In collaboration with Debbie Miskell, RN and Alma Leon, PharmD
Daylight Savings Time is coming up this weekend and if you’re like me, you’re not looking forward to losing an hour of sleep. I enjoy sleep, plus I know it’s good for my health. Sleep helps with memory consolidation, control of inflammation, hormone regulation, heart health, and many other important functions. Not getting enough sleep, or getting poor quality sleep, can lead to poor health outcomes. If you’ve never had any sleep issues, count yourself lucky. If, however, you are like millions of other people and have occasional or chronic sleep issues, read on for some tips and resources to get back to sleep.
Many people can overcome poor sleep by adjusting their environment or behaviors, such as:
- Maintain a consistent sleep schedule – get up at the same time every day, even on weekends.
- If you are in the habit of taking a nap, do not exceed 45 minutes of daytime sleep.
- Avoid alcohol 4 hours before bedtime and do not smoke.
- Avoid caffeine 6 hours before bedtime. This includes coffee, tea, sodas, as well as chocolate.
- Avoid heavy, spicy, or sugary foods 4 hours before bedtime. If you are hungry, have a light snack.
- Exercise regularly, but not right before bed.
- Use comfortable bedding.
- Find a comfortable temperature setting for sleeping and keep the room well ventilated.
- Block out all distracting noise and eliminate as much light as possible.
- Reserve the bed for sleep and sex. Don’t use the bed as an office.
- Reduce your fluid intake before bedtime.
There are also many who try these things but still find themselves unable to sleep or unable to get quality sleep. This may be due to underlying medical issues, a job that requires overnight or shift work, or temporary situations such as insomnia due to stress. If you fall into one of these categories, there are still opportunities to get help.
There are many natural and over the counter supplements and medications that can help with sleep. If you have occasional or mild sleep disturbances these may be a good choice in conjunction with the sleep tips listed above.
- L-tryptophan (amino acid found in egg whites, cheese, cod, soybeans, and pumpkin seeds)
- St. John’s Wort (Warning: has many drug interactions)
- Chamomile tea (safe for breastfeeding mothers)
- Some people recommend Valerian Root but it has many side effects and our recommendation is that most people avoid this product.
- Antihistamines, such as Benadryl, Unisom
- May cause dry mouth, dry eyes, constipation
- Avoid if you have enlarged prostate, BPH or glaucoma
- Potentially inappropriate for elderly individuals
- Recommended for short term use
- Rebound insomnia may occur
If you have chronic sleep issues, you should speak to your doctor so that he or she can determine the underlying cause and help you find a solution. Your doctor may recommend a prescription medication to promote sleep.
- Sedative Hypnotics such as Ambien, Lunesta, Belsomra, etc. (Controlled substance)
- Benzodiazepines such as Ativan, Restoril, and Halcion (Controlled substance)
- Others such as Rozerem, Silenor, and Desyrel
Avoid taking other medications that cause drowsiness such as anxiety meds, pain meds, muscle relaxers, and alcohol.
Sleep-related medications often come with a warning label that you should avoid operating a vehicle or heavy machinery. If it does and you are in a safety-sensitive position (subject to random drug tests), you may need to update your HR prescription form. Check the Employee Intranet or call HR for more information.
Manatee YourChoice Pharmacy Benefits
Generic sleep medications are covered
- $5 copay/30-day supply at preferred pharmacies (Apothicare, Pelots, and Winn Dixie)
- $15/30 day supply at non-preferred network pharmacies.
- Controlled medications are limited to 14 tabs/28-day supply
Brand Medications – refer to the co-pay structure on our website
- Ambien and Lunesta are excluded from coverage
- Sonata is a non-formulary brand product.
- Belsomra requires step therapy; no generic available
OTC and Natural products are not covered by pharmacy benefits but are generally inexpensive. Some sleep aids, such as Benadryl and Unisom, can be purchased using a Health Care Flexible Spending Account.
Medical Sleep Interventions
Your doctor may recommend a sleep study if you have excessive daytime fatigue, awaken with gasping or choking, have a BMI greater than 30, have narcolepsy, or other issues. If so, the Manatee YourChoice Health Plan covers testing for sleep disorders when using an in-network provider. The plan benefit pays according to your level of benefit: Ultimate Plan = $25 co-pay; Best, Better and Basic = deductible and co-insurance apply.
Sleep studies can be performed in an office, sleep lab, or at home. If you are diagnosed with sleep apnea and need a CPAP machine, this is covered by the medical plan.
- Ultimate Plan Members will have a 10% co-insurance
- Best Plan Members will have a 20% co-insurance + deductible
- Better Plan Members will have a 25% co-insurance + deductible
- Basic Plan Members will have a 50% co-insurance + deductible
Hopefully these tips and resources will get you on your way to better sleep. Everyone's situation is unique, so if you have specific questions about sleep, YourChoice Advocates are here to help. For medical questions, contact Debbie Miskell, Nurse Advocate. For pharmacy questions, contact Alma Leon, Pharmacy Advocate. We also have a team who can help you adjust your diet and exercise routine and/or help with stress reduction. Contact us any time!