Mar 03 2025 60 mins 192

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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.

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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