’s Sleep Aids continued...

Ambien CR: Ambien CR, approved by the FDA in 2005, was designed to target both common sleep problems: difficulty falling asleep and difficulty staying that way.Think of it as a layer cake: one layer dissolves quickly to help you fall asleep, while the second layer dissolves more slowly to help you stay asleep. Clinical trials showed that Ambien CR decreased wake time after sleep onset for the first seven hours during the first two nights it was taken, and for the first five hours after two weeks of treatment.

Lunesta: Of all the newer sleeping pills approved so far, Lunesta has the longest half-life -- about six hours. This means you may feel groggy in the morning if you take it in the middle of the night, or at a time when you can't get a full night's sleep. On the other hand, this pill could help you if you tend to wake up in the middle of the night a lot. Lunesta is approved by the FDA for long-term use and has been found to help menopausal women sleep through the night.

Benzodiazepines: These older sleeping pills, which include drugs like Valium and Halcion, are useful when you want a drug that stays in your system longer. For instance, they have been effectively used to treat sleep problems such as sleepwalking and night terrors, says Arand. "The biggest problem with these is daytime sleepiness, although you also have to monitor them more closely for dependence as well," she says. (Dependence means that you always need the drug to go to sleep.)

These drugs aren’t all created equal: Valium, for example, has a much longer half-life (about 6-8 hours) and therefore stays in your system a lot longer than Halcion, which has a 3-4 hour half-life.

Antidepressants: Insomnia is a common symptom of depression. Thus, some antidepressant drugs, such as Trazodone, are particularly effective in treating sleeplessness and anxiety that's caused by depression, even though they are not specifically approved by the FDA for the treatment of insomnia.

"In those cases, the antidepressant helps treat the sleep problem, but is really treating the underlying cause," says Arand. Could your insomnia be linked to depression? If you think you have other symptoms, talk to your doctor about this possibility.

Over-the-Counter Sleep Aids: Most of these sleeping pills, such as Sleep-Eze, are antihistamines. This means they're somewhat sedating and can cause some drowsiness the next day. They're safe enough to be sold without a prescription, but if you're taking other drugs that have similar effects -- like cold or allergy medications -- you could inadvertently take too much.

The American Academy of Sleep Medicine reviewed research on these sleep aids in 2006 and concluded that they may provide “modest, short-term benefits,” but “sufficient evidence does not exist to support over-the-counter sleep aids as an effective treatment for insomnia.”

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How much sleep do you get most nights?