Treating Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia: Dr. Teitelbaum on Maximizing Sleep Prescriptions

Dr. Teitelbaum believes that getting a solid eight to ten hours of restful sleep is absolutely critical to the healing process in ME/CFS and may require taking as many as five or six different sleep aids. Since most of the side effects (and fewer of the benefits) come at higher doses, he believes patients can maximize their benefits by taking small amounts of several sleep aids at once.  He states ‘the best way to need less medication in the long run is to take as much as it takes to get eight hours of solid sleep each night for six months”  In order to find the optimal doses of sleep medications Dr. Teitelbaum recommends that you:

1. Take the lowest recommended dosage of your and your doctors choice of a medication, either natural or prescription.  Except for 5-HT you will know by the morning if its is effective.

2. Increase the dosage until you either

• get eight to nine hours of sleep,
• have side effects,
• stop getting better effects from it.

You should end up the lowest dose that gives you the most benefit.

3. Go on to the next medicine and do the same. As you come up with more ‘hits’ you can try different combinations.  If you’re the kind of patient in which a positive effect wears off after a few days then rotate your medications. Once you have found your optimal group of sleep medications stay on them at least six months and then try to taper off them. Dr. Teitelbaum find that most ME/CFS patients can taper off all medications after about 18 months. Some may have to stay on them for years.

During Times of Increased Stress increase your intake enough to be able to maintain seven to eight hours of solid sleep.