Quotations by W. Chris Winter

Sleeping pills were designed for sporadic use, and in some appropriate cases they work very well. They were not designed to sedate individuals to sleep on a nightly basis. No sleeping pill has ever been shown to increase daytime performance. On the other hand, the discontinuation of hypnotics has! [2017] - W. Chris Winter

Melatonin seems to be most beneficial for helping with circadian problems like jet lag. As a long-term sedative, its effectiveness is questionable. [2017] - W. Chris Winter

Valium and benzodiazepine have been shown to suppress slow-wave sleep. This is an unfortunate outcome for someone wanting to feel better the next day. For sleep to have an impact in your life, it needs to include a robust amount of deep sleep and all of the restorative things that go along with it. Simply sedating someone doesn't produce this effect. Ambien (zolpidem), a drug introduced in 1993, seemed to feature only a sleep-promoting effect without all the dirtiness associated with benzodiazepine. Despite this new drug, people continued to have insomnia. [2017] - W. Chris Winter

Guess which prescribed medication is the most common sleep medication. It's an FDA-approved antidepressant with no FDA approval for sleep. It's trazadone. Another is Remeron. The great thing about Remeron is that its name implies that taking it will turn REM on. Unfortunately, it all too often turns on weight gain too. The new fun thing to do is to skip the antidepressants and go right to the antipsychotics. Drugs like Seroquel (quetiapine), Zyprexa, and Risperdal (risperidone), which used to be used exclusively for patients with mania or psychosis, are now being used off label to treat simple insomnia. [2017] - W. Chris Winter

Sleeping pills are best used when people have specific and transient problems with their sleep. Here are some examples: 1) "I travel for work a couple times a month, and I really have problems sleeping in the hotels my company puts me up in. Outside of that, I'm fine." 2) "My husband was just diagnosed with cancer, and I'm really struggling to relax and sleep at night." 3) "I just returned from two weeks in India, and I'm struggling with jet lag." The key with sleeping pill use is having a plan. An essential component of the plan is when you will not take the pill or stop taking it entirely. [2017] - W. Chris Winter

Who needs a sleeping pill? This list is fairly short: 1. For brief periods of acute stress secondary to clearly identifiable stressors or sleep disruptors: loss of a loved one, loss of a job, divorce, chronic pain, and so on. 2. Environmental issues: sleeping in a hotel, camping with your family, or other episodic events that temporarily put you in an environment where sleep is difficult. 3. Shift work disorder. 4. Jet lag. 5. There are some who would add "primary insomnia" to this list. I'm not buying it. I believe there are patients who have higher-than-normal arousal than others. These patients need cognitive behavioral therapy, not a pill. [2017] - W. Chris Winter

The single most important piece of advice for achieving best sleep is "pick a wake-up time and stick with it!" There is no such thing as a good or bad wake time. Establishing a consistent wake time is the most important first step in setting your schedule and solving your sleep issues. [2017] - W. Chris Winter

Sleep restriction is an integral part of cognitive behavioral therapy (CBT-I). Patients may need to temporarily spend less time in bed. [2017] - W. Chris Winter

Jet lag is a form of circadian rhythm disorder as well, so make sure earplugs and a comfortable eye mask travel with you everywhere. Instead of a bulky neck pillow to support your head during your next flight, consider a NapAnywhere (www.napanywhere.net). This collapsible head support is comfortable and lightweight, and it folds up into the shape of a Frisbee to easily fit into a thin computer bag. [2017] - W. Chris Winter

Sleep Efficiency (%) = Time Spent Asleep ÷ Time Spent in Bed x 100. We'll say 85-90% is the target. Humans wake up when they sleep. That's not only okay, but normal. So aiming for 100% is an unrealistic goal. It's okay to nap when: 1. Your nighttime sleep is efficient yet despite this, you still feel sleepy (not fatigued--sleepy). 2. And the napping doesn't disturb your schedule for the upcoming night. A nap is typically intended to complement or enhance an efficient night of sleep. It's not meant to make up for lost sleep when the sleeper had the opportunity to sleep but did not. [2017] - W. Chris Winter

Sleep doctors have a saying: An early nap adds to the previous night of sleep but a late nap subtracts from the upcoming night of sleep. It's vitally important that the nap be scheduled. Shortly after lunchtime is the time when we experience a natural increase in our daytime sleepiness. Many sleep researchers and many cultures believe this is not only a great time to nap, but that we were evolutionarily designed to nap at this time. The duration of your nap is important. A 20-30 minute nap is an ideal duration to provide a boost to your wakefulness without leading to post-nap funk (PNF). [2017] - W. Chris Winter

Lavender is a trigger for sleep if you use it consistently in your bedroom, but some small studies suggest lavender might be in and of itself sleep promoting. My favorite lavender spray is the two-ounce Aura Cacia Pillow Potion. I like this because I can keep it in my carry-on (for spraying in my Marriott Hotel room), and it won't get confiscated by the airline TSA agents. [2017] - W. Chris Winter

I think we can reply modest sleep debts as long as they're repaid quickly and in full. A 2016 study by Josiane Broussard showed that 2 nights of makeup sleep (after 4 nights of sleeping 4.5 hours) seemed to return insulin levels and diabetes risk to normal levels. [2017] - W. Chris Winter

Teeth grinding, or bruxism, is usually not seen during sleep, but rather in the transitional periods between sleep and wakefulness. Most dentists treat bruxism with mouth guards--a physical barrier between one molar and its mate. Very occasionally medications are used. But finding out the underlying reason why a patient is awakening during the night and treating it can often by itself greatly reduce or eliminate bruxism. [2017] - W. Chris Winter

A home sleep test (HST) is a portable device that allows sleep doctors to look at your sleep from the comfort and privacy of your own bed. While being able to sleep in one's own bed is a real positive, home sleeping studies have their drawbacks and limitations. They were really designed for use in the following patients: 1. patients likely to have sleep apnea or a breathing disturbance. 2. Patients unable to have a regular sleep study because of lack of insurance or inability to easily leave the home for health or social reasons. [2017] - W. Chris Winter