2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

A Good Night’s Sleep

You may have discovered as you travel this weary road of life that you’re not sleeping quite as well as you did as when you were younger. Gone are the glory days when you fell asleep listening to a bedtime story and then, suddenly, it’s morning! What happened? “Why,” you ask (and probably too often), “am I lying here in the dark waiting to get back to sleep? I know I’m going to be exhausted in the morning.”

Actually, despite your worries, you’ll probably be less tired than you fear. You’ve fallen for that old myth about needing eight hours of uninterrupted sleep. Last week’s Sunday New York Times summarized what sleep specialists have known for the past few years: that the human animal was never really intended to sleep steadily through an eight-hour block of time. Children, yes–eight, ten hours. But for adults, nearly half of us (myself certainly included) find it virtually impossible to experience this type of uninterrupted sleep regularly.

Just 40% of us clamber into bed, are asleep within a half hour or so, and awaken refreshed the next morning. Our sleep abilities, by the way, steadily decline with age. Sixty-year-olds have more trouble than 40-somethings, who in turn sleep poorly when compared to teenagers. Another 40% of us sleep erratically, waking in the middle of the night, moaning as we glance over and see 2:30 AM or thereabouts on the clock. Once this was called being “sleep deprived,” but researchers have had second thoughts given that the allegedly deprived sleepers were often quite energetic and functioning well the following day…if they were able to get back to sleep in an hour or so.

This pattern of dividing sleep into two phases is called Sleep #1 and Sleep #2. For Sleep #1, you’re able to fall asleep fairly promptly and you actually sleep quite efficiently, but then you find yourself awake in the middle of the night. At this point, you can go down one of two paths. In the first, you lie awake worrying about getting back to sleep, agonizing over how tired you’ll be later in the day, bitter that it’s now too late to take a sleeping pill. On the second path you’re more accepting of the situation. You use the waking time to read for awhile, mull over something pleasant, or listen to some relaxing music until you sense you’re getting sleepy enough to go back to sleep. You then enter Sleep #2, a phase not as deep as the first, but if you can manage three or four hours you’ll do just fine the next day.

The remaining 20% probably need sleep medications
People endlessly worry about sleep meds. In fact, many people worry so much that the worrying alone keeps them from getting to sleep. Are sleeping pills addictive? No, and you won’t go through withdrawal if you stop them suddenly. No 7-11 has ever been robbed by an addict seeking money for his Ambien. But are they habit forming? The other term for habit forming is “psychological dependence” and the answer is yes, they are habit forming. For example, if you’ve been using Ambien and you run out of pills, you’re likely to worry that your need for sleep won’t be fulfilled. If you stay off the Ambien you’ll experience a few days of what’s called rebound insomnia as your brain queries, “Hey, pal, where’s my Ambien?” before returning to your old sleep-deprived self.

We can be psychologically dependent on a lot of things that aren’t dangerous: coffee in the morning, a cocktail before dinner, jogging. Are you seeing the difference here between crystal meth and Ambien? I’m trying to help you over your fears.

There are two groups of medication-needing insomniacs:

  • Group one  A lot of people, no matter how exhausted they are at bedtime, simply cannot fall asleep regularly. Most in this group can differentiate between a night when they’ll “probably” fall asleep on their own from a night when they’re certain sleep will elude them. For you in this group, I recommend having a sleep medicine (called a hypnotic) available. There is no more self-fulfilling a prophecy than lying in the darkness wondering if you’re going to fall asleep. Just take the Ambien (or Lunesta, trazodone, or whatever works), turn out the light, and go to sleep. Feeling guilty won’t help you relax.
  • Group two  People in this group fall asleep quite easily but then snap awake in the middle of the night and, instead of returning to Sleep #2, simply can’t get back to sleep. You’ve tried all the back-to-sleep tips without success. Now you’re awake and dawn is three or four hours away. You agonize over how sluggish you’ll be at work. For you, two medications are available that many patients don’t know exist, Sonata and Intermezzo. When Sonata (zaleplon) was introduced years ago, it was a flop because patients were taking it at bedtime and then waking up refreshed at 2 AM. Years later, it was recognized that Sonata’s short sleep effect was ideal for people who awoke as late as 3 AM, because the drug is virtually out of your body by 6:30 or 7:00 AM. Unfortunately, it was too late for the manufacturer to get FDA approval for “middle of night awakening” and Sonata quietly went generic (100 capsules cost about $50.00). Intermezzo is a newly released form of Ambien available in a much smaller dose (3.5 mg instead of the usual 10 mg) as an instantly dissolving lozenge, melting in your mouth and putting you to sleep within minutes. Intermezzo is definitely not generic but is covered by most health insurers.

