A large group of drags that is used to induce sleep and can be purchased from the chemist without prescription is antihistamine, which is used for treating hay fever and allergic disorders. One of the main side-effects of these tablets is drowsiness, and hence they induce sleep easily. One well-known brand is promethazine, marketed as Phenergan. Antihistamine also possesses another property called the anticholinergic effect, by which the muscles of the urinary bladder are relaxed, causing urinary retention in people with prostrate trouble, since the bladder is unable to contract and void urine out through an obstructed urethra. It can also cause dizziness, irritability, and poor co-ordination, especially in the elderly.
Tryptophan is another non-prescribed hypnotic drug. It is one of the amino acids, and is a basic component of protein. Since this is a naturally occurring substance in most of our food, it had considerable appeal to the non-drug enthusiasts.
Trytophan is a precursor of serotonin in the brain, and serotonin is involved in the modulation of mood and sleep. Many studies have been conducted on the effectiveness of tryptophan in helping sleep. In animals and human subjects, tryptophan speeds up sleep onset, increases total sleep time, and reduces the number of awakenings during the night. It also has the advantage of not suppressing REM sleep like other sleeping pills. However, it is a very mild hypnotic compared to benzodiazepine.
Tryptophan is present in many foods, such as milk, eggs, meat, vegetables, and so on. It has been documented that a glass of malted milk before bedtime can help induce sleep. Tryptophan is marketed in Australia as Bioglan, Sedatol, Trypto-Sleep, Vita Glow, and Neuroremed.
The recommended dose is 1 to 4 g as a single dose one hour before sleep. A normal diet contains only a minute amount of tryptophan compared to the other amino acids. If tryptophan is taken after a high protein meal, only a small amount of tryptophan goes into the brain. It is recommended that tryptophan be taken instead after a high carbohydrate meal. The rationale is this: the carbohydrate induces secretion of insulin from the pancreas, which promotes absorption of competing amino acids into the muscle and leaves the tryptophan to be transported into the brain for inducing sleep.
The last drug I want to mention is alcohol. We have taken for granted that we can have a brandy as a nightcap. No doubt alcohol is a tranquillizer, and in larger doses a hypnotic which has been used for centuries. It has recently been shown that, not only is there a high risk of developing addiction if alcohol is taken regularly, but also there is a mini-withdrawal a few hours after sleep. This is because alcohol has an extremely short half-life. Awaking in the night after taking alcohol is a common occurrence.
Contra-indications
Are there any other reasons for not taking sleeping pills? Pregnant women run the risk of deformity and other harm to the foetus. The tragedy of Thalidomide is well documented, in which babies born to a mother taking Thalidomide sleeping pills had deformed or non-existent limbs. Women who are breast-feeding should not take sleeping pills either, as most drugs pass through the breast milk to the baby. The elderly who have to wake a few times at night to go to the toilet are also advised not to take them, as they can be very drowsy with sleeping pills and can injure themselves with falls easily.
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