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  1. I agree that medication should be the last resort if anything else fail. Medication should only be taken if you can not sleep at all. Since it is highly dangerous for the mind to not sleep.

    I regret that I only learn how to deal with the cause of insomnia only recently. I learn it from Reichenbach book, somnambulism and cramp. It is available for free.

    Some of is content can be seen on my article here:

  2. I was given a copy of your book, INSOMNIAC, when it was first published. My daughter bought it for me (it isn’t the first book on the subject she brought to me.) I have read so many of the same old, same old books on sleep deprivation, that I put it on the shelf and never opened the cover … until last night.

    It is NOT like the other books. I am tired (and tired of hearing the same advice). I have been an insomniac for half my life. I have suffered with zero sleep sometimes for days at a time. I have a son who is like me and it saddens me. He is now into BMT. I’m not sure how it is working for him because I don’t even like to bring up the subject of insomnia.

    I became so engrossed in your book, I think my brain went into overdrive (over-active). I am on Temazepam but it is not working too well for me. I lay awake for five hours and then got up and took a Temazepam. It didn’t work. So I had a cheese sandwich and a glass of wine, diluted with water (I don’t like wine). Eventually, I fell asleep but it was not restorative. I know that is not good but I get desperate.

    I think I need to read your book early in the morning, in small sections. I think I was so excited to read truth, it wrecked my night’s sleep, but it was worth it.

  3. I have had difficulty sleeping all my life. As a result, I seen several psychiatrists and psychotherapists. I have tried CBT, DBT, yoga and a variety of behavoiral modification methods. My current drug regimen allows me to be successful as a graduate student and intern but at the same time, I feel lke a drug addict, I currently take 15 mg of ambien and 200 mg of seroquel. Unfortunately, I continue to feel guilty taking this medication because my doctor is constantly trying to lower my dose. I hate feeling this way but at the same time, these drugs allow me to sleep each and every night.

  4. I would be really interested to hear what, if any, experience people have had using marijuana as a sleep aid, specifically ingesting it rather than smoking. I was given some pot by a sympathetic friend with a recipe for cannabutter and green dragon drink. I’m a bit fearful of trying it, but I’ve certainly tried a lot of other things mentioned here and suffered side effects and ineffectiveness from many of them. I find there’s a lot of research out there on uses of pot for pain and nausea, but not finding a lot on sleep… anyone?

  5. I just ordered your book, and am very excited to read it. One of the worst things about insomnia is the impression, nurtured ion those sleepless hours of listening to spouses/family members/roommates snore away contentedly, that we are all alone. Perhaps this book will bring some of the peace of mind that comes with camaraderie.

    I do find that a sense of well-being nurtured by supportive community is one of the best soporifics. I have been an insomniac since I was a young girl still sleeping with my mom, and now I have found a measure of relief from taking a low dose of Xanax every night. Having alternated between Xanax and Ambien on a nightly basis for nearly 7 years, I am in disbelief of the number of doctors who still refuse to prescribe these drugs for long-term use because they insist that they become ineffective over time. I suppose that as you say, everyone has such individual responses to these drugs and there are so many flavors of insomnia.

    There are still many times when nothing gets me to sleep, no matter how tired or well-exercised I am, and like all of us I await the discovery of just what chemical imbalance we have in common.

    My mind doesn’t race; it just sits there in limbo. For hours.

    Things (besides Alprazolam or Ambien) that sometimes work for me:
    1. yoga–specifically sun salutations–in the middle of the night, when I can’t sleep
    2. Strong Valerian tea (not pills)
    3. having other people around (in addition to my partner. As in having overnight guests, or sleeping in a commune)
    4. Tylenol PM, but only when I really need it for the pain, like on those days I have menstrual cramps. Benadryl contains the same drug and in the same dosage, but doesn’t work for me in general–I think there must be a relaxing psychological effect of taking the same drug on the same two days every month.
    5. Writing

  6. I have had insomnia most of my life and have tried everything from pharmaceutical drugs to morning light therapy, biofeedback, acupuncture and herbal remedies. Marijuana is by far the most effective and reliable way for me to sleep.

  7. I am 60 and suffer a steadily worsening insomnia of many years. I am a biomedical researcher, in a field that has nothing to do with sleep or insomnia.