We know that people who sleep enough so they’re not tired the next day do feel better and overall are healthier. It’s not so much the number of hours you’re sleeping, but how you feel the day after. Some people need six hours, some seven, some nine. And even though an average number for humans might be seven, those who feel great with six should leave well enough alone.

People who don’t get enough sleep feel dull and tired the next day. Ideally, they should be allowed daytime naps, but virtually no employer permits this luxury (except for Google, which encourages napping). If you feel dull and tired after a wakeful night, analyze your sleep pattern. If you simply can’t fall asleep, start by trying supplements like tryptophan, valerian, or melatonin. Work with a sleep-inducing CD and also review my list of suggestions for better sleep. If you get nowhere with these, ask your doctor for a sleeping pill.

If you’re in the second group, waking in the middle of the night, try reading some poetry or visualizing an especially nice vacation until you drift back to sleep. If you’re stuck and can’t get back to sleep, ask your doctor for a Sonata or Intermezzo. Life’s too short to feel guilty about taking a sleeping pill.

Be well,

David Edelberg, MD



Leave a Comment

  1. Ellen Hargis says:

    There is also historical evidence of two sleep cycle: the “first sleep” and the “second” sleep in medieval and Renaissance writings, and in 17th and 18th century paintings, depictions of people working at sewing or reading or repairing tools around a fireplace while someone else is sleeping in a bed in the background. Very interesting.

  2. Ann Raven says:

    This is a helpful article. I know people who do not sleep well at night and fall asleep in classes and concerts but absolutely refuse to consider sleeping pills. They are afraid they will become addicted. Dr. Edelberg provides a needed explanation here. It is a waste to go through your day feeling sleep-deprived!

  3. Andrea Holliday says:

    Aced it again, Doc! Your columns are always right on.

  4. Eliza says:

    Good information for a common problem. I try to relax and think that at least my body is still and resting when I can’t fall asleep. Dr. Oz just had a show warning about too much melatonin ruining sleep.

  5. Addie says:

    The CDC suggests this might be a much more serious problem than you suggest. It describes sleep deprivation in the U.S. as a public health epidemic. This report links sleep deprivation to traffic accidents. Other CDC reports, relate lack of sleep to many other health problems. I’d be interested to see studies that relate sleep deprivation to auto immune issues because they all seem to relate in one way or another to how we handle stress.

  6. Lori Lippitz says:

    Thank you for this very informative article with lots of good “leads” on standard and alternative sleep aids. I have tried Temazapam, which works better for me than Zolpidem (Ambien), but feels druggier. I also use Melatonin. Whatever the risks of dependence, it is better than being sleep deprived, which resulted in my having a terrible home accident that might have permanently injured or killed me. Don’t ignore your insomnia!

  7. Lisa Romano says:

    Good information – and very well written! Thank you.

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!


Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our


The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Join our Newsletter

Get health recommendations, recipes, medical news, supplement reviews, birthday discounts, and more!

Upcoming Workshops

**Winter Solstice Celebration: An evening of Acupuncture and Shamanic Healing
Tuesday, December 17, 5:45–7:30pm
Hosted by Katie Oberlin, HTCP and Mari Stecker, LAc

Course Fee: $75.00

Take a break from the hustle and bustle of the holiday season to enter the stillpoint of the Winter Solstice, reflect on the lessons of 2019, and set intentions for the new year. This will be an evening of individual and group healing, ceremony, and celebration. More →

Recent Health Tips

  • Infertility Issues? Start With The Guy

    I’ve lost track of the number of couples we treat at WholeHealth Chicago who are involved in one of the hormone injection/surgical procedure stops on the conveyor belt of infertility centers. Currently, it’s estimated that 15 to 20 percent of couples are struggling with infertility, half of them due to male factors. The infertility docs are nice enough and certainly well-meaning, but I note a Read More

  • Issues with Endocrinologists: Thyroid Approaches and Big Pharma

    My beefs with endocrinologists pretty much center on how they manage thyroid gland concerns, though they rarely win prizes for managing adrenal issues either. I don’t know any endocrinologists personally and rarely refer my patients to them. Occasionally, a patient with newly diagnosed hypothyroidism (low thyroid) will want to confirm the diagnosis with an endocrinologist. I suggest she prepare for a scolding if she’s taking Read More

  • Six Beefs With Rheumatologists

    If you find yourself in the waiting room of a rheumatologist, you’re likely there because your joints hurt and have been hurting, often for years. You’ve been getting by on aspirin or Advil for the pain, but with things worsening your primary care doctor suggests you should see a joint specialist, a rheumatologist. And because there’s a shortage of physicians in this specialty, your appointment Read More

Join our Discount Program!

Member benefits include 10% off all your purchases. Low, one-time membership fee of $25 ($35 for family).