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

Matt Walker welcomes Dr. Ranji Varghese back to the podcast today to complete the whole sleeping pill story by discussing newer sleeping pills, beyond benzos and Z-drugs. Together, they explore Melatonin receptor agonists (like Ramelteon) that signal sleep preparation, unlike sedating GABAergics. They also detail how DORAs inhibit the wakefulness-promoting orexin, how off-label options (ex. trazodone, low-dose doxepin) affect histamine, the risks and benefits of each. Dr. Varghese goes on to explain the mechanisms and side effect profile for each sleeping pill, including over the counter options. He stresses that all medications carry risk and require careful use, noting that sleeping pills are tools not cures, and that CBTI is preferred for chronic insomnia. Our duo finish up by reminding listeners that open communication with your doctor is vital for safe, short-term medication use. Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way. One of our sponsors this week is the biochemical electrolyte drink company LMNT, and they are very kindly offering eight free sample packs when you purchase any one of their orders at drinklmnt.com/mattwalker. LMNT is an electrolyte sports drink that I can get behind - it's created from the basis of science, and it has no sugar, no coloring, and no artificial ingredients – all qualities that are so important to maintaining your blood biochemical balance. If you want to give LMNT a try, just head on over to drinklmnt.com/mattwalker and get your eight free samples with your first purchase. Matt will be the first to tell you that launching his sleep-related merchandise sales was incredibly smooth, thanks to our new sponsor Shopify and their integrated sales and inventory system. And now, just for you, Shopify is generously offering an exclusive trial at shopify.com/mattwalker. Whether it's online or in-person sales, Shopify simplifies it all. So, be sure to stop in at shopify.com/mattwalker to start your exclusive journey now! Matt’s good friend Dr. Peter Attia has helped develop David, a revolutionary new protein bar, and a sponsor of today’s episode! 28g of protein, 0g sugar, only 150 calories – the best ratio EVER! Amazing taste, six flavors, incredibly satiating, and a great source of the protein that helps build muscle, manage metabolic health, and keep you full. Visit davidprotein.com/mattwalker now for an amazing deal: Buy 4 cartons, and get a 5th FREE! . Hurry! Your new favorite protein bar awaits! As always, if you have thoughts or feedback you’d like to share, please reach out: Matt: Instagram @drmattwalker , X @sleepdiplomat , YouTube https://www.youtube.com/@sleepdiplomatmattwalker9299 Dr. Varghese: LinkedIn: https://www.linkedin.com/in/ranji-varghese-md-3591665a/ Minnesota Regional Sleep Disorders Center: https://www.hennepinhealthcare.org/specialty/minnesota-regional-sleep-disorders-center/ Institute for Integrative Therapies: @iit-mn.com Society of Behavioral Sleep Medicine: https://www.behavioralsleep.org/ Instagram: https://www.instagram.com/docvarghese/?hl=en X: https://x.c