Read This If You Cannot Sleep

If you or a loved one cannot sleep, this Advanced Respiratory and Sleep Medicine blog article is a must-read. The good news is if you think you cannot sleep, you are probably wrong. It's not that you can't sleep. It's that you are not sleeping like you want, or you are not getting the results from sleep, like feeling refreshed that you expect. The reality is if you cannot sleep, you die. If you are reading this, then that has not happened yet. The only way you would die from insomnia is if you had a very rare neurological disease that affects middle-aged people called fatal familial insomnia. Insomnia is only one of the symptoms.

Other symptoms include hallucinations and movement problems such as difficulty walking. I have never been diagnosed with fatal familial insomnia (and I hope I never will), so I am certainly not an expert on it. I have also never seen anyone die from insomnia, so I don't think I have missed a case. Most people deal with insomnia at some point in their life.

Don’t reach for the sleeping pills.

Unfortunately, when people recognize they are having trouble sleeping, the first thing they do is reach for a bottle of pills. Pills do not solve the problem, and the most common prescription "sleep" medicines are associated with an increased risk of death. It does not make sense to prescribe these medicines for a condition that is not life-threatening, to begin with. New data out this week suggests over-the-counter medications, commonly referred to as supplements, may not be safe either.

What about nutritional supplements?

A JAMA article published in 2018 highlighted a high rate of adulterated substances in nutritional supplements. The article was not specific to substances marketed to sleep. Still, I think it would be naive to think they are not contaminated. That information should make you lose sleep at night. The reality is that when you buy a supplement, you have no idea what you are putting in your body. You are relying on the integrity of the company making the product. Call me cynical, but the first goal of most companies I encounter is not to promote my well-being. Rather, it is to help me depart with some of my money.

If you need help with your sleep, instead of looking to the pill bottle, approach your insomnia or poor quality sleep like any other problem. Identify the underlying cause and treat it accordingly. I can't promise the process will be simple, but it will be more effective than taking pills.