Guide to Wellness – July 2019

confused, distracted, or forgetful.

People taking supplements were

also far less likely to say the products

helped a lot than were those taking

OTC or prescription drugs.

Still, melatonin may have limited

but important uses for certain

situations, says Alcibiades Rodriguez,

M.D., the medical director of the

Comprehensive Epilepsy Center—

Sleep Center at New York University,

especially for people older than

70, who tend to make less melatonin.

It may also help people who need

to fall asleep at a time that’s not in

sync with their internal clock—

shift workers, for example, or those

suffering from jet lag.

There’s less evidence for other

supplements or herbal sleep aids. A

2015 review of 14 studies found that

people with insomnia who took the

herbs valerian, chamomile, kava,

and wuling didn’t sleep significantly

longer or better than those who

took a placebo.

Another sleep aid growing in popu-

larity: CBD (cannabidiol), a compound

extracted from cannabis plants,

including marijuana and hemp. (CBD

does not get you high.) In a separate

nationally representative 2018 CR

survey, of more than 2,000 people,

10 percent of people who had tried

CBD said they used it to improve

sleep, and a majority of these people

said it helped.

Limited research in humans suggests

that CBD may ease anxiety, and

improve sleep in people with chronic

pain. But there is still no clear medical

evidence that CBD helps with insomnia.

For more on CBD, see page 42.

Why a Nightcap

Is a No-No

About as many Americans drink

alcohol to help them sleep as take

supplements, according to CR’s survey.

Alcohol does make some people feel

sleepy, “but it disrupts sleep later on,”

says Jennifer Martin, Ph.D., associate

professor of medicine at UCLA.

For example, alcohol can interfere

with chemicals in your brain that

govern waking and sleeping, could

worsen apnea and snoring, or

may make you need to get up to go

to the bathroom.

And consistently getting disrupted

sleep can worsen a sleep disorder. In

some cases, this sets up a destructive

loop, in which people drink more

to try to sleep through the night, not

realizing that worsens the problem.

A Safer Path to Sleep

Make sure you’re not sabotaging your

shut-eye by, for example, drinking

caffeine late in the day, exposing

yourself to bright lights near bedtime,

or taking a smartphone to bed.

If you can’t solve the problem on

your own, talk to your doctor before

dosing yourself with OTC sleep aids.

In general, drugs should be reserved

for short-term insomnia, such as that

caused by jet lag or anxiety.

For sleeplessness lasting more than

a few weeks, look for a physician

certified in sleep medicine or ask your

doctor about CBT-I (see below). Some

people with severe sleep problems

may benefit from taking a prescription

sleep aid along with CBT-I, tapering

off as the therapy takes effect.

But long-term use is typically

not recommended. The drugs may

become less effective over time,

and in some cases people become

hooked and can’t stop. “Very few

people need sleep drugs long-term,”

Sateia says. “And in those cases

patients should be monitored carefully

to make sure that the drugs are

still effective and that they are not

developing a dependency.”

For more on sleep drugs, go to

CR.org/sleepdrugs0319.

Finding

a Sleep

Therapist

38 %

REPORTED SOME KIND OF MISUSE

AT LEAST ONCE IN THE PAST YEAR.*

AMONG U.S. ADULTS WHO USED SLEEP DRUGS:

50 %

TOOK A SLEEPING DRUG WITHOUT ALLOWING FOR AT LEAST

7 HOURS OF SLEEP AT LEAST ONCE IN THE PAST YEAR.*

Cognitive behavior

therapy for insomnia

typically involves four

to six sessions with

a therapist, who will

coach you on strategies

to improve sleep.

Unlike drugs, “the

benefits of CBT-I

last after therapy

ends,” says Jennifer

Martin, Ph.D., a sleep

psychologist at UCLA.

It’s best to work with

a therapist certified

in behavioral sleep

medicine. Go to absm.

org/bsmspecialists.

aspx to find one.

Online programs

might also help. One

is Sleepio, in which

a virtual sleep expert

guides you through

eight to 10 weekly

sessions tailored to you.

Sleepio is available

in the U.S. only through

certain insurers and

employers, and as part

of research trials. If

you’re interested, go to

sleepio.com.

A similar program,

SHUTi (myshuti.com),

is also looking for

research volunteers.

Martin also suggests

trying a free app called

CBT-i Coach.

CR.ORG GUIDE TO WELLNESS 71