- Question from CindyH: I am a 56-year-old postmenopausal woman who has a lot of problems sleeping. I take 1 Flexeril and 1 melatonin at bedtime. I take the Flexeril for a bladder condition. I do not have caffeine after 1 p.m. and try to do some exercise. Is there anything else? I am up at least 3 times per night. I forgot to mention my husband snores. Ha.
You raise a lot of different issues. One thing that we could discuss first is the issue of melatonin. Melatonin is a hormone produced in our brain by the pineal gland and melatonin causes us to be sleepy. People have been taking samples of melatonin that you can buy at health food stores. However, melatonin from a health food store is not a drug regulated by the Food and Drug Administration (FDA), so we cannot assess its purity, effectiveness, or safety. So in general, I don't like to prescribe melatonin for my patients for those reasons. There is a new medication called Rozerem (chemical name: ramelteon), which is a melatonin agonist, so it works like melatonin and this one is a drug approved by the FDA.
One of the questions you may want to ask yourself is what's causing you to wake up at night. Is it some physical sensation, like having to go to the bathroom? It could be very possible that your bladder is causing you to wake up at night. Other patients with asthma wake up wheezing at night. Other patients with chronic pain may wake up with back or extremities pain. There are certainly common conditions that can result in people waking up multiple times at night. One of the most common is obstructive sleep apnea, which is a disorder characterized by periods where you stop breathing or have shallow breathing during sleep. It's interesting that you mention your husband who snores. Snoring is one of the red flags for sleep apnea. Exercise may help, but again I would recommend it earlier in the day. And it's just good for general health and wellbeing.
My favorite solution, at least temporarily, is silicone earplugs. These are little balls of silicone that you put over the opening of your ears. They don't go inside your ear; they're external. They're very comfortable. They reduce noise. You can get them at the pharmacy. I like Mack's brand. Position therapy: I always say there's nothing like the elbow of a good wife, so you want him to sleep on his side rather than on his back. And then obviously, you don't want to ignore snoring if it could be associated with sleep apnea, so you may want to take him in for an evaluation.
- Marisa Weiss, M.D. I had to kick my Labrador retriever out of the bedroom because of lip smacking and snoring.
- Helena Schotland Sleep hygiene is basically common sense tips on getting a good night's sleep. It doesn't mean Lysol. It means lights off, not Lysol. Things like making sure to go to bed and wake up at a regular bedtime, and that bed is for sleeping and sex only. A more complete and examples of sleep hygiene will be posted in the transcript from an earlier answer.
The Ask-the-Expert Online Conference called Sleep Well: Healthy Habits for Good Rest featured Helena Schotland, M.D. and moderator Marisa Weiss, M.D. answering your questions about ways to improve your sleep.
Editor's Note: This conference took place in January 2007.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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