Medications and Insomnia: A Simple Overview

**This is not medical advice. Please see the full disclaimer at the bottom.**

My World of Sleep Meds

When I had insomnia, I think I tried every drug known to man. The only one I couldn’t bring myself to take was Xyrem, otherwise known as the “date rape” drug. That just felt like an absolute low in terms of desperation, so I managed to escape the grip of at least one med. 

Everything else was fair game.

There were several reasons I loathed taking sleep meds, the first of which was they never really worked that well for me. Or, they would work for a while and then they wouldn’t. This usually resulted in taking even higher dosages of the med, or changing meds altogether.

It was an exhausting merry-go-round of medication management. 

Plus, the side effects were no picnic. I often found myself stuck in the conundrum of figuring out which was worse: the discomfort of not sleeping, or walking around like a zombie?

Good times. 

Then there were all of the super fun emotions that came with taking them — deep feelings of shame and guilt (like I had somehow “failed” at something as simple as sleep). I beat myself up endlessly.

Even worse were the ongoing fears that preoccupied my life like:

“What if my doctor cuts me off?”
“What if the pharmacist thinks I’m an addict?”
“What if I build up a tolerance to every med on the market?”
“What kinds of side effects am I going to get from this med?”
"What if it causes long-term damage?"
"How am I ever going to get off these things?"

It was a never-ending cycle of anxiety. What's more, I had no understanding of how sleep meds even worked.

How Medications Work

Medications work primarily by virtue of delegation. Let me explain…

We know, fundamentally, that sleep is a passive process and the harder we try to sleep, the less we actually do.

When we take a medication (or supplement, or any intervention for that matter) we think, “Oh good, now I don’t have worry about my sleep anymore! I can just relax because this pill’s got me covered."

We put all of our stress and worry onto the medication, which allows our sleep drive to take over and we can fall asleep! 

So, it’s not the pill as much as it is letting go of all of the other stuff that allows sleep to happen.

Essentially, we outsource the struggle. 

Now you’re probably thinking, “Yeah, but aren’t the pills at least sedating?”

They are, but...

Sedation Alone Is Not Enough for Sleep to Happen

It’s true that many medications have a sedating effect; if we are sedated, our inner alarm system gets blunted. But sedation alone won’t create sleep. Often, I would take a bunch of medication and STILL be wide awake all night (probably the most frustrating thing on the planet).

This happened because sometimes, even with medication, I still feared not sleeping. This led me to worry, problem-solve and further try to control sleep, all of which create hyperarousal and subsequent sleeplessness.

It was almost as if I could feel the hyperarousal underneath the sedating effects of the meds. I was knocked out on the outside, but awake on the inside — or at least not sleeping in a way that felt anywhere near regenerating or refreshing.  

It was perplexing at best.

It's important to note that whenever sleep DOES happen, it's because your own body produced it, not the med. You can chalk it up to the innate wisdom and intelligence of your own amazing sleep system! 

It's tempting to believe that something outside ourselves can give us the sleep we so desire. Alternatively, we believe that if we don't sleep, it's the pill that somehow failed us, or stopped working. But that's not how sleep works.

Sleep is always an inside job. 

Besides, the medication itself isn't really the problem.

The Real Problem with Medication

Here’s the thing about medication…

In and of itself, it’s neither good nor bad. It’s whatever you believe it to be.

Medications only become a problem when we have a conflict about taking them. I know plenty of people who take medications every night of their life and don’t think twice about it. They’re not beating themselves up or feeling like a failure for taking medication, in fact, they’re absolutely thrilled to be taking it!

Our perception of the medication determines our experience of taking it.

As a sleep coach, my stance on sleep meds is relatively neutral. I’ve seen them be helpful, and I’ve seen them be harmful. There were many times during my insomnia cycles that I felt grateful for meds because they at least helped me feel slightly less insane. Even though they didn’t provide particularly nourishing sleep, they knocked me out and gave me a break from my own mind.

I’ve also seen medication work as a temporary bridge for some people, giving them the bandwidth they need to do some of the other work necessary to get beyond insomnia.

So, there’s no right or wrong when it comes to medication, only your perception of it.

When we take a medication and feel badly about taking it, we experience inner conflict. This ultimately leads to more hyperarousal and struggle around sleep (which is the last thing you need when you’re going through insomnia).

Let’s take a look at a few ways we can approach conflict…

How to Resolve Conflict About Taking Sleep Meds

If you are currently on meds, or coming off of meds and have a lot of inner struggle about the situation, there are a two ways you can resolve it:

1. Notice how you are thinking about taking medication and replace whatever self-criticism comes up with self-kindness. When you are okay with taking medication, there is no conflict or struggle. Move forward in your recovery knowing you can always re-evaluate down the road. 
   
   
2. You can also stop taking the medication (with your doctor’s approval), which also ends the conflict.

 
Either of these approaches will resolve conflict around taking meds.

The method I don’t recommend is the “wait and see” approach. This approach involves going to bed at night with the “hope” that medication won’t be needed. The intention behind this approach is noble, I tried it many times over the years.

What can happen with the wait and see approach, however, is a natural tendency to want to “monitor” if the approach is working. We create hyperarousal by trying to stay awake to see if we fall asleep.

If you decide to take medication, it can be helpful to take it every night at the same time without judgement. In fact, there is a simple way to reframe medication altogether…

“Vitaminizing” Medication

I love the idea of “Vitaminizing” medication. Now, I’m not telling you to go out and buy a bunch of vitamins in the form of medication. But if you’re stuck in a cycle of self-judgement about taking sleep meds, this could be a great way to look at it.

When you think about it, we never beat ourselves up for taking vitamins. To the contrary, we pat ourselves on the back and feel a sense of pride and achievement for even remembering to take them!

What if taking medication is just a temporary measure of self-care? An act of self-love as you navigate out of insomnia. 

The good news is any personal decisions you make about medication will in no way affect your ability to recover from insomnia. So, if you decide to stay on medication, do so from a place of kindness and acceptance. This isn't your forever. 

Big love,

Beth Kendall MA, FNTP

Holistic Sleep Coach

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DISCLAIMER: I am not a medical doctor and this is not medical advice. My goal is to empower you with information. Please make all health decisions yourself, consulting sources you trust, including a caring health care professional.