Sleep Aids---Melatonin VS Tylenol PM

Out of Curosity I was wondering which might be better as a Sleep Aid? I have been taking Melatonin 3 mg for about a month and Last night I took a Tylenol PM as I was having Pain in my Knees. I slept better with the Tylenol Pm than I did with the Melatonin. I know it is Bad to take too many Tylenol on a Regular Basis but I was thinking of alternating between the Tylenol Pm's and the Melatonin.

Tylenol PM has Benadryl in addition to the pain reliever. Benadryl is generally not recommended as a sleep aid though it has been used as such and continues to be used as such. I can cause excessive drying and generally leave you in a fog the next day. Plus it apparently doesn't put you in the level of deep restful sleep and can have long term negative impact on your brain. Melatonin is not a drug, it's a hormone that occurs naturally in your body. It's attributed to the regulation of sleep but not specifically a sleep aid. So to answer your question, neither, though if Melatonin works for you, it is generally presumed safer. I read an article about a study that said that 0.3mg was the optimum dose and higher doses can actually be counterproductive in regards to sleep. If you need a sleep aid, it would be best to consult your Doc.

I'm taking 0.3 mg of melatonin and it seems to help me fall asleep earlier.

But one ancedotal result does not a scientific study make.

And remember that the Tylenol PM is helping your knee pain, too. You should try taking melatonin plus regular acetaminophen.

Hi,

I don't have much experience with CPAP yet and am definitely not qualified to give medical advice, but the following is my experience with melatonin and Tylenol.

My GP told me to take 3mg of Melatonin and it didn't do anything at all. I spoke to my sleep specialist and he told me to take at least 9mg and to take it several hours before bed. I take 9mg on a regular basis. It doesn't substitute for a sleeping pill, but it is definitely easier to fall asleep when I take it. It doesn't, however, help me stay asleep.

I am probably overly cautious but I won't take Tylenol unless absolutely necessary anymore. For years, I took it almost every day because of severe headaches. Two years ago my cousin died suddenly at the age of 40 because of liver failure from taking too much Tylenol for pain. During one of the meetings with the ICU team/Doctors, before she died, they said Tylenol overdose is one of the biggest reasons for liver transplants and that everyone's tolerance level is different when taking more than the recommended dose, especially on a regular basis because it builds up in the liver. I suppose that is why there is warning on the bottle to see a physician if required for longer than a certain time period. That being said, when I refused to take it anymore, my doctor assured me that it is safe to take occasionally at or below the recommended dosage. He also said that other OTC analgesics can be just as dangerous if taken incorrectly. He did understand why I didn't want to take it and recommended something else.

That is just my experience in the long quest to get some sleep....

R

DannyP wrote:Out of Curosity I was wondering which might be better as a Sleep Aid? I have been taking Melatonin 3 mg for about a month and Last night I took a Tylenol PM as I was having Pain in my Knees. I slept better with the Tylenol Pm than I did with the Melatonin. I know it is Bad to take too many Tylenol on a Regular Basis but I was thinking of alternating between the Tylenol Pm's and the Melatonin.

I agree with Rusty, there is no good "sleep in capsule form".

If you don't have sleepiness the next day from melatonin and you think it is helping you, then it is fairly harmless so keep taking it every night.

Tylenol PM includes diphenhydramine hydrochloride (Benadryl). This is a nasty chemical that causes morning drowsiness in many people. I almost always recommend against it.

Straight Tylenol (actaminophen) is safe for longterm use in the dosages listed on the label. I would take it on the nights knee pain is present.

You might want to ask the doctor about the knee pain. If it is from inflammation he may prescribe some type of anti-inflammatory that would clear up the problem. Tylenol will relieve pain but it does not treat the source of the pain.

Don't know your equipment situation, but one of the best things CPAPers can do for themselves is to get a fully data-capable machine with a card reader and software. In my experience, this is the only way to optimize your CPAP therapy. Get it optimized and you may find out you can sleep much better and need no pills.

rooster wrote: Get it optimized and you may find out you can sleep much better and need no pills.

I'm going to have to disagree here. I'm fighting insomnia and I'm pretty much %100 perfect on everything. 1 cup of coffee a day, no other stimulants, no meds with stimulate properties just my lisinopril BP med and Nasonex, I have dinner between 6-7pm, no other snacks afterwards, no tobacco. Perfect by the book sleep hygene, have a Marpac white noise machine to mask the CPAP noise, my weekly avg. weekly AHI on the machine is under 4, I average 8.5 hours on the CPAP per night. I've tried staying up late, going to bed 2-3 hours early, melatonin, valerian, tilo. Still I cannot sleep, can't fall asleep, can't stay asleep, exception is when I take AmbienCR which I prefer not to do, at least not over several consecutive nights. The cycle of sleep deprivation followed by 2-3 days of good drug induced sleep is wearing on me. If I knew of a drug that I could take every day that ensured sleep, had no rebound insomnia, no addicition issues, no major side effects, I'd be on it like water.

