Treatments for Insomnia

November 29, 2014 / Charles W. Lapp, MD / Ask The Doctor

Q: Are there any reliable treatments for insomnia?

A: Most experts on ME/CFS agree that sleep disruption is the one symptoms that should be addressed first. Sleep allows the tired achy muscles to recover; and lack of sleep increases pain and fatigue. There are many ways to approach insomnia, starting with good sleep habits, especially winding down, choosing a schedule and fixed wake time, aiming for 8-10 hours sleep per night, and avoiding TV and tablets at night. Then an over-the-counter remedy may be helpful such as diphenhydramine (Benadryl, Tylenol PM or Advil PM), doxylamine (ZzzQuil), melatonin, or an herbal sleep aid. Next, consider non-hypnotic medications such as eszopiclone (Lunesta), zaleplon (Sonata), or ramelteon (Rozerem). If these are insufficient, then a hypnotic agent such as zolpidem (Ambien) might work, but is associated with many more side effects. Doctors will sometimes prescribe benzodiazepines such as clonazepam, temazepam, lorazepam, etc., but these can be habituating and at higher doses may actually interfere with sleep. If these don’t work, then I recommend consulting a sleep specialist. So the answer to your question is that there are good treatments for sleep, but none that reliably work for everybody.

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Dr. Hillman was born and reared in Utica, New York. He attended college at Clarkson University where he earned a bachelor’s degree in engineering, and then spent two years toward a master’s degree in biochemistry/oncology at the University of Buffalo’s Roswell Park Division, where he did research in leukemia. Dr. Hillman attended St. George’s University School of Medicine, and completed his clinical years at the Maimonides Medical Center in Brooklyn, New York, graduating in 1996. During the Summer of 1994 he also did research at the University of Buffalo Dental School using PCR technology on RNA subtyping of gram negative oral bacteria. Following medical school, Hillman went on to a Family Practice Residency at North Shore / Long Island Jewish Hospital in Bay Shore, NY.

After his residency, Dr. Hillman worked for the US Army at the West Point Military Academy (Keller Army Hospital family practice unit), worked in the Emergency Room and hospital admitting areas, and ran a private practice as well. From 2005-2006 he also worked at the Winn Army Hospital at Fort Stewart, GA, before setting up a private Family Practice in Huntersville, NC in 2007. In addition to his private practice Dr. Hillman also has an interest in helping clients with disabilities. He has worked for ProMed Urgent Care in Occupational Medicine and performed over 13,000 examinations for Social Security Disability.

Dr. Hillman has a family member with Chronic Fatigue Syndrome, so he has a long standing interest and empathy with the disorder! He is married and has two sons and a daughter. The family lives in Huntersville.