#93 - Sleeping Pills and their Alternatives with Dr. Ranji Varghese

In this episode, Matt hosts Dr. Ranji Varghese to discuss newer classes of sleeping pills, including melatonin receptor agonists and dual orexin receptor antagonists (DORAs), and off-label options like Doxepin and Trazodone. They explore how these medications work, their effectiveness, and potential side effects, highlighting the importance of understanding individual circumstances before prescribing. The conversation covers the risks and benefits of each type, emphasizing the need for a well-trained clinician and an open, honest relationship between patients and healthcare providers. They also touch on the role of antihistamines as sleep aids and the long-term cognitive risks associated with anticholinergic activity, concluding with the importance of cognitive behavioral therapy for insomnia (CBTI) and a plan for discontinuing medication use.