Decades-long sleep disruptions

Dear Dr. Roach: For over 20 years, I have experienced difficulty with getting enough sleep at night. I typically get between five and six hours of sleep per night. I fall asleep quickly at about 10 p.m., but wake up between 3:30 a.m. and 5 a.m., unable to fall back asleep.

I have tried various sleep medications over the years, including overthe-counter products and prescriptions from my doctors. Two years ago, I met with a sleep doctor. He told me I am probably just in the lower end of the bell curve of how much sleep people need in order to feel and function well.

However, other information I read contradicts this opinion.

Recently, I have tried to wean off the melatonin and cyclobenzaprine sleep aids I am using. Unfortunately, I am having no success sleeping more than one or two hours per night without the use of some sleep aid product. I am 59 years old and did not have sleep problems until I was 37.

What are your thoughts/suggestions on how I can finally break out of this decades-long sleep problem?

B.M.G.

Answer: Cyclobenzaprine is used as a muscle relaxant and definitely can make people sleepy; though, I have never seen it used as such, and using it as a sleep aid is not in the list of approved (or even offlabel) uses for it.

I suspect this is the one (not the melatonin) that you are having trouble getting off of. It acts in a similar fashion to over-the-counter sleep aids like diphenhydramine, for which I don’t recommend long-term use of.

Among other things, they can dramatically reduce the quality of sleep you get, so you are never well-rested.

Getting off of sleep medication requires a slow taper (weeks, maybe months, and a pill cutter will make this easier) as well as effective sleep treatment.

Although in most cases, people can do this themselves, I would recommend a sleep medicine expert to you. Decades is too long to have this go on.