What about pain and sleep meds?

There's a lot of discomfort that our bodies and physically "power through," but lack of sleep or sleep quality is not one of them. How should you go about getting proper sleep and where do meds fit into that equation?

• Pain interferes with sleep, and sleep deprivation compounds pain.
• You may be able to change this cycle yourself by willpower alone, but other times you'll need help.

• The first thing to do about sleeplessness is to understand its source: Is it pain? Anxiety? Stress?
• Many things can contribute to sleeplessness, some without you even realizing it's happening.

Once you know what's affecting your sleep, you can try lifestyle changes such as:

• tweaking your diet (skip the coffee)
• changing your sleep habits (establish a sleep routine, listen to relaxing music before bed)

Despite your best efforts, there may be times when a sleeping pill can help temporarily if these changes haven't helped:

• if you have tried eliminating caffeine
• hanging room-darkening shades
• stretching in the evening
• going to bed at the same time every night
• or if your insomnia is causing anxiety and interfering with your waking activities.

But if used for more than four weeks, some sleeping pills can be psychologically if not physically addictive. They may also lessen the restorative dream stage of sleep, the REM stage.

If you do need sleep medication, your doctor may suggest one of the following options:

• Ibuprofen and diphenhydramine (Advil PM) and acetaminophen and diphenhydramine (Tylenol PM): These may help you sleep because of the addition of diphenhydramine, an antihistamine that causes drowsiness. But you may experience a spillover of daytime drowsiness and fuzzy-headedness.
• Nonbenzodiazepine hypnotics: These include prescription sleep medications you've probably heard of: zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata). These drugs are approved for short-term use only, that is, two weeks or less, with the exception of Lunesta, which may be used for a longer period of time.

After using sleep medications for a stretch, it is important to maintain good sleep habits so that you can get regular and restful sleep. This should help your pain and your mood.