Psychiatry & Psychotherapy Podcast Commonly Prescribed Sleep Medications and Treatment for Insomnia
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Sep 15, 2021 Shilpa Krishnan, a psychiatry resident focused on trauma-informed care and LGBTQ health. Shizuka Tomatsu, a resident exploring sleep’s biopsychosocial links. Michael Cummings, board-certified psychiatrist and sleep medicine expert. They discuss definitions and clinical approaches to insomnia. They cover CBTI access barriers, sleep hygiene and screens, melatonin and chronobiologics, classes of sedatives, and risks of long-term sedative use.
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Cut Screens Around Two Hours Before Bed
- Stop bright screens by about two hours before bedtime.
- Michael Cummings suggests stopping exposure by ~8 p.m. because melatonin onset is around 9 p.m. for many people and screens emit blue light that suppresses melatonin.
Cowboy Movies Were A Patient's Sleep Cue
- Some patients have unique sleep associations that help them sleep.
- Shizuka Tomatsu described a patient soothed by old Western movies because it mirrored childhood bedtime rituals, so a timer and dimmer helped keep that benefit without disruption.
Long Term Sedatives Link To Higher Mortality
- Chronic sedative use links to higher mortality and tolerance.
- Cummings cites large UK data showing long-term benzodiazepine or Z-drug use associates with ~3–4x hazard for all-cause mortality and rapid tolerance to sedative effects.