    If there is something universal about the health authorities’ recommendations regarding the insomnia drugs across the globe, it is the insistence on short-term use. But insomnia is long-term for millions of people! Extensive literature exists to recommend treating such long-standing conditions by various behavioral therapies. I am convinced, that in many (most?) of those chronic cases the “shrink approach” doesn’t work, or is just not enough (and often impractical). In other words: it’s not our bad life-style, it’s our bad biology. Ww need drugs for chronic use.

    I think Gayle’s post on drugs is excellent, but it would be great if people wanted to contribute some specific experience: which drugs did work for you over long haul? Did you have to switch ? (Back and forth? Cycle between several varieties?) Was that helpful? This is where I am now myself: after a year on almost nightly zopiclone (cousin to eszopiclone in the US) I may be seeing a wearing-off of the effect (technically known as “tolerance”.I cannot be sure, though: it could also be, that my insomnia just got worse over that year, and the old dosis is no longer adequate). Are there people out there with a similar experience? I am thinking of switching to zolpidem (Ambion), or perhaps to another, completely unrelated drug (like doxepin – Sinquan). Has anyone tried this kind of strategy? Has anyone been told by a competent doctor that it is a good idea?

  8. Anyone ever tried stimulant meds instead? I had an idea that if sleep meds interfere with restorative sleep, then why not take stimulants in the morning to avoid the fatigue and irritability while you try your CBTs to kick the insomnia? I tried to talk about this idea to the Dr. and you’d think I was asking about taking meth… While it may be a horrible idea to the Dr., I still have to put in full days of work on 4-5 hours of sleep for days on end and so giving up caffeine and other stuff is simply not an option for me. However, maybe someone else has tried it, and did it help?

  9. I tried doxepin a while ago, I think 3mg? It didn’t help me sleep through the night as promised. All it did is make me really, really pissed off that not only am I still up at 2AM, but now I’m also fighting the effects of this drug, too.

  10. Thanks Gayle for your excellent and beautifully written book. At last an impassioned but reasoned response to the CBT crowd, who, having spread throughout psychology like a virus, have also colonised sleep disorders. I work as a mental health nurse and am also studying counselling/psychotherapy, so have studied CBT in some detail. While it can be very useful, it is also something of a simplistic “paint by numbers” approach which ignores individual differences and contexts and tends to blame the victim. In keeping with this, CBT sees insomniacs as sissies who just need to “man up” and learn to survive on little sleep and/or as directly responsible for their own problems. Unfortunately they have managed to propagate their fundamentalist views to doctors in general, to the point where most now see insomnia as a problem of bad habits and faulty reasoning on the part of the sufferer.

    Imagine if doctors told depressives to just try to “hang tough” and cope with their feelings without meds. Or people with high blood pressure, high cholesterol or even impotence. Why do these patients get meds at the drop of a hat, despite the evidence that lifestyle and attitude may contributes to their illnesses, while insomniacs are left to hang in the wind. When we try to get meds, we are made to feel ashamed for our “weakness” in wanting what most people take for granted—regular sleep—or we are treated like drug addicts. I have a friend who till, recently, hadn’t slept more than three hours a night for over twenty years. She looked exhausted all the time and had lots of aches and pains, great trouble concentrating and lots of other life difficulties. I’m sure it has taken years off her life. Her doctor refused to prescribe anything for her till very recently, when she finally relented and gave her a script for Amitryptilline 25 mg. She takes one or two a night and sleeps better now (but has gained some weight—one of the side effects).

    I’ve had insomnia all my life—since babyhood according to my mother. It might be more accurate to call my condition Circadian Rhythm Disorder combined with Non 24 syndrome. I could get 7 hrs sleep at a stretch but my body can’t make up its mind when to switch on the sleepiness. However, it’s never, ever switched it on at a normal time. Left to my own devices, I might not get sleepy till 5 am, 7am or even 9 am. Waking up at the same time each day is no cure for this, despite what the CBT’ers insist. I once worked for 6 months on morning shift, starting at 7am, 5 days a week. My body still refused to get sleepy at anything like a normal time but did relent a little, sometimes letting me sleep by 2 or 3 am. I spent that 6 months living on 3 hrs sleep/night. I got lots of colds and viruses and felt like crap the entire time.

