DEAR DR. BLONZ: I would like your opinion on the use of over-the-counter sleeping aids, as I am concerned about long-term use. My wife and I use doxylamine succinate nightly. I've researched OTC sleep aids to some degree using Google Scholar, and am not finding any serious evidence against long-term use that outweighs the importance of getting a full night's sleep. There is enough, however, for me to be concerned.
We take 12.5 milligrams (half of a 25 mg tablet) and also take 5 mg of melatonin each. We are 70-ish, not overweight, and are healthy eaters and exercisers. On the "bad" side, we drink a bottle of wine every night. I have no caffeine intake; my wife has a cup of strong coffee in the morning. -- J.I., via email
DEAR J.I.: Sleep is our primary restorative, but there can be complex issues at play when it isn't working. Given that we spend about a third of our life asleep, it would be best if it accomplished its purpose. I am hopeful this response, with plentiful reading suggestions, will provide some guidance and assistance.
Here are some resources you may find helpful:
-- A primer on sleep: "How Sleep Works" from the Sleep Foundation (b.link/7nd2as).
-- Information on insomnia: "Why Can’t I Sleep?" from the University of California at San Francisco (b.link/p7ca8s).
-- An additional insomnia resource: the "What Is Insomnia?" page from the National Institutes of Health (b.link/qmmjr7), which includes a downloadable guide to healthy sleep.
-- Many sleep disorders exist, and some experts estimate that about one-third of adults have a sleep disorder of some kind. Peruse the National Library of Medicine's list for details (b.link/uu944y).
-- There are dozens of "sleep hacks" -- tweaks to our activities and behaviors -- to try. See one long list from CNN Health (b.link/h26bmv).
One basic fix is to limit time spent in front of a screen prior to bedtime, especially if it is a screen without a blue-light filter. These filters reduce light frequencies that can impede the release of melatonin, a hormone normally released by the pineal gland to prepare the body for sleep. (Many, including you, I note, take melatonin as a dietary supplement.)
Then there is the role of alcohol in sleep disruption. A daily shared bottle of wine is pushing it for a 70-ish couple. While it can facilitate the initial doze, this is not "normal" sleep. Your body's metabolic attention is prioritized on breaking down the alcohol, which is considered a toxin. Higher intakes of alcohol disrupt sleep, particularly during the second half of the night. Studies also show that alcohol may exacerbate sleep-disordered breathing, such as snoring and obstructive sleep apnea.
Doxylamine is an antihistamine sold as an OTC sleep aid. It is approved for occasional sleeplessness, but not recommended for regular use. Alcohol is not advised when taking doxylamine, as it affects its breakdown.
I realize there is a lot to digest here. You have much in order regarding diet and lifestyle, but it is wise to be concerned about the long-term use of any OTC medication not being taken at your physician's direction. It is always best to check with your family physician to rule out any health problems.
Lastly, remember that changing routines can take time, so give your body a chance to adapt to new behaviors.
Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.