How do we fall asleep? Do we actively go out and get sleep, or do we create a set of conditions where we allow sleep to come to us?
This may seem like a hypothetical or philosophical distinction, but it’s vital to understanding sleep management.
The advent of the sleeping pill has led to the misconception that sleep is something you can actively obtain, or “go get.” Unfortunately, that’s a false promise.
The Sleeping Pill: A Dangerous Path
The sleeping pill has led us down a detrimental path for two main reasons.
First, sleeping pills are dangerous. There’s robust evidence that sleeping pills are associated with an increased risk of falls, pneumonia, motor vehicle accidents, cognitive impairment, and premature death. At the societal level, they’ve created a very high burden of side effects.
Sleeping pills are also often taken for chronic daily use for years on end, which is off-label (meaning it’s not how they were studied and what they were approved for by the FDA). The safety and efficacy of sleeping pills has only been demonstrated in trials of several months’ duration. Even then, the absolute magnitude of sleep provided was minimal at best.
Secondly, sleeping pill culture has created a false understanding of how we fall asleep. The most healthy and efficient route to sleep focuses not on how to obtain sleep, but on how to identify and maximize the multiple necessary prerequisites to create the conditions for healthy sleep.
The sleeping pill masquerades as a single, simple solution to an undoubtedly multifactorial problem. This is far from the truth. Complicated problems require complicated solutions.
Rethinking Healthcare’s Approach to Sleep
Unfortunately, turning to a simple prescription is all too common. Our healthcare system at present doesn’t support a broader, deeper, multifactorial approach that would be more appropriate and help us sleep better.
That’s what I seek to address as a concierge physician.
Rather than seeing you for a 10-minute appointment, hearing a quick rundown of your sleep habits, and writing you a prescription, I may spend an hour speaking with you before I make a recommendation about how to improve your sleep.
And if I ever prescribe any kind of medication, I will be available if you have questions or encounter unforeseen difficulties.
Today’s Takeaways
- Think beyond the sleeping pill. When it comes to sleep, broaden your vantage point to see beyond “quick-fix” medication.
- Think like an internist. Create a “differential diagnosis” by listing the multiple factors you may need to address in order to improve your sleep.
- Remember the fundamentals of good sleep:
- Exercise
- Reduce stress
- Be cautious of your caffeine intake
- Create an environment conducive to sleep
Finally, make sure your physician’s philosophy aligns with your own. Otherwise, you probably won’t see the health results you want.
