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PaperclipPerfector  10mo ago (text post)   3146 thread views

Small-Scale Question Sunday for December 31, 2023

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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You said safest, not the most effective, so I'm going to go with a glass of cold milk haha.

Truth be told, there isn't much in the way of good, almost perfectly safe choices, at least in OTC drugs that I'm aware of, and availability might well be in different in the States from what I'm used to. I could vaguely recommend l-theanine as a highly safe anxiolytic, even if it's not a sedative. Melatonin is highly dubious in terms of usefulness. But if you want to be knocked the fuck out, older antihistamines are your friend.

I don't have a particularly strong opinion on doxylamine beyond my theoretical knowledge, it's not the antihistamine used regularly where I hail from, but used in moderation? Doesn't seem all that bad. But it will almost certainly have the cognitive effects I mentioned above.

Just did some reading of actual studies. E.g. this meta-analysis from NCBI:

Research conducted among hospitalized older adults found that pharmacological (e.g., benzodiazepines) and non-pharmacological (e.g., diphenhydramine) medications resulted in an 18% and 22% respective increased rate of delirium among the sample.14 Also, research conducted among community-dwelling older adults found that non-pharmacological medication use was associated with lower cognitive function scores as compared to those not taking these components over a 10-year follow up period.15

Why should I find this plausible, rather than making the standard "correlation is not causation" point? Surely people with issues sleeping are in general less healthy, physically and/or psychologically. I don't see anything in there to indicate they controlled for anything.

Some references also seem to do nothing more than ask if people took any sleep aid, lumping together everything from melatonin (presumably very safe, maybe placebo) to daily benzos (clearly neither very safe nor a placebo).

Edit: I am bad at reading (maybe it's the doxylamine). They did control for things. But my question re causation stands. I feel like TheMotte is usually very skeptical, and I find myself surprised by the strength of multiple posters' convictions here.

while controlling for demographic covariates, including age (0= 65 up to 75 years of age; 1= 75 years of age and above), sex (0=male, 1=female), race (0=white, 1=non-white), and relationship status (0=widowed, single, or divorced, 1=living with partner or married). Third, we examined the relationship between sleep medication use and incident dementia while controlling for Model 2 demographic covariates and health conditions (0=no chronic conditions; 1=heart attack, 2=depression, 3=hypertension, 4=stroke, 5=diabetes). Depressive symptoms were measured using the Patient Health Questionnaire-2.34

Fascinating that you say melatonin is dubious in usefulness. I swear by my 300 micrograms a day (dosage at Scott's recommendation).

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