Sleep Aid

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Captain Sleepless

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Friends - For some reason, I'm having difficulty sleeping. Melatonin doesn't work for me. Even a couple of Benadryl tablets haven't worked (and, yes, I wait the requisite period after taking Benadryl before flying).

Can anyone recommend a sleep aid that is allowed by the FAA (even one that requires a waiting period before flying)? FWIW, I'm on Basic Med, if that's pertinent to the discussion.

Thanks!
 
The old proverb says, "eat when you're hungry, sleep when you're tired." Some people require more sleep than others. Have you had a sleep study done?

On a humorous note ... reading the FARs should put you out pretty quick!
 
Physically tired does it for me. Half an hour going flat out on the exercise bike, for example. I would sit in a chair for a few minutes before tackling the stairs up to the bedroom. That beat chemicals in every way.
 
I will generally try to steer my patients away from any sort of medication or supplement intake as I find it's rarely helpful, especially in the long run, and sometimes develops into a psychological dependence in which the person comes to believe they need a medication to sleep (a self-fulfilling prophecy that's difficult to break). Usually better is to figure out why sleep patterns have changed. Stress, pain, and circadian rhythm disruption (e.g., shift work) are frequently a factor.

I recall having a conversation with a colleague some years ago who was a sleep specialist. He gave me a piece of advice that I've used myself to good effect (used to have terrible intermittent insomnia). The advice was this.

Commit to a waking-up time, and only go to sleep when you're tired.

In the morning, you wake up at that time every single day (including weekends). Doesn't matter if you got 8 hours or 8 minutes of sleep. You commit to waking at that time and starting your day.

When you wake, maximize light to give your brain the appropriate wake-up signals. If you enjoy coffee, this is a good time to have a cup. Avoid afternoon caffeine. In the evenings, dim the lights about an hour or so before you want to go to bed (this will stimulate melatonin production in the brain, which is preparatory for sleep). If you feel tired, go to bed. If you don't, read a book or a magazine (don't argue with people on the internet!) until you feel tired. If you go to bed and don't fall asleep in about 30 minutes, get up again until you feel tired once more. The clock manages your wake-up time, not your bed-time. Finally, remove all visible clocks from your bedroom and set an alarm. If you wake up during the night, don't check the clock (you'll start doing math, which wakes up the brain). If the alarm hasn't sounded, it's still sleeping time and irrelevant what time it is. The bedroom should, of course, be cool, dark, and quiet without screens.

Done consistently, this method will have you waking up with or even slightly before your alarm, feeling well-rested. You will oscillate somewhat (some late nights and earlier nights) until gradually settling into a fairly consistent time in which you suddenly feel sleepy (the natural melatonin hitting). It requires you to hit the "I believe" button for a few weeks, but it's worth the effort.

Medications are not unreasonable if you need to rapidly acclimatize to time-zones (I've used them for military aviators crossing oceans) but I would steer clear otherwise.

Not what you asked, I know, but perhaps the above might be helpful.
 
If you have true insomnia, you should consult with a specialist. If you consume any caffeine at all, you should stop entirely. If you want to understand sleep, "Why We Sleep," is a great book.

As far as the FAA is concerned, all sleep aids are off limits while flying. That means you're expected to wait 5x the maximum dosing interval between taking a dose and flying. For a pill with a 6-hour dosing interval, that means you have to wait more than a day. You can see how this is untenable for something you take regularly if you ever want to fly.
 
Silence in the house at night doesn't work for me because there's road traffic, airplane traffic and neighborhood noise. I live under the 17 approach to KAPA - only the police helicopter is a problem. But I'm also very close to 2 of the busiest roads in the city (0.2 mile either way) and a major interstate (0.3 mile). Semi trucks doing deliveries, sirens, even gunshots at times. One neighbor’s teenager gets dropped off from work after 11 pm, the driveway is under my bedroom window. Another neighbor goes to work about 5 am. Gotta love car doors slamming.

So I have 4 different sleep playlists on my iPod which ties into the sound system. Blocks out noise, and I'm out cold in no time. I've noticed that I rarely get past the 2nd or 3rd song on the playlist. Need songs that are ballads or similar. Think of it more pleasant noise generator.
 
