Use Sleep Aids? Don’t Let the Wrong One Ruin Your Game

I guess it wouldn’t be fair if I told you the benefits of sleep without giving you advice on the best sleep aids available. There are a multitude of factors that lead me to believe that sleep aid use is quite common in the world of poker. They include: 1) the overuse of stimulants such as caffeine, Red Bull, Amp, Adderall, etc 2) the long duration of poker games, some lasting until the next morning 3) the increased play of on-line poker, lasting well into the night. I would imagine that poker players have their sleep schedules pretty screwed up. I’d even bet that their own circadian rhythm is probably a little off tilt. Don’t worry though. Hopefully after reading this section, you’ll be able to choose the right sleep aid for you so you can experience all of the great benefits of a good night’s sleep. You may even win more often.

Sleep aids

The majority of sleep aids are relatively safe and effective. Some are controlled substances, however their abuse potential is minimal compared to other controlled substances. The most important concept concerning selecting the best sleep aid is residual drowsiness. The last thing a poker play wants is to be drowsy the next day at the table. Too many bad things can happen if you’re sluggish. You need to pay attention to the sleep aid’s half-life. Half-life is really just a fancy medical term that describes the time it takes the body to eliminate half of the original concentration of the drug. Usually, it takes anywhere from 5-7 half-lives for the drug to be entirely eliminated from the body. Thus, if the original concentration of the drug was 10mg and has a half-life 2 hours, then after 2 hours the new concentration would be 5mg, and after 4 hours the new concentration would be 2.5mg, and so on. I’ll briefly discuss the most common sleep aids below. I’ve grouped them into the drug classes based on their mechanism of action. At the end, I’ll tell you my recommendations.

Prescription sleep aids

Non-benzodiazepine (non-BZN) sleep aids

These all work the same way. They bind to the benzodiazepine 1 receptor in the brain. The side effect profile is also similar. It includes drowsiness, dizziness, amnesia, headache, and GI problems. The difference between drugs in this class is their duration of action and potency.

Ambien is the most common sleep aid prescribed today. The half-life of Ambien is around 2.5 hours. Thus, it takes around 10 or so hours for it to be completely eliminated from your body. It’s pretty good at getting you to sleep and keeping you asleep. It’s also generic so it’s very cheap compared to some of the other sleep aids. If you’re looking to get a good night’s rest of at least 8-10 hours, this is my drug of choice. Its effectiveness and price make it the best of all of the sleep aids. However, if you’re in a tournament and may only get 5-7 hours of sleep, there is a strong possibility you may have some residual drowsiness the next day.

Lunesta is a relatively new sleep aid. The half-life is around 6.5 hours. Thus, it’s going to take a long time to get out of your system. It also does not have a generic so it’s pricey. Because of its long half-life and high probability of residual drowsiness, I don’t recommend this drug for poker players. The only time you should use this drug is if you can sleep for a couple of days straight.

Sonata is my drug of choice for this class. Its half-life is around 1 hour. Thus, it will be out of your system in 5-7 hours. It may not be as strong as Ambien or Lunesta, but it should do the job. If you’re unsure of how much sleep you’ll be able to get, you should select this drug. The chances of residual drowsiness are the least of any of the other drugs in this class. Because of its short half-life, it can also be used if you wake up early in the night and have trouble getting back to sleep.

Benzodiazepine sleep aids

These drugs are not as selective as the non-BZN sleep aids. They bind to not only the BZN1 receptor, but also the BZN 2 receptor. Thus, there is a higher likelihood of side effects. Side effects include drowsiness, decreased concentration, cognitive impairments, anterograde amnesia, daytime anxiety, and rebound insomnia. The differences in drugs in this class are time to onset of action, duration of action, and potency.

Restoril is the most commonly prescribed BZN sleep aid. However, it’s probably the worst one for poker players. The half-life is between 10-15 hours. Because its metabolites are also active drugs, if used for consecutive days, the half-life of the drug will actually increase to even more than 15 hours. Thus, there’s a strong likelihood you’ll experience daytime drowsiness. Even though it is cheap, I recommend staying away from this drug. The half-life is just too long.

Triazolam isn’t prescribed much anymore, however it’s primarily used for insomnia. Because it’s more fat soluble than Restoril, it’s onset of action is quicker, and its half-life is only around 2 hours. It’s good at getting you to sleep and keeping you asleep. In fact, this was the drug of choice by my professor of pharmacology. Side note: This guy was involved in the creation of Gatorade. His memory was unbelievable. He never used one note during his lectures. The problem I have with triazolam is its high incidence of anxiety and amnesia. Because it’s so fat soluble, it is in and out of your system leading to a higher incidence of side effects. Still though, if I had to use a BZN sleep aid, I’d choose this one over Restoril.

