Prescription, over the counter & alternative sleep meds
Sleep deprivation is much a part of our culture as apple pie at your July 4th picnic. An astounding 1 in 4 Americans say they use sleep medication on a regular basis to fall and stay asleep. If you’re struggling to get a good night’s sleep, you might be tempted to try over the counter sleeping pills or visit a sleep doctor for a prescription. But before you reach for a sleeping pill, do you know the risks? Have you considered alternative therapies? Is your sleep partner involved in the discussion?
This is part three in a three part series featuring Dr. John La Puma M.D. Read the first two:
Dr. La Puma specializes in helping people take control of their health and weight. He’s a New York Times best-selling author, taught the first nutrition and cooking course for medical students in the US with Dr. Michael Roizen and has appeared on Dr. Oz, The Today Show, Good Morning America, Oprah.com, Martha Stewart radio to name just a few.
When did getting a good night’s sleep become risky behavior?
If you sleep with a partner, you have an untapped resource lying beside you, says Dr. La Puma. Sleep partners can make insightful diagnosticians when it comes to sleep issues, no special education required. S/he can help you figure out the source of the problem by discussing other medications you take, illness, sleep environment, snoring and too much stimulation in the bedroom (like TV or computer). “It might be a hard conversation but it will shed light on issues you may not be aware of.”
According to Dr. La Puma, there are 4 legs in the table of a healthy lifestyle:
- Accountability – Write down what you eat, your sleep routine and how you feel throughout the day – your sleep partner can help. This will help you understand the choices you’ve made and why, which will help you change.
- Individualized diet – A cookie cutter diet doesn’t address your unique metabolism or taste preferences.
- Engaging exercise – “For exercise to be effective, it needs to be long enough and intense enough.”
- Personalized stress management – Stress can be an over-looked contributor to sleep deprivation.
Using medication to fall and stay asleep comes with risk, regardless of whether you opt for over the counter pills or a prescription. Melatonin is the only hormone available over the counter in the US because it’s found naturally in some foods. And because it’s not technically a drug and manufactured in factories, it’s unregulated by the FDA. A typical dose may elevate your blood melatonin levels up to 20 times normal, according to the National Sleep Foundation. When it comes to prescription drugs, the FDA recently issued warnings for Ambien, Lunesta, Rozerem, and Sonata because of their often unpredictable reactions in some people, including allergic reactions, sleep walking and even sleep driving.
“In my practice, sleep medication is a bridge to treating the underlying cause of the sleep issue,” says Dr. La Puma. “Try everything else before you consider medication and when you’ve exhausted your options, talk to a doctor.”
Dr. La Puma says there are three questions you should ask your doctor before taking sleep medication.
“Is this the right dose of medication for my gender?” Men and women metabolize medication differently, create hormones differently and need to be prescribed medication differently. Last year, the FDA ruled that dosages for certain sleep medications to be lowered for women. It takes longer for women to filter sleep medication through their system, which can leave them too impaired for activities that require alertness the next morning. The FDA suggested dosage should be lowered for men as well.
“How long will I be on this medication?” A short stint on medication can solve the immediate problem of sleep deprivation, which will allow your doctor to investigate underlying medical issues. If your doctor prescribes medication without a plan for further testing, it’s important to understand what withdrawal issues you’ll face when you decide to stop taking them.
“How long will it take to fix the underlying medical issue?” Go to your doctor with lots of questions – even ones you’ve printed out from the internet. Your doctor is there to help you cut through the clutter and curate information for you. “It can be hard to figure out medical issues on your own – that’s what your doctor’s here for.”
If you decide to opt for sleeping pills, be smart while taking them:
- Refrain from drinking alcohol
- Take only the prescribed dose
- Don’t mix with other sedating medications
Remember, sleep medication isn’t a solution in and of itself – the goal is to get you off them and find out what’s coming between you and a good night’s sleep.
Dr. La Puma, founder of ChefMD believes food can be the strongest of medicine. He says this pear, sage and walnut pizza with bleu cheese is an excellent source of Omega 3 fatty acids, which are beneficial for your skin, blood pressure and weight. Use the bleu cheese sparingly to keep the fat content low; sprinkle it on top of the pizza to call attention to your eye that the cheese is there. It will help you enjoy its flavor and give you the illusion there’s more of it.
Pear, Sage & Walnut Pizza with Bleu Cheese
Reprinted with permission from ChefMD.com
Servings: 10 (Pizza Makes 10 Slices)
- 6 fresh sage leaves, slivered
- 2 teaspoons extra virgin olive oil
- 2 large yellow onions, diced medium
- 1 cup walnut pieces, toasted and cooled
- 4 large pears, bosc or d’anjou preferred
- 4 tablespoons very good quality balsamic vinegar
- Two 12 inch pizza shells, frozen or room temperature, Boboli thin crust preferred (check for trans fat absence)
- 4 ounces very good quality bleu cheese
- One-half teaspoon fresh ground nutmeg
Immerse the sage leaves in the olive oil. To a very hot saucepan add the olive oil, reserving the sage, and then the onions: cook until golden, about 10 minutes. Toast the walnuts in a 350 degree oven for 12 minutes. Remove when they start to darken, and let cool. Stem the fruit and slice lengthwise, very thin–about one-quarter inch thick. Paint each shell with balsamic vinegar. Layer with the onions and then fruit. Crumble cheese and walnuts on top of each shell, and sprinkle with nutmeg. Bake in a 425 degree oven for 10 minutes, remove and garnish with sage. Allow to cool on a perforated pan for five minutes before cutting into wedges and serving.
Culinary Taste Tip: Toasting walnuts brings out extra flavor. Be sure to remove walnuts from heat when they begin to darken
Nutritional Analysis: Calories, 302; Calories from fat, 132; Total fat, 14.7 g; Saturated fat, 3.8 g; Cholesterol, 8 mg; Sodium , 378 mg; Total carbohydrates, 34.6 g; Dietary fiber, 3.7 g; Protein, 7.9 g.