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Try a cup of chamomile tea with an eye dropper dose of passion flower extract. Works well for me, with no drowsiness the next day.

An hour or two (but probably no more than three or four) of rigorous sex can also help, and if it doesn’t at least it’s worth losing a night’s sleep.
 
Lindberg said:
That's a bit too strong of a statement. The FAA still cares if pilots operating under Basic Med or SP rules are chemically impaired.
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True, but they don’t express their deep sense of caring until the accident investigation.
 
Half Fast said:
True, but they don’t express their deep sense of caring until the accident [or other] investigation.
Click to expand...
I fully agree with the sentiment as far as how such an issue would come to the FAA's attention, since there's no affirmative notice like there is when you fill out a MedXpress form. But I can envision scenarios other than an accident investigation, such as someone at the airport reporting a pilot who appears to be impaired, or even a scorned lover dropping a dime. We've seen both scenarios alleged by posters here.
 
AvNavCom said:
I will generally try to steer my patients away from any sort of medication or supplement intake as I find it's rarely helpful, especially in the long run, and sometimes develops into a psychological dependence in which the person comes to believe they need a medication to sleep (a self-fulfilling prophecy that's difficult to break). Usually better is to figure out why sleep patterns have changed. Stress, pain, and circadian rhythm disruption (e.g., shift work) are frequently a factor.

I recall having a conversation with a colleague some years ago who was a sleep specialist. He gave me a piece of advice that I've used myself to good effect (used to have terrible intermittent insomnia). The advice was this.

Commit to a waking-up time, and only go to sleep when you're tired.

In the morning, you wake up at that time every single day (including weekends). Doesn't matter if you got 8 hours or 8 minutes of sleep. You commit to waking at that time and starting your day.

When you wake, maximize light to give your brain the appropriate wake-up signals. If you enjoy coffee, this is a good time to have a cup. Avoid afternoon caffeine. In the evenings, dim the lights about an hour or so before you want to go to bed (this will stimulate melatonin production in the brain, which is preparatory for sleep). If you feel tired, go to bed. If you don't, read a book or a magazine (don't argue with people on the internet!) until you feel tired. If you go to bed and don't fall asleep in about 30 minutes, get up again until you feel tired once more. The clock manages your wake-up time, not your bed-time. Finally, remove all visible clocks from your bedroom and set an alarm. If you wake up during the night, don't check the clock (you'll start doing math, which wakes up the brain). If the alarm hasn't sounded, it's still sleeping time and irrelevant what time it is. The bedroom should, of course, be cool, dark, and quiet without screens.

Done consistently, this method will have you waking up with or even slightly before your alarm, feeling well-rested. You will oscillate somewhat (some late nights and earlier nights) until gradually settling into a fairly consistent time in which you suddenly feel sleepy (the natural melatonin hitting). It requires you to hit the "I believe" button for a few weeks, but it's worth the effort.

Medications are not unreasonable if you need to rapidly acclimatize to time-zones (I've used them for military aviators crossing oceans) but I would steer clear otherwise.

Not what you asked, I know, but perhaps the above might be helpful.
Click to expand...

I also wake up at the same time everyday. I almost never use an alarm clock. I go to bed when tired, turn down any LED based screens an hour or so before bed. I have an ereader I often use to read at night, the ereader uses the e-ink paper with a red light, no blue light at all. Works great.

Tim
 
Lindberg said:
I fully agree with the sentiment as far as how such an issue would come to the FAA's attention, since there's no affirmative notice like there is when you fill out a MedXpress form. But I can envision scenarios other than an accident investigation, such as someone at the airport reporting a pilot who appears to be impaired, or even a scorned lover dropping a dime. We've seen both scenarios alleged by posters here.
Click to expand...

So are you advocating someone not have a conversation with their health care provider?
 
