Lately, I feel as though I’ve forgotten what it means to wind down. There’s never enough time in the workday to finish my endless to-do list, so I often find myself coming home and slogging through emails and paperwork on my couch until I’m too exhausted to continue. But despite my fatigue, I often have trouble falling asleep. Is there an email I forgot to respond to? Am I prepared for my presentation tomorrow? Did I remember to feed my two collies? So I find myself blinking at my bedroom ceiling long after I should be asleep.
I know I’m not alone. Women today face more responsibilities than ever before. Our worries about meeting the demands of our families and professional lives keep us up at night, yet we know we can’t afford to be worn out the next day. For this reason, more and more women are turning to sleep medication—or as The New York Times dubbed it in a recent article, “Mother’s New Little Helper.”
Back in the ‘60s, the Rolling Stones wrote their classic song “Mother’s Little Helper” about Valium, which was a new drug at the time. Who can forget these lyrics?
Mother needs something today to calm her down
And though she’s not really ill, there’s a little yellow pill
She goes running for the shelter of a mother’s little helper
And it helps her on her way, gets her through her busy day.
The song refers to the many housewives who were taking “a little yellow pill” to relax and get through days of boredom and repetition. And although women and their roles have changed, there are still so many correlations between sleep meds today and Valium back then: both were/are marketed towards women, and users of both have a legitimate fear of addiction. The abuse and misuse of sleeping pills is becoming a serious problem today, just as the abuse of Valium became in the ‘60s. The difference is that today, we should know better. We as a society should learn from past mistakes: habit-forming pills are indeed a recipe for addiction.
Another difference is that Valium was marketed to the stay-at-home, bored mom—the housewife who just wanted to calm down, zone out, and get through the day. Today’s moms, on the other hand, are likely to be working career women who can’t afford to be so relaxed. So, the solution becomes a “go-go-go” (and often caffeine-fueled) mentality during the day, and then conking out with drugs at night to “recoup.”
Of course, true insomnia can be a devastating medical problem. But we shouldn’t jump to conclusions and assume that potent medications are the first course of treatment for our insomnia. Instead, we should take steps to determine the source of the problem and whether or not it can be helped without the use of addictive medication. First, we should examine our daily habits in an effort to pinpoint changeable things that might be keeping us awake. How much caffeine are we drinking? Are we exercising or eating right before bed? Getting too much screen time? Has the TV/Kindle/iPad/Blackberry invaded the bedroom? All of these are stimulating and can affect sleep habits. Before resorting to sleep medication to wind down the day, we can try other methods first: removing the aforementioned stimulants, sticking to the same sleep schedule every night, light stretching, breathing exercises, meditation, and yes – warm milk!
If these methods don’t help, we should still make sure to rule out other possibilities before jumping to the “chronic insomnia” conclusion. Do you fall asleep pretty easily at night, but find yourself wide awake in the wee hours of the morning, unable to get back to sleep? That’s a classic symptom of major depression. Are you waking up to go to the bathroom? There could be a bladder issue. Hormone and thyroid issues also affect sleep patterns. These are all completely treatable medical causes for insomnia—issues that can be treated behaviorally or with more benign, non-addictive medication. If you’re consistently getting five or fewer hours of sleep per night, if you’ve tried the above methods with no relief and your physician has ruled out these types of medical conditions—then, see if the use of sleep medications can help.
Sleep medications are a valid treatment for debilitating chronic insomnia, but it absolutely should not be the first choice. Sleeping pill addiction is not a myth; in 2008, 621,000 American adults reported abuse of prescription sedatives such as Ambien, and more people died from prescription overdose than from heroin and cocaine combined. My concern is for the larger prescription abuse epidemic that I see every day—there is a misconception that if you get something from a doctor, it’s going to be completely safe and non-addictive. Unfortunately, as more and more prescription overdoses are attesting, “legal” does not always mean “safe.”
Deni Carise, Ph.D.
Chief Clinical Officer