Seeking sleep solutions

January 19, 2009 2:09 PM

Can I get any better (stronger, more effective) OTC sleeping meds in the UK or Canada than I can in the U.S.?

I've got the chance to spend a few months in London, and don't want to pass it up. But I'm very bad at sleeping away from home, and won't be able to afford a very quiet, very luxurious hotel. Usually on vacations and business trips I just don't sleep much, but then I come back wiped out and usually sick. I don't want to go 3 months like that. I've tried every kind of over-the-counter medication I can get in the U.S., including herbals, and none of them work for me. I've also tried all the usual non-medical approaches: meditating, relaxation tapes, etc., with no success either.

I'm not sure if I can get a prescription for sleeping pills, but if there's anything I can get in the UK or Canada (where I'll be stopping on the way), I'd much rather try that than ask.

If it matters, I'm in my 50s, so am not likely to just grow out of this.

posted by still_wears_a_hat to health & fitness (11 comments total)

You're better off with a prescription pill. They're less habit forming, and it's easier to find a pill that is a good match for your problem (falling asleep, staying asleep, light sleeping, etc.). Talk to your doctor before you leave.
posted by decathecting at 2:31 PM on January 19

I agree with decathecting. And you should start taking them well in advance of your trip, rather than after you leave, because not every sleeping pill works the same way for every person, so you may have to go back to the doctor to get a script for something else.
posted by kate blank at 2:49 PM on January 19

If OTC options such as Tylenol PM have not worked, definitely get a prescription. Sleep is way too important. Asking for a sleeping perscription is very normal. President Bush 41 took them whenever he traveled. (I think he blamed his pill as the reason he threw up at a state dinner in Japan.)
posted by JohnnyGunn at 3:00 PM on January 19

Before you leave, go to the doctor and ask for a prescription. As JohnnyGunn mentions, travel is a totally legit reason to get sleeping meds. You can ask for something mild (like Trazodone) if you're worried about taking "hard drugs" or you can just go whole hog and get some Valium (f'rinstance. I'm not recommending any specific drugs).

I have sleep problems and I can tell you from experience that after two weeks, the OTC stuff won't work for you anymore. Worse, it doesn't work all that well to begin with, as you well know.
posted by grapefruitmoon at 3:14 PM on January 19

What kate blank said, except maybe your doctor could give you some samples first, then write the script for the one that works best.
posted by Robert Angelo at 3:33 PM on January 19

They're less habit forming...

I thought prescription sleep aids were usually benzodiazapines. Benzos are most definitely addictive, though not if used rarely or briefly.
posted by Chocolate Pickle at 4:09 PM on January 19

I thought prescription sleep aids were usually benzodiazapines. Benzos are most definitely addictive, though not if used rarely or briefly.

Just a note: I take prescription sleep aids regularly and in the past few years a lot of advances have been made - currently, doctors do not regularly prescribe benzos for mild sleep issues as they are, definitely, addictive.

Ambien, for one, is non-habit forming, as is Trazodone, which I mentioned. I'm not sure about Lunesta, which is even newer than Ambien. There are a LOT of options and most are not habit-forming.
posted by grapefruitmoon at 4:15 PM on January 19

As in the USA, most of the over-the-counter sleep aids available in the UK are diphenhydramine based. However, the UK version of contains promethazine, which is a prescription-only medication in the USA.

Any sleep medication, including the ones you get over-the-counter can be habit forming (that is, you can come to rely on it for sleep and find it impossible to sleep well without it). Benzodiazepines are both habit forming and addictive (they cause physical dependency and have a nasty withdrawl syndrome). This is also a problem with the nonbenzodiazepine hypnotics like Lunesta and Ambien.

Unfortunately, there are few good solutions for sleep problems. The available medications tend to be ineffective (antihistamines), addictive (benzodiazepines) or often cause unpleasant side effects (trazodone and seroquel). Sometimes all three.

There's some evidence that melatonin can be more effective at low doses. So you might want to try that if you haven't already, (break a 2mg tablet in half or quarters and take a couple of hours before you want to go to sleep). You'd need to bring it with you because it's not available in the UK without prescription.
posted by xchmp at 4:59 PM on January 19

Just a word of caution on Ambien (zolpidem tartrate - also marketed as Stilnox). It's a great sleeping drug solution for a lot of people but be careful if you are prone at all to sleep-walking or sleep-talking.

Users report vivid hallucinations, episodes of sleep-eating and sleep walking. New Scientist article here.

I used to take it as prescribed and go on all kinds of somnambulistic adventures - including cooking entire meals, shaving parts of my body and doing laundry - and have no memory of them the next day.
posted by evil_esto at 8:40 PM on January 19

Just on balance from evil_esto: I've taken Ambien (as prescribed) for over a year now, and I've never had any extracurricular sleep adventures, though yes, it is a side effect of the drug. Doesn't happen to everyone though.

And Ambien is non-habit forming. That is, I've been able to go off of it for months at a time without any serious withdrawal symptoms.

Still, no drugs are perfect.
posted by grapefruitmoon at 3:59 AM on January 20

grapefruitmoon: Ambien hasn't been habit forming for you so far. But this doesn't mean that it's never habit forming, nor does it mean that it cannot cause withdrawal symptoms on discontinuation. The current UK clinical guidelines (pdf) discuss this in some detail, point to the limited evidence available and call for further research. In particular:

The Committee was particularly concerned that patients may be preferentially prescribed Z-drugs or transferred from benzodiazepines to the Z-drugs because of a perception that they are less likely to induce dependency than the benzodiazepines. In addition, the Committee considered that the substitution of the Z-drugs for patients who were being withdrawn from benzodiazepines was inappropriate and not supported by available evidence of reduced potential for dependency.

posted by xchmp at 7:20 AM on January 20