Do ANY sleeping pills work?

COMMONLY prescribed sleeping pills can be helpful in the very short term for treating acute anxiety or distress of the sort that follows a bereavement or job loss.

I confess I use zopiclone to help with jet lag when my job sees me jetting to the U.S. or Australia.

But like all medications, sleeping pills have potential side-effects. They can become habit-forming, and they become less effective over time.

modern sleeping pills are less addictive than the old-fashioned barbiturates, but they can become habit-forming quite rapidly. That is why a GP will rarely give repeat prescriptions, saving them for short-term use.

If you are going through a more prolonged period of stress which is affecting your sleep, your GP might prescribe a low dose of amitriptyline — a drug used at higher doses for anxiety and depression but which can improve sleep at a lower dose.

It’s not a perfect fix. It leaves some people feeling a bit dopey or ‘hung over’ first thing in the morning, and it can have irritating side-effects such as a dry mouth. It can also interact with other medications.

There is a range of supplements and herbal remedies which can help if you have a short-term problem, and these are available over the counter. They don’t offer a longterm solution because they do not tackle the underlying causes of insomnia — but you might find some work with elements of my Fast Asleep plan to help intensify the beneficial effect.

▪ Chlorphenamine (Piriton) is a popular over-the-counter antihistamine used to treat hay fever and insect bites, and sometimes as a sleep remedy because it makes you feel drowsy. But it can clash with anti-depressants.

▪ Diphenhydramine (Nytol) is another sleep-inducing antihistamine which seems to be reasonably effective and has similar potential side-effects.

▪ Magnesium — small studies suggest supplements may help elderly people fall asleep faster. You can take it as a tablet or, because it can be absorbed through the skin, you could try a gel or bath flakes (both available from healthspan.co.uk) Alternatively, boost magnesium levels in your diet by eating avocados, leafy green vegetables, legumes and nuts, such as cashews and almonds.

▪ Tryptophan is an amino acid found in turkey which, when taken in moderate doses as a supplement, can help to improve sleep. It has been found in some cases to interact with other medicines such as antidepressants and it can also cause sideeffects such as sweating, anxiety, nausea and vomiting.

▪ Valerian is a popular sleeppromoting herbal supplement. There have been studies in which people taking 300-900mg of valerian before bedtime found it improved self-rated sleep quality. Again, watch out for drug interactions.

▪ Melatonin is a hormone that is produced by the pineal gland, a pea-shaped structure in the middle of your brain.

When it starts to get dark in the evening, light sensors in your eyes send a message to a specific area of your brain called the suprachiasmatic nucleus (SCN) which acts as your body clock.

This, in turn, instructs the pineal gland to start releasing melatonin. As levels then rise, the hormone helps to coordinate the other parts of your brain that tip you into sleep.

Studies show your melatonin levels naturally peak at around 3am and then slowly start to decline to prepare you for waking up in the morning.

As we get older, our brains tend to produce less melatonin (studies show levels at age 70 are only a quarter of those seen in younger adults), which is one reason our sleep quality tends to deteriorate with age.

Production is also affected by your exposure to natural light. So if you keep your home brightly lit, or you watch TV or work on a computer throughout the evening, there will be less of a dusk-stimulus for the SCN, and potentially a lower release of melatonin.

That’s why my Fast Asleep plan recommends dim lights in the evening as part of an effective wind-down plan (see tomorrow’s pull-out for more advice).