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Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Mon Feb 18, 2013 11:02 pm
by MichaelRyanSD
So the only mountain I've climbed worth mentioning is Mt.Whitney in May, so I gained a little experience in crampons(I was totally winging it by the way)

Anyways I've been looking at Rainer later this year and was wondering what your guy's thoughts would be on taking Tylenol PM to help me sleep at altitude. I did it while on Whitney at about 12000ft and it worked out great. Slept like a baby in 45 MPH wind gusts.

I was curious for some of you more experienced and medical types if this routine could cause problems.

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 1:35 am
by ScottyP
Isn't that a respertory suppressant ? Try melotonin

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 1:43 am
by mrchad9
Melatonin is my go to. I don't need it for altitude, but when I can't get to sleep at sunset or I'm dealing with 13 hr nights etc it always puts me out. I have 3 mg pills but always break them in half and that's plenty.

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 2:32 am
by MoapaPk
A lot of "PM" medications merely have the active ingredient of benadryl (diphehydramamine HCl), and that ingredient is supposedly "OK."

Lots of stuff repeated on high-altitude-oriented web sites (about sleeping aids) is vastly out-dated. I recall attending a 2007 lecture wherein the MD specifically forbade benzodiazepines. Yet this study came out in 1998:
http://www.bmj.com/content/316/7131/587 and was followed by
http://www.ncbi.nlm.nih.gov/pubmed/17118102

MDs usually have a hard time keeping up with all the changes wrought by research after their med school days.

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 4:29 am
by Steve Pratt
It would be fine as it pertains to altitude and breathing. The problem with diphenhydramine is the half life. I dont care for it because when you wake up you're still still sluggish a few more hours. It also causes dry mouth and constipation which is no fun on the mountain.

Chlorphenirimine ("Chlortrimeton") has a shorter half life. Same type of drug and does not require a prescription, but you feel better the next day. With the typical Rainier alpine start you need something that act fast and wear off fast, and chlorphenirimine would be a better choice.

Melatonin has evidence for jet lag, but the studies for insomnia were disappointing. Climbing is in between the two, so who knows. But personally I dont pack melatonin.

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 4:40 am
by pvnisher
Tylenol PM puts me out, but as others mentioned it has a "reputation" of suppressing respiration and thus acclimatization. I dont know if that's true or not.
1 full tablet generally affects me for 10-12 hours, so I typically bite it in half or thirds (for help traveling, etc). I don't use it on the mountain because I don't want to risk the acclimation issue.

Melatonin works wonders for some people, but a full tablet only lasts about 6 hours for me. And worse than that, it wakes me up at 5-6 hours. So if I have the opportunity for more than 5-6 hours I won't take melatonin or else it jacks me up. But if I time it right then it works pretty well. Other people find it quite useful. I think melatonin seems to affect people differently than PM does.

And bring earplugs. And if you are a snorer, then bring earplugs for your mates.

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 9:37 pm
by DrGranola
The benadryl has always left me super groggy in the mornings so I stopped taking it all together. Benadryl hangovers suck something awful! I have tried melatonin one time and had crazy bad dreams (an apparently no so common side effect) so I never took it again. I have found that taking approx 800-1000mg of ibuprofen usually deals with any headache I might have and that has helped. I'm a big fan of the earplugs too because it seems like it is always windy here in Idaho.

I personally have never had a good experience with sleep aids, so I just pass.

Tom

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Tue Feb 19, 2013 11:12 pm
by Damien Gildea
MichaelRyanSD wrote:So the only mountain I've climbed worth mentioning is Mt.Whitney in May, ... was wondering what your guy's thoughts would be on taking Tylenol PM to help me sleep at altitude.


I'm only posting this for the record here Michael, but given your inexperience I would not want this thread to give you the impression that taking drugs to sleep is widespread in climbing at altitude, it is not - nor is it widely considered OK - it is not. Proper acclimatization and hydration will prevent most headaches and enable proper sleep.

Whitney, Rainier, Shasta etc are mountains that have a particular problem of people racing up them too fast, wanting to do it in a weekend from the city and not really acclimatising properly. They get away with it (usually) because they are not high for long, they can get down fast. Aside from any actual AMS, altitude problems or headaches, people are often rushed and nervous and out of their normal routines and comfort zones, so sleeping can be hard, regardless.

Any drug that 'helps' you sleep will impair your ability to get up in the middle of the night and deal with whatever situation may have arisen - storm, avalanche, sick partner, injured strangers. damaged tent etc. Climbing mountains is hard enough without drugging yourself down below a normal level of awareness. Intervention with drugs, for convenience rather than first aid or trauma, is rarely a good idea.

If you do get a mild headache and drinking two liters of water doesn't help? Sure, take some ibuprofen or paracetamol. Regular ibuprofen dose is around 200-400mg and this should be fine for any level of headache that is acceptable in these situations. If one dose of 400mg and more water does not work, and the headache persists, go down. America has a real problem with excessive ibuprofen consumption. You can Google the regular recommended dosages.

Earplugs are a good idea.

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Wed Feb 20, 2013 1:37 am
by mconnell
If you are going to take something with diphehydramamine, go to the store and get a generic or store brand version of benadryl. Costs about 1/10 of the cost of "sleeping pills".

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Wed Feb 20, 2013 12:44 pm
by Bark Eater
+1 for ear plugs. Great isolation from tent walls rattling in the wind and snoring climbing partners :-)

Re: Tylenol PM to help sleep on the mountain, your thoughts?

PostPosted: Wed Feb 20, 2013 4:47 pm
by mrchad9
Florida Frank wrote:and snoring climbing partners

I bring my crampons into the tent for that.