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Gabby Cinnamon (Host): Welcome back to the Well Within Reach Podcast, brought to you by Riverside healthcare. I'm your host, Gabby Cinnamon. And today, I am so excited to be joined by Kathleen Gallagher, Manager of Pulmonology and Sleep Medicine at Riverside, to talk about sleep aids.

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Host: Thank you so much for coming back on the podcast today, Kathleen.

Kathleen Gallagher: Thanks for having me. This is a topic we haven't really talked about before, sleep aids. But it's a really good one.

Host: It is. It is. Before we get in today's episode, can you tell us a little bit about yourself and your background?

Kathleen Gallagher: Well, I've been working here at Riverside. I think this is going on my eighth year. I first started out just in the sleep center and then acquired pulmonology along the way, which was perfect, because those are my sleep doctors over there and having good access to them. Really having a great experience here at Riverside. If you're looking for a job, come on over. Lots of spots for you.

Host: Yes, yes. So, you're right, we have not talked about sleep aids, and this is a topic that I hear a lot about. I feel like everyone I know takes melatonin or some kind of sleep aid. Can you explain to us what is a sleep aid.

Kathleen Gallagher: Sleep aid, anything that helps you sleep. I would say it's just really simple like that. I personally have never taken a sleep aid. I know there are a lot of people who are out there that do. Even a lot of the younger people are taking it.

Host: Yeah. I even hear of kids now taking melatonin.

Kathleen Gallagher: There are a lot of kids taking melatonIn. However, there is some research that suggests or has proven that it does delay puberty in children.

Host: Oh, interesting.

Kathleen Gallagher: So, maybe people might want to look into that.

Host: Yeah, yeah. Are there different kinds of sleep aids? You know, over-the-counter, prescription. What are the different kinds?

Kathleen Gallagher: Sure. There definitely are prescription medications. So, those are the ones your doctor is going to give you. There's over-the-counter medication that you certainly can walk up and go in any Costco, CVS and purchase prescriptions. And then, there's dietary supplements that people like to take too, rather than go for the other kind of supplements that are out there.

Host: Interesting. So, why do you think the use of sleep aids has risen so much over the last 10 to 15 years?

Kathleen Gallagher: Well, honestly, I think right now it's an easy fix. It's a quick fix. It's a lifestyle thing. Long ago, before there was technology at our fingertips like it is, somebody had to get up and change that channel on the TV, you know, everybody went to bed. But there's so much other stuff going on. There's sports, there are people who want to get that last workout, and there's different things going on.

But you know what? It's interesting because when I looked up what the sleep aid projection looks like, they're saying that the increased demand for the growing occurrence of sleepiness around the world is what's going to cause this. So globally, in 2022, it was estimated it was about a $78-billion business for sleep aids. By 2032, it's supposed to grow to be a $131-billion business globally, because the demand is going to be for people to create better drugs or things on the market to help people sleep, because some of the things that are out there, you know, we talk about how you gain a tolerance to them. So, what else is there going to be out there that can help me sleep?

Host: Yeah, the tolerance thing is interesting because I feel like I have friends that take melatonin. They're like, "Oh, yeah. You know, I'm just so used to it. I have to take however much." And I'm like, "Oh, my gosh. It's like it's enough to tranquilize a horse," like, my word. But yeah, people build up a tolerance to it.

Kathleen Gallagher: And the one thing about melatonin that I've learned after speaking to a lot of people is one kind might work for you, another kind might work for somebody else. They're not really FDA regulated, so you don't know how much melatonin is in product A versus product B.

Host: Interesting.

Kathleen Gallagher: Or different types of capsules versus tablets, et cetera. Gummies, you know, people take a lot of that stuff, too.

Host: Yeah, yeah. What are some of the dangers of using sleep aids? Are there any unwanted side effects that people should be aware of, especially ones that they might not think about?

Kathleen Gallagher: Sure. There are definitely dangers to taking some sleep aids. Again, most sleep aids are just designed to be short-term fixes. They're not designed to be taken long term. But a lot of people do take them long term, and like we just said, they develop a tolerance to them. But they increase their dosage, abusing the sleep aid. it also can band aid another underlying issue that you're not realizing. And not only that, it can interact with other medications you're not even thinking about. So, these are things that maybe you might want to talk to somebody about. And they vary, the potential side effects vary among different types of medications.

