Good Night's Rest – At What Cost?

I've lived with insomnia for a very long time.

Some seasons, I try to ebb and flow as my insomnia does, managing it from a sleep environment, sleep hygiene, mental, and emotional health stability perspective. Sometimes, this works great. I get some sleep more often than not, and I've learned how to navigate the nights (and days) that are more challenging.

During other periods, I've needed more support. Getting longer, more quality rest has at times been imperative for my physical and mental health, and the only way to do that sometimes is by taking sleep medication.

Transitioning to sleep medication

This past summer was one where I made the transition from about 3 years off of any regular sleep-related medication to taking a pill (or 2) nightly.

I share more about the reasons why in this article, but the short story is that I survived a traumatic pregnancy loss, and my insomnia became greater than I could bear. I was hyper-focused on flashbacks and my anxiety was consuming me, making sleep nearly impossible.

Flexible dosing

About 2.5 months ago, my psychiatrist prescribed a new-to-me medication to help me get some rest. The pills are 10mg each, and she told me that based on my weight and other medications, I could take 1, 2, or 3 pills each night in order to both fall and stay asleep. The dosing was flexible based on my needs and the properties of the medication.

More sleep came with a cost

At first, I started with just 1 pill. I had hoped the dosing would be enough. Immediately, I noticed that sleep was coming easier to me. I still had to work hard before going to bed to get into the sleep mentality, but this medication allowed me to actually fall asleep.

Unfortunately, it wore off earlier than I'd have liked, and by 2 to 3 AM, I'd be wide awake, lying in bed defeatedly staring at the ceiling. When I switched to 2 pills each night, I got a better, longer in duration sleep – but after a few nights, I realized it was coming with a cost.

The sleeping pill was leaving me with a morning hangover.

The lingering effects of medication

I'd fall asleep relatively well, and although I was waking to use the restroom a few times during the night, I was immediately able to fall back asleep – something that I have struggled immensely with over time.

However, when my alarm would go off for work, I'd find myself aggressively hitting the snooze button far more often than I used to, desperate for a little more time to rest. My days began requiring both a shower and some caffeine to get going, and it felt challenging to think clearly. It seemed that I was still navigating the effects of the medication after they should've worn off.

Where is the balance?

This is where I struggled mentally – where is the balance? What is the price I was willing to pay in order to get some sleep? How much different was my level of morning functioning after non-medicated awake all nights versus decent restful sleep via medication? And which did I prefer?

This is a challenge I honestly continue to navigate. Some nights, I take just 1 pill. I get some rest, and usually wake up feeling okay, albeit a bit groggy. On weekends or nights where I desperately need more sleep, I'll take 2 pills and adjust to any struggles as they occur the following morning.

I'd love to know if I'm the only one experiencing this struggle? If you've navigated this tightrope before, what has helped you to decide what's best, both short and long term, for your body?