- Question from Julia: What about Benadryl for sleeping?
- Answers —Helena Schotland, M.D.: I'm constantly taking my patients off of Benadryl (chemical name: diphenhydramine). The reason Benadryl is used for sleep is because it causes sleepiness, which is one of its biggest side effects. Benadryl can stay in your bloodstream many hours, thus you can awaken feeling very groggy. Benadryl can also interfere with sleep architecture, or the various stages of sleep we go through at night. People often have decreased REM (rapid eye movement) sleep with Benadryl and feel less rested as a result. Some have reported that Benadryl can lose its effectiveness fairly quickly after repeated use.
Editor’s Note: Benadryl (chemical name: diphenhydramine hydrochloride) is known to reduce the effectiveness of tamoxifen. If you are taking tamoxifen, talk to your doctor about alternatives to Benadryl. For more information, please visit the Breastcancer.org Tamoxifen page.
- Marisa Weiss, M.D., Breastcancer.org president and founder: Is there any effective sleep remedy that is over-the-counter?
- Helena Schotland, M.D.: None that I know of. So if someone needs a sleep medication, they should see a sleep physician.
- Marisa Weiss, M.D., Breastcancer.org president and founder: Do you have a favorite sleep medication to start with?
- Helena Schotland, M.D.: Sometimes, after doing all the sleep hygiene techniques first, I sometimes start with Rozerem, which is a melatonin agonist. The beauty of Rozerem is that it does not have any issues of dependence or tolerance (where the medication stops working over time). If that is effective, then you may not need to take further steps into a true sedative-hypnotic medication such as Ambien, Lunesta (chemical name: eszopiclone), and Sonata (chemical name: zaleplon).
- Marisa Weiss, M.D., Breastcancer.org president and founder: It's not a good idea to take someone else's sleeping pills. One size does not fit all.
- Helena Schotland, M.D.: Alcohol is a central nervous system depressant, as are the sedative-hypnotic medications. These are not two things that you should ever mix. Once you've taken a sedative-hypnotic medication, make sure you're ready to devote yourself to a full night's sleep. By no means should you be operating heavy machinery, such as a car, after having taken any sedative-hypnotics. You also may want to limit your activities the following morning after the first dose of a sedative-hypnotic until you see how the medication can affect you. Some people report drowsiness upon awakening in the morning. So it is important to know how you are going to react.
- Marisa Weiss, M.D., Breastcancer.org president and founder: In terms of sleeping habits, if you have to wake up early during the week, is it okay to sleep late on the weekends? Or will that varied sleep schedule during the week cause a problem overall?
- Helena Schotland, M.D.: If you don't have insomnia you can vary your sleep schedule without too much problem. If you have the opportunity to sleep in, by all means—enjoy! However, if insomnia is an issue for you, you may not want to deviate more than an hour each way in terms of your bedtime and your rise time.
- Marisa Weiss, M.D., Breastcancer.org president and founder: Are there certain hypnotic noises, like the waves on a beach, or soft blowing winds, or a soft train sound that help some patients go to and stay asleep?
- Helena Schotland, M.D.: Some people do fall asleep to a timer and have a noise-producing machine, but I don't like people to have those run for the entire night's duration. I prefer that they are set on a timer. It's amazing to me in my practice how many of my patients use the white noise of the TV to fall asleep. That's actually a bad thing, and if people are really dependent on the TV, I have them put it on a timer. One of the nice things about using silicone ear plugs is that you can hear your heartbeat and your breathing very easily. That's an internal stimulus that can be very relaxing to some people.
On Wednesday, January 17, 2007, our Ask-the-Expert Online Conference was called Sleep Well: Healthy Habits for Good Rest. Helena Schotland, M.D. and moderator Marisa Weiss, M.D. answered your questions about ways to improve your sleep.
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.
A production of LiveWorld, Inc.
Copyright 2010. All rights reserved.
Thank you for your input!
Helena Schotland, M.D. specializes in sleep medicine and is the director of the Pulmonary Diagnostic and Wellness Center and the co-director of the Sleep Laboratory at Bryn Mawr Hospital in Pennsylvania.
Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.