But what I really hear from people, especially those who take melatonin, is sometimes you can have a hangover effect. And I believe that can happen in the other ones too, where you might not feel so coordinated, you're dizzy, you're definitely going to be tired in the morning because that sleep aid still might be lingering in your system. But then, you got to worry about driving, you know, because you might be feeling dizzy. You can have other things. Imagine you have an allergy to any kind of medication, so that kind of stuff can even happen if you're taking a medication for the first time and you're not really sure of.

Host: Yeah. I feel like I'm the same as you. I've never taken melatonin or anything like that. I'm also the type of person who takes a single Benadryl and is knocked out. So, that's part of the thing, I think too, that keeps me from taking or trying it melatonin or something like that. Because I feel like I would just be a mess the next day, like unable to function. And I can't imagine.

Kathleen Gallagher: The different types of medications, when we said prescription, over-the-counter, and some of the supplements, the ones that are prescription are really designed to slow down your brain activity. They can even block that part of your brain that makes you feel alert. Whereas some of the over-the-counter drugs, you know, same thing Benadryl, Advil, like you said, there's a lot of sedative effects. Same with dietary supplements, like we said, melatonin. Some people take valerian root also for supplements, but the thing with them is you don't know if you're only getting one ingredient or multiple ingredients inside that package or bottle you're taking.

Host: Yeah, that's kind of scary to think about. I think that people don't realize when things aren't regulated, you don't really know what's in them. So, what advice would you or one of our sleep docs give someone who's maybe thinking about trying a sleep aid? It's like a first course of action, I guess, if they're having sleep issues.

Kathleen Gallagher: I think first you want to understand what the underlying reason is. Maybe there's some life event that just happened. You can have acute insomnia, because that's why we're taking this. It means something just brought on this, maybe a death in the family, an illness, or it's short-term and it'll eventually reside. Sometimes it's chronic, where it lasts for a long time. Sometimes insomnia, especially in women, presents itself as really maybe sleep apnea. And we would really suggest try relaxation techniques. You really need to set yourself up for sleep. Find that time to unwind before you go to bed. Listen to soft music. I always like to suggest that one. We have apps out there, which are great for listening to music. Guided meditation for sleep is something I always recommend because that guided meditation is going to help you turn off what you're thinking about in your brain, and you have to listen to what the relaxation techniques are as you can relax your body. Otherwise, cognitive behavioral therapy for insomnia is a big thing, and I'll say the docs actually recommend that.

Host: Oh, wow. Yeah. I think. It sounds like making some lifestyle changes is probably a better first step than trying sleep aids, because like you said, it's just a short-term fix. Especially if you take it and you have negative side effects, I mean, that's not a good long-term strategy.

Kathleen Gallagher: Exactly. And you know what? Like I said, it interacts differently. And I want to bring up alcohol. Because alcohol, if you're drinking alcohol, and combining these with any of these things, alcohol is a sedative too. And some people think alcohol helps them go to sleep. Well, yeah, alcohol is a sedative. But you know what? After it wears out in your brain, you're awake. So, it really causes restless sleep, even brings on nightmares.

Host: Oh, wow. Interesting. So, we are going to take a quick break to talk about primary care at Riverside.

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And now, back to our podcast about sleep aids with Kathleen. So if someone schedules an appointment with one of our sleep docs or they've been referred to our sleep doc team, what do they suggest that they do? If they come in saying, "I can't sleep, what do they tell them?

Kathleen Gallagher: Well, I'm sure patients will come in, tell our sleep docs that they can't sleep. They'll really get kind of a good history and background to find out what's going on. They don't typically recommend sleep aids. They'd like to find out what the underlying cause is, and maybe even test them to see if there's any sleep issues going on that can contribute to insomnia. So, imagine it's, let's say sleep apnea, for example, and it causes you to wake up sometimes during the night. You go to the bathroom. And then, you come back to bed and you can't go back to sleep. So, just making sure we don't have any other issues going on before they typically would recommend, you know, what the next steps would be.

Host: Yeah. I think too I hear of people who are on different medications. Certain medications can also impact your sleep for other conditions. I know people who are on Synthroid for thyroid issues, sometimes they can tell, they're like, "Oh, my Synthroid must be off or something," because they can't sleep if the dosage is too high or what have you.

