First of all, know that not all sleep medications are created equal. “The myth is, ‘It doesn’t matter which one you choose, they all work the same way, they all do the same thing.’ They don’t,” said Dr. Andrew D. Crystal, a psychiatrist at the University of California, San Francisco, who specializes in sleep disorders. Some drugs, such as zaleplon (Sonata), shorten the time it takes to fall asleep. , he said; while others, such as suvorexant (Belsomra), block signals in the brain that cause you to wake up. The hormone melatonin, as well as prescription drugs like ramelteon (Rozerem) that act on melatonin receptors, can help the body They help regulate your internal clock, but don’t necessarily help you stay asleep.

The best medication for you will depend largely on what’s causing your insomnia. “It’s really about choosing the right drug for the patient,” said Dr. Aruna S. Rao, a neurologist at Johns Hopkins Medicine. If your problem is that you can’t fall asleep when you fall asleep, a medicine that keeps you from waking up in the middle of the night might not help. If you fall asleep easily but can’t stay asleep by the end of the night, even drugs like zaleplon (Sonata), which wear off within a few hours, aren’t going to do you much good.

Many people also have sleep problems which are not cured by any sleeping pill. One such condition is sleep apnea, which afflicts 22 million people in the United States And that causes frequent waking, said Dr. Grace Pien, pulmonary, critical care and sleep medicine physician at Johns Hopkins Medicine. Sleep apnea is best managed with a machine that provides continuous positive airway pressure (CPAP), not with medication.

Another issue is that many sleep aids don’t have solid data behind them. Doctor. “The over-the-counter antihistamines I used to take, which contained diphenhydramine,” Krystal said, “hadn’t really been systematically studied for their effects on sleep.” They are recognized for their anti-allergy benefits, but are often used as a sleep aid because they cause drowsiness, he said. Some studies on diphenhydramine show that it does not help at all: Clinical Practice Guidelines According to the American Academy of Sleep Medicine, the benefits of antihistamines are “below the level of clinically significant improvement” in terms of additional sleepiness.

Sleep aids can also have side effects, some of them serious. A 2017 study found that, compared to older adults who did not take sleep medications, those who took any type of sleep aid recommended by their doctor were 34 percent more likely to fall, perhaps because the drugs affected his balance or provoked clumsiness. Another study found that people who were recently, For the first time, 90 percent more likely to have been prescribed sleep medications such as temazepam, trazodone or zolpidem (Ambien) involved in car accidents, and that their increased risk was comparable to that of drinking and driving. Some research also suggests that long-term use of hypnotic drugs such as norrazepam, clonazepam (Klonopin), flurazepam (Dalmane), and zolpidem (Ambien) may more than double the risk of dementia,

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