Captain Sleepless said:
Can anyone recommend a sleep aid that is allowed by the FAA (even one that requires a waiting period before flying)? FWIW, I'm on Basic Med, if that's pertinent to the discussion.
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Here's the issue. I don't think as a BasicMed pilot you are necessarily bound by the FAA's guidelines. The problem is that while those guidelines have a basis in reality, they don't take individual variations into account and they are seemingly inconsistent. Sleep aids is a good example.

The FAA guidelines on Rx sleep aids such as Ambien indicate a 24 hour waiting period. The guidelines on amphetamines, the ingredient in most OTC sleep aids (Unisom, Tylenol PM and the like) is 5 times the dosage interval. For comparison, that translates to a 24 hour waiting period for Ambien but 120 hours for the Unisom, which is a bit ridiculous.

The real problem isn't the guidelines. It's how these medications can affect you. The biggest issue with all of them is how they leave you feeling the next day. In addition to speaking with your personal physician, you might consider taking something when you won't be flying for several days. In many the next-day side effects are pretty obvious and, if you are used to being sharp, a noticeable dullness.
 
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Ever hear of a sleepless someone having coffee in the middle of the night to

HELP them sleep?
 
Doxylamine binds in the fat compartment (brain, spine) so it's 10 hour half life isn't what is active. There have been DUI 40 hours after use in which the cognitive overhang was severe. A "little ridiculous....?"

Zaleplon would be the shortest one....but chronic difficulties with sleep in and of itself has cognitive effects, re. 61.53....
 
OP here. Thanks everyone for the helpful information. Here are my responses to some of the issues/questions raised...

Dude. You are on BasicMed. Why are you not having this conversation with your PCM? There is no FAA involvement here.
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Understood, but I don't want to do or take anything that would run afoul of FAA protocols regardless of whether my primary care doc says it's OK.

If you consume any caffeine at all, you should stop entirely.
Click to expand...

I have one cup a day, early in the morning. These days, that's it.

Think of it more pleasant noise generator.
Click to expand...

I just ordered a white noise machine today.

Try a cup of chamomile tea with an eye dropper dose of passion flower extract. Works well for me, with no drowsiness the next day.
Click to expand...

I've tried a couple of different "sleepy" teas. No joy. :(

turn down any LED based screens an hour or so before bed
Click to expand...

Interesting. I typically watch a little bit of TV before going to sleep, and often feel myself dozing off while the TV is on. Then I shut the TV and try to fall asleep, and that's when the brain kicks into gear, and I can't fall asleep. It's obvious I'm tired because I start to doze with the TV on, but with it off...

Again, my thanks everyone. I really appreciate your thoughts and ideas.
 
Captain Sleepless said:
Understood, but I don't want to do or take anything that would run afoul of FAA protocols regardless of whether my primary care doc says it's OK.
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Good judgment.
Captain Sleepless said:
I have one cup a day, early in the morning. These days, that's it.
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Try none for a while. Like 2 weeks. See what happens.
Captain Sleepless said:
Interesting. I typically watch a little bit of TV before going to sleep, and often feel myself dozing off while the TV is on. Then I shut the TV and try to fall asleep, and that's when the brain kicks into gear, and I can't fall asleep. It's obvious I'm tired because I start to doze with the TV on, but with it off...
Click to expand...
Use the sleep timer on your TV, or get one with a sleep timer, so that when you get get drowsy, you can just doze off.
 
OP here. I think I had a bit of a sleepless epiphany last night!

Once again, I was watching TV and felt drowsy, so I turned the TV off, rolled over and, has been happening, suddenly felt anxious about falling asleep, and no longer drowsy. As I was laying there, I realized that I could hear my tinnitus, which I don't hear when I'm watching TV. So, I put on some comfy headphones with 60s rock playing just loud enough to drown out the tinnitus, and I think I actually got a decent night's sleep! Not OMG great, but I don't feel exhausted today.

Now I'm REALLY I'm looking forward to getting the white noise machine I ordered to see if that might give me some relief.

Thank you all again for the helpful suggestions and comments. I greatly appreciate them!
 
Try taking all clocks out of the bedroom or covering them from your sight. Once you see the time the mental math can begin which can stir concern and anxiety
 
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