    I believe my sleep problem is neurological and genetic. I have evidence that my grandfather and his brothers all suffered with it, and my young niece and nephew are showing signs as well. Left to their own devices, they go to bed at 3 or 4 am. When there are so many insomniacs out there like me, for whom the CBT programme just doesn’t work, why is medical science so uninterested in looking at biochemical causation? By contrast, the evidence for chemical imbalance in depression is quite weak. It is not proven that low serotonin levels cause depression. This is just a theory, and not even a very scientific theory at that. Yet doctors will write virtually anyone up for these drugs, despite their side effects and the fact that they cause dependence—people withdrawing from them can have a very rough time indeed. The same is true of antipsychotic drugs like Seroquel. I’m sure I could get my doctor to write this up for me. It’s treated as a benign drug and administered to virtually anyone with anxiety or agitation. I work in a psych hospital and am giving it out all the time to my non-psychotic patients. Why is this drug treated as benign when in fact it has dreadful side effects (predisposing people to obesity, diabetes, high cholesterol and other blood fats and very probably, given the consequences of these side effects, early death)? Yet the drug I take to sleep (Zopiclone, known here as Imovane) has far fewer side effects but is almost impossible to get a script for. At present I have a sympathetic doctor who prescribes it for me, but don’t know what I’ll do when she retires soon. I take it in combination with Amitryptilline—both in small doses (1/4 to ½ x 7.5 mg Zopiclone plus ¼ x 25 mg Amitryptilline). I now take these meds about 4 nights/wk on average. Previously I took them every night but then decided to try to only take them now and again. I have taken them for many years now but have NEVER had to increase the dose, despite what doctors and the CBT’ers insist about tolerance (the need to increase dosage to get the same effect) being inevitable. I find my insomnia is far worse when I’m premenstrual, which is when I go for ½ x Zopiclone 7.5 mg rather than ¼. At such times I am totally wired–without feeling stressed or worried. I’m just wide awake and no amount of relaxation is going to change that fact, anymore than relaxation would help a person with a normal sleep pattern fall into a deep sleep at say, 10 am.

    This med combo is the only thing that works for me when I can’t sleep. I’ve tried all the non-pharmacological alternatives—completely eliminating caffeine, avoiding late night exercise, avoiding getting stressed at night, getting up at the same time each day and even 2 years of psychotherapy, but still my insomnia refuses to budge. I’ve tried structuring my day so that I have plenty of time to “wind down” at night but that also had no effect. Short of attempting to live the quiet, restful and regimented life of a 90 year old in a nursing home, I don’t know what else I could do to comply with the CNT brigade’s instructions.

    I’ve also tried just living with it and telling myself that “it’s OK, you really don’t need that much sleep” etc. But trying to get through day after day on a few hours or no sleep is torture. No matter what they say, you are not operating on all cylinders when you’re sleep deprived, and Gayle has produced a lot of very convincing evidence about the very severe detrimental effects of sleep deprivation in her book—thanks especially for that, Gayle! I’ve nearly made some terrible errors in my job as a nurse due to insomnia. It’s simply impractical to expect people to lead a productive life on little sleep.

    There is so much stigma and ignorance surrounding insomnia. I think it’s one of the few remaining areas in health science where all the professionals feel free to be thoroughly judgemental and censorious. I doubt that any of those most guilty of these “holier than thou” attitudes has ever suffered the real pain and debilitating effects of chronic insomnia.

    Congrats Gayle on a great and much needed book, and hi to all my fellow insomniacs out there.

  11. Hi Gayle. I first became acquainted with your work on sleep when I heard you on CBC this past Sunday. You were excellent and by far the most know knowledgeable on the subject on the show. I had severe insomnia for 18 years and after a lot of resarch not to mention trial and error, I finally beat it. This is from a guy who was initially begging for medication from his doctor. I thank God he never gave it to me because if he had, I would never have learned what I did. The fact is, there are some causes of sleep problems that I have never seen before and are pretty bizarre by normal standards. From my experience, most sleep problems/solutions fall into a combination of 3 areas: nutrition, exercise and allergies, some of which you may not even know you have. I became a nutritionist as a result of my experience not only with sleep problems but asthma as well which I also eliminated not long after I conquered the insomnia. I suspect the lack of sleep contibuted to my asthma because my immune system was so compromised because of it. I came to the conclusion that the answers are always there. If you are persistent, you will find them.