Rustyolddude wrote: I'm going to have to disagree here. I'm fighting insomnia ... Perfect by the book sleep hygene,..

I'm right there with you, Rusty. I could write the book on sleep hygiene. I follow it and I'm still plagued by insomnia.

Having both insomnia and sleep apnea sucks eggs, believe me. Mine is fairly cyclical in nature. I can sleep pretty well for several months and then - out of the blue - BAM! I can't sleep to save my soul. I can go months and months without decent sleep no matter how good the sleep hygiene. Lunesta is one of the newer sleeping pills that *might* be less addicting. I don't think it's been out long enough to know that for a fact, however. It works well for me when I need it and then I wean myself off when my sleep gets better.

Yes, I know there are concerns about combining sleeping pills and CPAP. It could be dangerous. Not having a decent night's sleep for months on end is also dangerous. So, you pay your money and take your chances, right?

Rustyolddude wrote:

rooster wrote: Get it optimized and you may find out you can sleep much better and need no pills.

I'm going to have to disagree here. I'm fighting insomnia and I'm pretty much %100 perfect on everything. 1 cup of coffee a day, no other stimulants, no meds with stimulate properties just my lisinopril BP med and Nasonex, I have dinner between 6-7pm, no other snacks afterwards, no tobacco. Perfect by the book sleep hygene, have a Marpac white noise machine to mask the CPAP noise, my weekly avg. weekly AHI on the machine is under 4, I average 8.5 hours on the CPAP per night. I've tried staying up late, going to bed 2-3 hours early, melatonin, valerian, tilo. Still I cannot sleep, can't fall asleep, can't stay asleep, exception is when I take AmbienCR which I prefer not to do, at least not over several consecutive nights. The cycle of sleep deprivation followed by 2-3 days of good drug induced sleep is wearing on me. If I knew of a drug that I could take every day that ensured sleep, had no rebound insomnia, no addicition issues, no major side effects, I'd be on it like water.

Rusty,

You argument proves my point.

My advice was for DannyP. He didn't log in so we don't see a profile and might think he is new. You have done all the things I would advise DannyP to do. One of them is to first get your apnea therapy optimized. Some of the leading edge sleep doctors believe that sleep-disordered breathing (SDB) is the root cause of 90% of all insomnia. So it is perfectly prudent for DannyP, as a first step, to resolve his SDB and see if he is in the 90% that will be cured of insomnia.

From what you wrote it seems that this is what you did. You make sure your AHI is low, you follow good sleep hygiene practices and when all that fails to resolve insomnia, you reluctantly resort to Ambien. I think that would be an excellent route for DannyP to take. I would change one thing. Add a consultation with a good sleep doc before resorting to Ambien.

I am so sorry that you fall in the 10% with unresolved insomnia. I've had those problems and it can be an earthly hell.

The cyclical nature of your insomnia puzzles me, but I will suggest some things that you might try as a long shot cure.

-Drop caffeine entirely (You may want to go to one-half cup per day in the first step). Some people are hypersensitive to caffeine. Without conditioning, I cannot drink even one cup upon arising and sleep well that evening. I also "feel" the residual caffeine in most decaf brews.

-Drop the coticosteroid nasal spray for a few weeks. Some people are hypersensitive to even a small amount of cortisone and their sleep is impaired.

-If you do not have Encore Viewer and a card reader then get it. The Daily Details report is invaluable to many people and is not available in your LCD screen.

-An AHI around 4 can still mean about 30 events and arousals per night. This is not good conditioning for our brains and our sleep habits. Monitoring data with Encore Viewer might lead to some beneficial tweaking of your CPAP process. For instance, I consistently was getting AHI< 1.0 at pressure of 8.5 cm. I raised the pressure to 10.0 cm and my low AHI did not change but I slept much better! The pressure of 8.5 was taking care of my apneas and hypopneas very well. However, I have hypothesized that it was leaving me with some detrimental level of upper airway resistance syndrome (UARS) which would not be recorded as events. It is best to have the software tool before making pressure setting changes.

Best of luck for a speedy improvement,

rooster wrote: -Drop caffeine entirely (You may want to go to one-half cup per day in the first step). Some people are hypersensitive to caffeine. Without conditioning, I cannot drink even one cup upon arising and sleep well that evening. I also "feel" the residual caffeine in most decaf brews.

-Drop the coticosteroid nasal spray for a few weeks. Some people are hypersensitive to even a small amount of cortisone and their sleep is impaired.

-If you do not have Encore Viewer and a card reader then get it. The Daily Details report is invaluable to many people and is not available in your LCD screen.

