I was prescribed a medication for insomnia. When I take it, I wake up more often than I already did and I feel very hung-over the whole next day. Any suggestions?

We wish we had a sleeping medication that worked throughout the night to help you stay asleep—and then disappeared completely when you’re ready to wake up.  But biology doesn’t work like that.  Any medication that helps you stay asleep at 3 or 4 in the morning will stay in your system for quite a while after you wake up.  That’s why taking sleeping medications can interfere with your mental sharpness or increase your risk of problems like falls or auto accidents.  If you are feeling groggy well into the next day, ask your doctor if a shorter-acting medication would be better for you.

Adding to that, many sleeping medications can cause tolerance (it takes more and more to have the same effect) and dependence (you have a withdrawal or rebound if you stop taking them).  Tolerance and dependence are more likely if you take this type of medication regularly (more than 2-3 times a week) for longer than a few weeks.  Be sure to ask your doctor if the medication you are taking could lead to tolerance or dependence.

Taking sleeping medication may sometimes be necessary.  But you’re better off taking as low a dose as possible for as short at time as possible—especially with medications that can cause tolerance or dependence.  Here are some practical things you can do to improve your sleep and minimize the need for sleeping medication:

  • Stick to a regular waking time every day, even if you slept badly the night before.
  • Avoid naps during the day, since that will make it harder to sleep that night.
  • Limit your time in bed to no more than 8 hours per day.  Spending more time in bed more often leads to more depression rather than more restful sleep.
  • Move your bedroom clock so you can’t see it.  Watching the clock when you can’t sleep just makes you feel worse.
  • If you are lying in bed feeling more and more awake, get out bed, sit in a quiet place, and do something relaxing (or even boring) until you feel sleepy again.

Following those steps can be hard at first.  But they really do work—without any long list of side effects!

About the Doc

About the Doc

Greg Simon, MD, MPH, is a psychiatrist and researcher at  Kaiser Permanente Washington Health Research Institute in Seattle. His research focuses on improving the quality and availability of mental health services for people living with mood disorders, and he has a specific interest in activating consumers to expect and demand more effective mental health care.

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