*Always consult you pdoc, doctor, and you're mental and general health team before adding, adjusting, or changing your meds and/or using supplements etc.
I would start and end with sleep hygiene:
Sleep Hygiene: Tips & Techniques - National Sleep Foundation
Twelve Simple Tips to Improve Your Sleep | Healthy Sleep
There are four levels of sleep with 3-4 being the ones that heal and benefit body, mind along with REM sleep.
Stages of Sleep
Sleep Meds:
Chart on most common sleep meds:
Sleeping Pill Brands and Tyeps: The Pros and Cons
The first med. that most docs and pdocs go to is Trazodone. It's effects on the brain and the side effects are preferable then Z-drugs.
They very down to earth, so to speak.There is a lot of information on this site but
Desyrel (trazodone): A Synopsis for the Educated Consumer | The Good, the Bad & the Funny of these Crazy Meds
Some anecdotal reports, as usual take people's reaction with a grain of salt but if you read enough of them. You can get a feel of the overall impression. It is important to look at how long they took the med:
TRAZODONE HCL: Side effects, ratings, and patient comments
Trazodone - Reviews, Ratings, Comments by Patients
*Now you are already on an anti-depressant. I believe it's Venlafaxine-Effexor. I need to look at the O.P. There can be a lot of problems when mixing two anti-depressants, even at low doses. You have to have a skilled pdoc to work with. It can be very dangerous
A research paper on antidepressants including tricyclic's help with insomnia:
Quote:
Antidepressants
The use of antidepressants to treat insomnia is widespread (Morlock 2006; nhsuk 2011; Wilson 2010), but can be considered to be 'off-label' as none is licensed for insomnia. A consensus statement from the British Association of Psychopharmacology (BAP) published in 2010 (Wilson 2010) highlighted that "low-doses (sub-therapeutic of depression) of sedating tricyclic, particularly amitriptyline, dosulepin and doxepin, have been used for decades to treat insomnia. This is particularly common practice in the UK" and that "low doses of amitriptyline (10 mg or 25 mg) have been used for long periods in many patients with chronic illness particularly those with pain syndromes". Antidepressants are also widely prescribed 'off licence' in the USA for insomnia, with trazodone, a triazolopyridine derivative, being the most commonly prescribed (Lai 2011) at sub-therapeutic antidepressant doses.
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It continues on, a very good paper with good references.
FPIN's Clinical Inquiries: Antidepressants for the Treatment of Insomnia in Patients with Depression - American Family Physician
Tricyclics is a class of older anti-depressants that can induce sleep:
Tricyclic antidepressants (TCAs) - Mayo Clinic
The problem with the Z-drugs on a regular basis is that tolerance will build up and can make sleep habits and the 4 stages of sleep disruptive. They basically act almost like benzodiazepines. They affect GABA receptor sites. Which, as an anoxylitic will be calming and will make you sleepy. The problem it down-regulates GABA receptor sites over time= tolerance and lack of effectiveness. If you use them. I would only use them PRN strictly, IMO.
There are also other drugs like low doses of some antipsychotics- Zyprexa
That are used with positive results, but there are also side effects that go with any typical or atypical meds. Though they can be dose related. Even on low doses there can be side effects. This first paper below is short and gets straight to the point. The second one, longer and more information:
Choosing Wisely | Treating sleep problems
Off-label use of atypical antipsychotics: Lack of evidence for their use in primary insomnia | Formulary Journal
There are also over the counter drugs like diphenhydramine and doxylamine. The issues with those are that they are antihistamines and anticholinergic drugs.
Here are some studies and articles on the above:
Sleep complaints: Whenever possible, avoid the use of sleeping pills. - PubMed - NCBI
Quote:
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Because of these sedative properties, diphenhydramine is widely used in nonprescription sleep aids for insomnia. The maximum recommended dose is 50 mg (as the hydrochloride salt), as mandated by the U.S. FDA. The drug is an ingredient in several products sold as sleep aids, either alone or in combination with other ingredients such as acetaminophen (paracetamol). An example of the latter is Tylenol PM. Examples of products having diphenhydramine as the only active ingredient include Unisom, Dormin, Tylenol Simply Sleep, Nytol, ZzzQuil, and Sominex (the version sold in the US and Canada; that sold in the UK uses promethazine). Tolerance against the sedating effect of diphenhydramine builds very quickly; after three days of use at the common dosage, it is no more effective than a placebo.[13] diphenhydramine can cause minor psychological dependence when used improperly.[14]
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I don't believe tolerance builds that quickly, as mentioned in reference 13. I do believe it does build. As as an anecdotal and aside, a friend of mine was taking diphenhydramine daily. He started going up in dose from 50mg-75-100mg over time.
Quote:
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Diphenhydramine is a potent anticholinergic agent. This activity is responsible for the side effects of dry mouth and throat, increased heart rate, pupil dilation, urinary retention, constipation
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I think the most bothersome side effect is the dry eyes, mouth, and throat from my own experience.
Quote:
Diphenhydramine is an inverse agonist of the histamine H1 receptor.[32] It is a member of the ethanolamine class of antihistaminergic agents.[18] By reversing the effects of histamine on the capillaries, it can reduce the intensity of allergic symptoms. It also crosses the blood–brain barrier and antagonizes the H1 receptors centrally. Its effects on central H1 receptors cause drowsiness.[33]
Like many other first-generation antihistamines, diphenhydramine is also a potent antimuscarinic (a competitive antagonist of muscarinic acetylcholine receptors) and, as such, at high doses can cause anticholinergic syndrome.[34] The utility of diphenhydramine as an antiparkinson agent is the result of its blocking properties on the muscarinic acetylcholine receptors in the brain.
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Diphenhydramine - Wikipedia, the free encyclopedia
Finally a gigantic meta-analysis of sleep and sleep disorders. This is if you really want to delve deep or look at certain parts:
https://books.google.com/books?hl=en...page&q&f=false
That meta-analysis mentions the meds but also natural supplements:
First a caution- some supplements can have side effects with medications, some very serious
Some common supplements to promote sleep- melatonin, pwd magnesium(citrate or glycinate), l-Theanine, l-Tryptophan or 5-HTP-
-Trytophan and 5-HTP should never be used with any serotonergic drugs, SSRI's, SNRI's. It can cause serotonin syndrome. Which is very serious
Serotonin syndrome - Mayo Clinic
Serotonin Syndrome: Causes, Symptoms, and Treatments
Valerian root, chamomile, lavender and more:
Natural Remedies That May Help You Sleep - Health.com
And finally:
Insomnia | University of Maryland Medical Center
*Always consult you pdoc, doctor, and you're mental and general health team before adding, adjusting, or changing your meds and/or using supplements or any of the above!
*Sorry about my misspellings, my spelling and spell checker need to be updated.
*Thaks for pointing out trazodone jo_throne I missed probably the most prescribed one.