-An AHI around 4 can still mean about 30 events and arousals per night. This is not good conditioning for our brains and our sleep habits. Monitoring data with Encore Viewer might lead to some beneficial tweaking of your CPAP process. For instance, I consistently was getting AHI< 1.0 at pressure of 8.5 cm. I raised the pressure to 10.0 cm and my low AHI did not change but I slept much better! The pressure of 8.5 was taking care of my apneas and hypopneas very well. However, I have hypothesized that it was leaving me with some detrimental level of upper airway resistance syndrome (UARS) which would not be recorded as events. It is best to have the software tool before making pressure setting changes.

Best of luck for a speedy improvement,

My card reader & software should be here today. I'm interested in one particular night this week when I took Benadryl knowing better and my AHI avg. shot up a few tenths.

I did some googling and it seems there are some complaints about insomnia, muscle cramps, anxiety from lisinopril users, gonna research some more today & if I find enough evidence of lisinopril linked to insomnia, I think I'm going to monitor my BP closely each day and stop taking the BP med for a week and see if things change. I'm 120/70 average and was put on the med when I hit 140/90 so I'm not at super high risk. If I find it's the cause of my insomnia, I'll make a call to the doc and see about getting a new Rx. I've been cold turkey on caffiene in the past. It's the 3 days of withdrawl headaches that I don't want to deal with right now. But 1/2 a cup is enough to stave off the headaches.

My son was diagnosed with a sleep disorder that has to do with the body's circadian rhythm. (Diagnosed first by me at 14, and then a few years later by a sleep specialist when he was 18. So many sleep specialists, at least back then and at least where I live, don't deal with anyone under 18. Anyway, my sleep specialist recommended melatonin up to 6 mg for him and that did the trick. First and only thing that works for him. He's now 21 and rarely has to take it, but it still works like a charm when he does, although it can make him a little sleepy the next day. (This particular sleep problem often shows up around puberty and gets better or goes away completely in someone's early 20's.)

There is also a combined time-release version of melatonin. Part of the pill is released immediately and the rest a few hours later. My sleep doc recommended that for me since I was having trouble waking up several times in the middle of the night even after successful cpap therapy.

I'd go with melatonin.

Pam

WearyOne wrote: There is also a combined time-release version of melatonin. Part of the pill is released immediately and the rest a few hours later. My sleep doc recommended that for me since I was having trouble waking up several times in the middle of the night even after successful cpap therapy.

I'd go with melatonin.

Pam

I've tried melatonin in combination with Valerian. Didn't prove to be effective in my case, I can uderstand it working in adolescents because so much body chemistry is changing at that point in a persons life.

I'm working on finding the underlying cause of my insomnia with the end goal of not having to treat it with drugs. But I have to take the drugs to sleep just to be able to function.

Rusty - Have you always had trouble with insomnia? If not, how long has it been a problem? I can remember laying awake for hours as a child.

Melatonin and Sleep apnea

The results of this study indicate that melatonin worsens some parameters of sleep-disordered breathing in patients treated with CPAP. AHI, MAD, and LAD all increased significantly (p<.05) in the melatonin condition. Apnea index increased marginally (p<.10) and SaO2 nadir did not differ between melatonin and placebo sessions. Thus, at present we believe it is prudent to caution patients with OSA that are treated with CPAP against taking melatonin to promote sleep.

millich wrote:Rusty - Have you always had trouble with insomnia? If not, how long has it been a problem? I can remember laying awake for hours as a child.

I have, my sleep quality has always been poor and as a child I'm certain had undiagnosed apnea. I'm in my 40's now. It takes me a considerable amount of time to fall asleep. Best I can describe it is I always have an awareness of where I've been for the past 8 hours when I sleep. I can count on one hand the number of times I've truly slept (without sleep aids) and woke realizing it was morning and I had slept for 8 hours, two of those times I was under anesthesia. Alcohol keeps me awake.

I'm waiting for a copy of the results of my sleep studies, called the lab this morning to check the status, both times my sleep quality was poor and that was with Ambien. Since I'm not a typical OSA patient, their words not mine, I'm really curious to see what the indicators were for prescribing CPAP. I'm not disputing it as it rules out one possibility and it's drug free and I'm comfortable with it and I did have issues as a child. But it's not the whole solution.

Meanwhile, I'm reading more & more about Lisinopril causing insomnia in some patients.

Rustyolddude wrote:...reading more & more about Lisinopril causing insomnia in some patients.

Read this (originally posted by Rooster) http://eon.businesswire.com/portal/site ... ewsLang=en. Might ask your doc about switching to an angiotensin receptor blocker (there are several) as they effectively treat the hypertension caused by oxygen deprivation. It seems to me that my systolic pressure rises following nights when I have mulitple events that wake me up, nights when I have none or maybe 1-2 my systolic pressure remains stable -- I think I must be especially sensitive to desats (so need funds to purchase equipment to verify this). If my theory is proved, then I may only need to take an ARB on the day following a rise in AHIs to a certain number or have a certain amt of time desaturated or when it reached a certain percentage. My hypertension disappeared after many months of xPAP therarpy. Systolic only began rising when I started losing therapy air thru lips.