Other prescription sleep aids

These sleep aids don’t fall into any of the above categories.

Trazodone was originally used to treat depression. However, because of its unfavorable side effect profile and the introduction of more effective and safer antidepressants, it’s mostly only used for insomnia. The half-life is between 4-5 hours. Because of its long half life, and its ability to cause cognitive slowing, I recommend staying away from this if you play poker.

Rozerem is the newest sleep aid available. Because of that, it’s pretty expensive. It works a little differently than the other sleep aids. It actually binds to and stimulates the melatonin receptors in the brain. It’s been nicknamed melatonin on steroids. Its half-life is between 1-3 hours. It’s really only used in patients who have a history of substance abuse because it has zero addiction potential. In my opinion, there’s cheaper and better sleep aids available for poker players.

Non-prescription sleep aids

Melatonin is probably the granddaddy of OTC sleep aids. It’s a hormone that is secreted by the pineal gland at night. It’s thought to help regulate a person’s circadian rhythm. Its secretion is stimulated by darkness, and inhibited by light. It’s commonly used by people who experience jet lag or midnight-shift workers. Because poker players may have a screwed up circadian rhythm, it would be beneficial to include between 0.5-5mg nightly. Why the wide range of dosage? Some people sleep fine just using 0.5mg and actually experience stimulation on doses of 3mg. However, others need 5mg to help sleep. Find the dosage that’s right for you. If you experience drowsiness the next day, you probably used too much. I recommend the controlled-release melatonin over regular melatonin. In my opinion, those poker players that stay up late at night, and sleep well into the afternoon could greatly benefit from melatonin.

Valerian root is thought to have a similar effect as BZN’s because it inhibits the metabolism of GABA. Because it is not as potent as BZN’s, it’s onset of action is a little longer. You should take it about 2 hours before you go to bed. Because of this inconvenience, I don’t know how beneficial this will be to a poker player. If you do purchase some valerian root, look for supplements that contain 0.4-1% valerenic acid. A typical dose is between 400-900mg 2 hours before bedtime. If you’re looking for a natural supplement to reduce anxiety and help you sleep, this is definitely your best choice.

Magnesium is probably the hidden jewel when it comes to OTC sleep aids. It not only calms your nerves, it also helps improve the quality of your sleep. The majority of the US population is deficient in magnesium. It’s involved in hundreds of chemical reactions in the body, everything from anxiety to heart problems. Entire books have been written about the benefits of magnesium. Like fish oil, this should be a staple in every poker player’s nutritional regimen. Do not buy magnesium oxide due to its poor absorption. Take anywhere from 400-600mg of magnesium citrate or glycinate an hour before bed. Orange juice, apple juice, or tomato juice increases magnesium’s absorption while calcium or other diary products decrease its absorption. I cannot stress enough how important magnesium supplementation is.

Benadryl and other sedating anti-histamines should not be used by poker players. The increased likelihood of residual drowsiness and the lack of efficacy of improving sleep quality make these a poor choice for poker players. There are too many other sleep aids out there that are more effective.

I just wanted to give you an overview of some of the most commonly used sleep aids available. There are hundreds of others out there. There are plenty of Chinese teas and herbals that are purported to help improve sleep. My best recommendation is to read the science and research for yourself. You may even want to try a couple out. Only you will know if it works for you.

Summary

Hopefully you’ll take the above recommendations to heart. Remember, my recommendations are based on not only real-world feedback, but also on research. These aren’t just opinions. If you have any questions about anything I’ve said, please ask.

So the bottom line is to avoid sleep aids with long half-lives because the likelihood of residual drowsiness is much greater. Also, one thing I forgot to mention. If you take any of the above sleep aids with a meal high in fat, it’s going to take longer for the sleep aids to work. Fat actually slows down digestion.

My recommendations

If you think you’ll get less than 8 hours of sleep: Sonata

If you think you’ll get 8-10 hours of sleep: Ambien

If you’re circadian rhythm is off from too many late-nighters: Controlled-release melatonin along with a sleep aid.

The drug everyone should take: Magnesium citrate or glycinate

Remember, don’t take multiple sleep aids. When taken by themselves, they are relatively safe. However, when combined, they can be deadly such as the case of Heath Ledger.