Kathleen Gallagher: That brings up a good point. You know, as we are consumers, we have to be our best advocates. And you can look up online, " How does Synthroid affect my sleep? How does any medication I'm taking affect my sleep?" And it should tell you.

Host: Yeah. So, it could be other things that you might not realize that are causing these problems. So, let's say someone has been trying to take matters into their own hands and, you know, been trying sleep aids over-the-counter, but they're not helping or they try melatonin and they feel terrible the next day and it's not worth it to them, but they're still having these sleep issues. What would you recommend that they do?

Kathleen Gallagher: A, they can talk to their sleep provider, but I like to tell people to keep a sleep diary, try something different. Are you drinking caffeine too late in the day? Cut it out. Keep a little diary next to the bed and see, "Did I sleep better?" For everybody, insomnia presents differently in everybody, so try to change something different. Did you try to do some relaxation techniques? Did you do little stretches or yoga? A warm shower? Take some warm milk? That's another thing. Anything that can help you just relax to get to sleep. I really like the ideas of more the relaxation stuff than I do taking over-the-counter medication, because you don't know how you're going to react to it and people become dependent on it. So, I think it's best to talk to your provider about it and see what they say and what they can suggest or maybe your primary care will suggest, "Go see the sleep doc."

Host: Yeah, it's not sustainable. You know, it's more sustainable to make these changes. I know, for me, one thing, if we have an event after work or something, and I get home late, and I'm at the event, and I'm like, "Oh, my gosh. I'm so tired." But then, I get home, and I'm wired. There's so many things fluctuating throughout our lives or I work out too late, can't fall asleep. You know, you kind of have to look at, "What are these things that I'm doing that could be causing this?"

Kathleen Gallagher: Yeah. Working out too late might be one of them. You're kind of ramping up that body. You know, when we go to sleep at night, our body temperature has to lower, so even putting your temperature in the house about 65 degrees, because that's supposed to be the best ambient temperature. You can bundle up under those covers if you're cold, but at least in that temperature, your body would kind of maintain its temperature and sleep better. But I think setting yourself up for a good night's sleep is also something big. Take a warm shower, you know, because then your body temperature can easily work with taking a warm shower as your core is cooling off.

Host: Yeah. Let's say someone is maybe listening to this and they are an avid sleep aid taker. But they're like, "Oh, maybe I don't really want to keep taking these forever," what's the best course of action to stop taking the sleep aids and find some other ways to help with their sleep?

Kathleen Gallagher: I think they need to work on that with their provider, because you don't want to just stop taking something depending on what it is you're taking because you might have to gradually reduce it, and work with your provider and do that. But I think, even if you are on it, keeping regular visits with your doctor just to see if this is still what we're either maintaining or maybe we need to wean you off of it. But it's interesting because I still think back to that research that they are projecting, is that we as consumers are still going to look for better ways to get sleep because we know, as a nation, we're not getting enough sleep.

Host: People have just given up. You know, it's kind of like throwing in the towel and like, "Oh, I'll just take a sleep aid and who really cares?"

Kathleen Gallagher: We're the people that like a quick fix. "I don't want to have to work at it. Just give me the fix to put me to sleep because, you know, I need to get up in the morning and get through my day."

Host: So before we go, Kathleen, is there anything else you would like to add?

Kathleen Gallagher: I just think, you know what, people, it's about getting good quality sleep. And when I talk to people out there, teens on up, nobody is getting enough sleep. And I think we are our worst enemies. I've been guilty of staying up to watch that next episode on a series, because I want to see what's going to happen even though I know I'm cutting my sleep short, but I think we're all guilty of it. And I think if we really just consciously make the effort to change, we actually might feel better the next day.

Host: Yeah, yeah. Well, I think that's a great place to end off. Thank you so much for coming back on the podcast today, Kathleen. It's always a pleasure.

Kathleen Gallagher: Always happy to be here. We'll find a new topic for next time.

Host: Yes, we will. And thank you listeners for tuning in to Well Within Reach, brought to you by Riverside HealthCare.

For more information about Sleep Medicine at Riverside, visit riversidehealthcare.org/sleep. Also, make sure to rate and leave a review for the Well Within Reach podcast on Apple, Spotify, or wherever you listen to podcasts.