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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45248
Experience:  Board Certified Physician
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I am sufffering from an addiction to nytrazapan sleeping pills

Customer Question

I am sufffering from an addiction to nytrazapan sleeping pills and wish to come off.
Can you help?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

you need to start a very very slow taper off of the nytrazapan sleeping pills

Dr. David :

and also work on helping your sleep

Dr. David :

you need to be exercising daily to help you sleep better.

Dr. David :

and set a fixed sleep time.

Dr. David :

no computer or TV in the bedroom.

Dr. David :

no caffeine in your diet.

Dr. David :

there are good sleep hygiene habits that you need to stick to.

Dr. David :

http://sleepfoundation.org/ask-the-expert/sleep-hygiene

Dr. David :

avoid napping during the day.

JACUSTOMER-8lt1jefx- :

I do exercise, walking the dog. and have not yet started coming off these pills, yet I NEED SLEEP.

Dr. David :

can you do more strenuous exercise than just walking the dog?

Dr. David :

can you do any aerobic exercise or pool therapy or speed walking or exercise on the tredmill or stepper?

Dr. David :

are you following all of the sleep hygiene suggestions here

Dr. David :

http://sleepfoundation.org/ask-the-expert/sleep-hygiene

Dr. David :

http://umm.edu/programs/sleep/patients/sleep-hygiene

Dr. David :

hello?

JACUSTOMER-8lt1jefx- :

I cannot nap during the day. What are the sleep hygiene habits? I am allergic to caffeine.

JACUSTOMER-8lt1jefx- :

IThank you for your help, I did not mean to sign up for a monthly fee, can you tell me please if I have done this, or just this one question? I would l ike to know the sleep hygiene habits you mention.

JACUSTOMER-8lt1jefx- :

I have no computer or TV in the bedroom, how do I work on helping my sleep?

JACUSTOMER-8lt1jefx- :

Too tired to do the other exercise suggestions and too old!! I cannot see any sleep hygiene suggestions unfortunately

Dr. David :

this is just one question .

Dr. David :

no monthly feeds

Dr. David :

Avoid napping during the day. It can disturb the normal pattern of sleep and wakefulness. Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol, causing arousal. Exercise can promote good sleep. Vigorous exercise should be taken in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night's sleep. Food can be disruptive right before sleep. Stay away from large meals close to bedtime. Also dietary changes can cause sleep problems, if someone is struggling with a sleep problem, it's not a good time to start experimenting with spicy dishes. And, remember, chocolate has caffeine. Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle. Establish a regular relaxing bedtime routine. Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don't dwell on, or bring your problems to bed. Associate your bed with sleep. It's not a good idea to use your bed to watch TV, listen to the radio, or read.

Dr. David :

Your Personal Habits
• Fix a bedtime and an awakening time. Do not be one of those people who allows bedtime and awakening time to drift. The body "gets used" to falling asleep at a certain time, but only if this is relatively fixed. Even if you are retired or not working, this is an essential component of good sleeping habits.



• Avoid napping during the day. If you nap throughout the day, it is no wonder that you will not be able to sleep at night. The late afternoon for most people is a "sleepy time." Many people will take a nap at that time. This is generally not a bad thing to do, provided you limit the nap to 30-45 minutes and can sleep well at night.



• Avoid alcohol 4-6 hours before bedtime. Many people believe that alcohol helps them sleep. While alcohol has an immediate sleep-inducing effect, a few hours later as the alcohol levels in your blood start to fall, there is a stimulant or wake-up effect.



• Avoid caffeine 4-6 hours before bedtime. This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate, so be careful.



• Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime. These can affect your ability to stay asleep.



• Exercise regularly, but not right before bed. Regular exercise, particularly in the afternoon, can help deepen sleep. Strenuous exercise within the 2 hours before bedtime, however, can decrease your ability to fall asleep.

Your Sleeping Environment
• Use comfortable bedding. Uncomfortable bedding can prevent good sleep. Evaluate whether or not this is a source of your problem, and make appropriate changes.



• Find a comfortable temperature setting for sleeping and keep the room well ventilated. If your bedroom is too cold or too hot, it can keep you awake. A cool (not cold) bedroom is often the most conducive to sleep.



• Block out all distracting noise, and eliminate as much light as possible.



• Reserve the bed for sleep and sex. Don't use the bed as an office, workroom or recreation room. Let your body "know" that the bed is associated with sleeping.

Getting Ready For Bed
• Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.



• Practice relaxation techniques before bed. Relaxation techniques such as yoga, deep breathing and others may help relieve anxiety and reduce muscle tension. 



• Don't take your worries to bed. Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.



• Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.



• Get into your favorite sleeping position. If you don't fall asleep within 15-30 minutes, get up, go into another room, and read until sleepy.

Getting Up in the Middle of the Night
Most people wake up one or two times a night for various reasons. If you find that you get up in the middle of night and cannot get back to sleep within 15-20 minutes, then do not remain in the bed "trying hard" to sleep. Get out of bed. Leave the bedroom. Read, have a light snack, do some quiet activity, or take a bath. You will generally find that you can get back to sleep 20 minutes or so later. Do not perform challenging or engaging activity such as office work, housework, etc. Do not watch television.
A Word About Television
Many people fall asleep with the television on in their room. Watching television before bedtime is often a bad idea. Television is a very engaging medium that tends to keep people up. We generally recommend that the television not be in the bedroom. At the appropriate bedtime, the TV should be turned off and the patient should go to bed. Some people find that the radio helps them go to sleep. Since radio is a less engaging medium than TV, this is probably a good idea.
Other Factors
• Several physical factors are known to upset sleep. These include arthritis, acid reflux with heartburn, menstruation, headaches and hot flashes. 



• Psychological and mental health problems like depression, anxiety and stress are often associated with sleeping difficulty. In many cases, difficulty staying asleep may be the only presenting sign of depression. A physician should be consulted about these issues to help determine the problem and the best treatment.



• Many medications can cause sleeplessness as a side effect. Ask your doctor or pharmacist if medications you are taking can lead to sleeplessness.



• To help overall improvement in sleep patterns, your doctor may prescribe sleep medications for short-term relief of a sleep problem. The decision to take sleeping aids is a medical one to be made in the context of your overall health picture.

Dr. David :

you can also try over the counter sleep aids such as tylenol PM or benadryl or 1-3mg of melatonin which can help with sleep.

Dr. David :

boiled milk or warm milk or camomile tea can help with sleep.

Expert:  Dr. David replied 2 years ago.
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Expert:  Dr. David replied 2 years ago.
please see my response above

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