One of the most common symptoms that can lead to significant brain disorders, like anxiety, depression, post traumatic stress disorder, bipolar disorder, and memory loss, is insomnia. Insomnia refers to the difficulty falling asleep, staying asleep, or waking earlier than one would expect or want to wake from sleep. In my field of medicine, psychiatry, they are fortunately many treatments for insomnia. Most people do not need medications for simple insomnia.
A simple place to start with the treatment of any insomnia is Cognitive Behavioral Therapy for Insomnia (CBTi). This form of therapy sounds expensive and unattainable for most, but the reality is that over the last 5 years, this form of very effective treatment is available FREE and it works. CBTi Coach is an App that was paid for in federal US dollars and offers a full self-guided CBTi program. This therapy is highly effective and should be used prior to trying any medication for insomnia per most guidelines and algorithms. CBTi should be used even prior to using over-the-counter medications.
When CBTi is not effective for insomnia symptoms, often physicians and clinicians in our office will recommend Melatonin or Magnesium or some combination of the two over-the-counter medications before using prescription medication. These again cost little, but it is important to know that not all melatonin and magnesium products are the same and that many of the over-the-counter melatonin products are not effective because the supplement industry is not held accountable by any government agency; supplements are not regulated.
These are some ways that over-the-counter supplements can be used. It is important to consult your physician as medications could have drug-drug interactions.
- Melatonin should be taken two hours prior to bedtime and when it is effective it will give some fatigue and drowsiness within the two hours and help an individual to fall asleep and stay asleep. If you fall asleep too quickly you are likely taking too much melatonin. Two brands that many of our patients find effective are Natrol Melatonin and REM Fresh.
- In addition, magnesium supplements can help together or instead of Melatonin. Good reputable US-based products are often the best bet for these supplements. Magnesium citrate is not recommended, however, other forms, such as Magnesium glycinate, Magnesium taurate, or Magnesium aspartate are very absorbable forms and can be taken 200mg to 500mg each night with or without Melatonin. Dosing may need to be reduced for side effects (for example, if diarrhea or loose bowels begins, your dose may be too high).
It these non-prescription options do not work for insomnia, a consultation with a psychiatrist or a sleep specialist may be necessary.
It is important to know that the NeuroScience & TMS treatment center does not sell supplements and we are not endorsing one product over another by offering this educational information. These brands and apps are the ones which we have seen our patients receive the most benefit.
At the NeuroScience & TMS Treatment Center, we have several treatment options we can use, beyond common medications and therapy, to aggressively treat you for brain diseases. Learn more about our treatments and services on our Comprehensive Behavioral Health Page.
Blog Post Authors
Michelle Cochran, MD, DFAPA
Founder & Chief Medical Officer • Medical Director, Nashville Locations
Dr. Cochran has been living and working in the Nashville area for over 25 years. She supervises the skilled Nurse Practitioners who work in our clinics. She has been offering TMS services since 2011 and lectures and consults nationally and internationally about TMS. She is Board Certified and is a Distinguished Fellow of the American Psychiatric Association. Learn more about Dr. Cochran.
Jonathan Becker, DO
Medical Director, Brentwood Locations
Dr. Becker is a native of Tennessee, born in Memphis. He completed his undergraduate and master’s degrees in Developmental Psychology at Tulane University in New Orleans before attending Des Moines University for Medical School. He completed his psychiatry residency program at Vanderbilt University and served as a faculty member there for 7 years before transitioning to our office. While at Vanderbilt, Dr. Becker served as the medical director of the neuromodulation service from 2017-2020. Dr. Becker has also published many psychiatric articles. Learn more about Dr. Becker.