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Aurornis | on: Sleep regularity is a stronger predictor of mortality risk than sleep duration (2023)
The comment above just said “sleeping pills” which is ambiguous. Melatonin is an OTC supplement. True “sleeping pills” are usually controlled substances and few doctors would prescribe them as first-line options for a patient who shows up with first time complaints of sleep problems. They won’t be prescribed long-term either. The part of the post that says doctors (plural) tried to prescribe the pills makes me think it’s not traditional sleeping pills, because in this environment you would be unlikely to find one doctor willing to prescribe scheduled sleeping pills long term at all, let alone multiple doctors pushing them.

The usual suggestions from doctors for first line treatment are more mild medications that have drowsiness as a side effect, prescribed at low dose. I would actually prefer many of these low dose options over some of the high dose melatonin supplements. Melatonin is a hormone and taking it can throw off natural production

lII1lIlI11ll | parent | next
> True “sleeping pills” are usually controlled substances and few doctors would prescribe them as first-line options for a patient who shows up with first time complaints of sleep problems. They won’t be prescribed long-term either.

Modern orexin antagonist sleep medications are not addictive and can be taken long-term.

bigmadshoe | parent | next
It's worth keeping in mind that melatonin is also prescription-only in many countries e.g. UK, Canada, Japan, Australia.
derekja | root | parent
OTC in canada
bigmadshoe | root | parent
My bad, apparently it's prescription-only for children in particular.
voxic11 | parent | next
Lots of people take diphenhydramine products as sleeping pills and they are advertised as such OTC in the US. Long term Diphenhydramine use is associated with many negative health outcomes and despite the warning labels many people become dependent on them.
Aurornis | root | parent | next
The parent post was talking about doctor prescribed medications.

The reason diphenhydramine Is associated with a slight increase in dementia risk is the anticholinergic properties. This risk increase is from correlational studies on other medications with anticholinergic medicines being taken for many years by elderly people, so the risk of taking Benadryl occasionally is low to none.

The prescription alternatives like doxepin have the same antihistamine properties without the anticholinergic properties when used at the prescribed dose.

This is an example where people can get themselves into the wrong outcome by assuming anything their doctor prescribes is a last resort quick fix, but anything they can source by themself is safer and superior.

xp84 | root | parent
Yes - I saw a very interesting video the other day that educated me a lot on Benadryl - apparently it has a lot of side effects, can cause dementia, and is probably best avoided.
Aurornis | root | parent
Occasional Benadryl is fine. The dementia risk is from correlations found in other medicines that share some of the same properties, when taken for many years.

It’s not a good idea to take Benadryl for many years, but occasional use or even for months while going through a difficult period isn’t going to cause dementia.

ragall | root | parent
The dementia risk is from disrupting the circadian rhythm and suppressing the REM phases.
fc417fc802 | parent | next
> They won’t be prescribed long-term either.

Tramadol is routinely prescribed long term where I live. I know someone with a massive bottle good for something like 6 to 12 months of daily use. (I don't know if that's a good thing but it is certainly a thing.)

Aurornis | root | parent
Tramadol is a pain medication, not a sleep medication.

It has opioid effects and can cause drowsiness but would never be prescribed for sleep.

It’s also typically a controlled substance. I don’t know where you live but I’d be surprised if anyone was handed a 12 month supply in a bottle.

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Gluber | parent
In Austria a lot of times as second line ( after melatonin etc ) quetiapine is prescribed for its off label effects.