    I would like to make you an offer.I would like to help you eliminate your sleep problem and I will charge you nothing for my time. I will stick with you until such time that we either beat it or you give up in frustration. The only thing I ask is that you keep an open mind and honestly work at it with me. I assume you are on medication right now and that will certainly complicate the situation.
    I’m honestly not sure how we deal with that aspect of things. Let me know what you think.
    Take care,
    Rick Tufts, Nutritionist, Toronto

  12. Hi Gayle, it was interesting reading your blog. I was insomniac since I could remember about myself. I never had a problem falling asleep, but would wake up after 2 (two) or three hours and always had difficulties falling asleep again. After let’s say 5-6 weeks of not sleeping, I would just crash at 7pm, sleep for 5 hours and wake up around midnight with the biggest headache (as 5 hours sleep is not my routine). I did try Valerian and Melatonin on couple of occassions, and they made me so drowsy… I was walking like a Zombie. The good thing about not sleeping is that my home is spotless, washing is done and I can go to work and come home and feel good. I did mention to my doctor(s) about not being able to sleep – they were not reluctant putting me on meds that I never took. So this is just my story. Josy from the Blue Mountains, Australia

  13. You are absolutely correct in stating that medication should be used as a last resort. The thing about medication is they do not cure your insomnia, they only mask it. While they may provide temporary sleep for a night or two, they are definitely not a long term solution.

    …Not to mention the fact that they can make you feel like a zombie in the morning. Of course, some of the medications are worse at this than others, but it’s always nicer to cure the insomnia naturally.

  14. Very nice article and debate.. Medicines are more dangerous than anybody thinks..People suffering from insomnia often start taking medicines and pills only in the hope that it will cure their insomnia permanently but as the evil habit of taking pills on regular basis starts growing , it starts lowering the quality of life of sufferers…So to avoid the ill effects of such medicines many natural insomnia remedies are now available which not only have zero side effects but can even help overcome insomnia permanently naturally…

  15. I am not going to say I am an insomniac, but I definitely suffer from not being able to sleep well. I used to have to take sleeping pills to go to sleep and those really didn’t seem to work. On average I would get 3 or 4 hours of uninterrupted sleep per night. I actually have an appointment to see if I have sleep apnea on Nov 5th which I am really hoping I do only because it will let me know why I am not sleeping well. Anyhow, I read that pure essential oils (certain ones) can help you sleep. I thought it was hocus pocus but I was at my wits ends so I broke down and purchased Lavender Pure Essential Oil and Roman Chamomile Pure Essential Oil from I mixed a few drops of each in a tiny bit of Virgin Olive oil that I purchased at the supermarket and I rub it into the soles of my feet at night time and I put a cotton ball with lavender on my nightstand. I know it sounds crazy but I actually think I am sleeping more soundly. I get a few more hours of sleep (except for having to wake up to use the rest room but normally after I do I am wide awake and now I am still groggy enough to go to bed). I don’t know why or how it works, but I believe it to be working. I don’t think it matters what company you use, you just want to use pure essential oils and not diluted or fragrance oils. Thought I would pass it along, as I know how horrible it is not being able to get to sleep. My bags under my eyes are not going away unfortunately but maybe they will if it turns out I have sleep apnea.

  16. Meds yes sometimes extra ones. If I don’t sleep my depression goes to a factor of 10 and that is not a good thing. Glad I found your blog. I just started one more faith based and dealing with chronic illness. Check it out if you get a minute. Would love to hear your comments. Thanks.

  17. I realize that this post is more than 4 years old but I just came upon it. Oh to have the choice to medicate or not! A bunch of years ago, my psychiatrist at the time put me on a ‘sleep cocktail’ – I really was desperate. But that cocktail – 200 mg trazadone, 7.5 mg. zopiclone and .5 ativan no longer does the trick consistently. So now i’m overmedicated and stil not sleeping properly – I fall asleep fine but then wake up around 2 am, stay awake for 3 hours or so and then sleep very fitfully after. It is awful.

  18. I just saw a great article in the New York times about people 65+ plus on meds. It pretty much had the same stance on the issue that you have. I happen to agree. Personally, it scares me how many older people take meds to sleep. What if they have sleep apnea and they do not even realize it? It could endanger their lives.

  19. I’d personally avoid pills – I had a bad experience once. A lot of people I know are using them to mixed results so I guess it depends on you really.

  20. I have been using Hemp Oil and it has helped ease my Insomnia a lot. I suggest one should definitely give it a shot.

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