Nora sighed as the “Are you still watching?” message popped up on her screen once again. It was the middle of the night; she should have long ago fallen asleep.

But yes, she was still watching.

And unfortunately, this wasn’t the first time Nora found herself watching endless episodes until her body finally drifted off.

It used to be something that happened only every once in a while. She’d find herself unable to sleep, watch TV to shut down her mind, and hours later wake up to find her TV still playing in the background.

But lately, it was becoming more of a regular occurrence- something that happened at least a few nights out of the week.

When she did finally manage to get some shuteye, she felt like the quality of her rest wasn’t what it should be. She’d wait until the absolute last minute she could until she finally had to peel herself out from under her covers in the mornings. And then rush to get ready to make it to her work on time.

On the weekends, she was losing more and more of her mornings to lying around in bed. She knew these were bad habits, but she was just so tired.

She was desperate for sleep- good sleep, normal sleep.

01

What’s Normal Sleep Anyway?

Well, it depends on you.

Each of us has different needs based on our age, our health, our lifestyles, and other factors.

What defines healthy sleep varies from person to person. But for most, "normal" means getting 7-9 hours of consistent, uninterrupted sleep every night.

Sleeplessness or finding yourself waking up often throughout the night are both markers of insomnia.

Chances are you’re not getting the kind of rest you need if you’ve noticed any of the following about yourself:

• You feel groggy most days
• You’re a frequent yawner
• Your mood is prickly
• Your concentration levels are low
• You’re forgetful
• You struggle to take in new information
• Your appetite is insatiable
• You’re clumsy
• Your motivation levels are low
• You rely on caffeine or carbs to keep your energy levels up

All of these are signs that you’re not getting the rest you need.

Even if you’ve only been experiencing any of these for a few weeks or months, they can still be signs that insomnia is causing harm to your physical health, mental health, and productivity levels.

But it turns out that there’s nothing abnormal about experiencing sleep problems. In fact, one in seven adults reports experiencing insomnia at any given point.

02

Insomnia Triggers

So what leads to poor sleep? Unfortunately, there’s no one easy answer.

There’s a laundry list of reasons, and figuring out why you can’t sleep is a key component of finding a way to get you back on track.

Make a list of anything you think of that could possibly be a source of your insomnia. Be sure to think through factors that might not be so obvious right off the bat, like not enough natural sunlight, too much screentime close to bed, and unresolved anxiety producers.

To help you identify what’s keeping you up at night, you can start by asking yourself:

• Are you under a lot of stress right now?
• Have there been any changes to your lifestyle or schedule?
• Are you keeping consistent times for going to bed at night and waking up in the morning?
• Are you interacting with your phone in bed or screens too close to bedtime?
• Are you eating and drinking too much within an hour of going to bed?
• Have there been any changes to your health recently?

Ultimately, you may need to work with your doctor to find out why you can’t sleep, but starting off by asking yourself questions like these can help point you in the right direction.

For Nora, she knew the light from the TV probably wasn’t doing her any favors when it came time to get better rest. But mindless television was the only thing she could think of to shut down her mind that didn’t require effort at the end of a long day.

She had struggled to get to bed before. But it was usually only something that happened every once in a while. For the most part, she actually was a great sleeper.

Lately, however, her once short-term sleep deprivation was becoming more and more frequent. She had started a new job, but it was a job she had fought for. It was one that she was excited about. She looked forward to walking into her office each day and actually enjoyed the projects she was working on. It was the first time she actually felt like she was doing a job she wanted to be doing.

It couldn’t the thing keeping her up at night, could it?

03

How To Treat Insomnia

Insomnia is a lot of things- it’s annoying and it’s distressing. But beyond that, lack of sleep can be detrimental.

It can leave you at risk for:

• Poor mood
• Increased anxiety
• Increased impulsivity
• Poor memory
• Less creativity
• Weakened immunity
• Weight gain
• Reduced sex drive

So what do you do when you’re spending more time counting sheep than getting shuteye?

If you’ve tried for better rest to no avail, it may be time to reach out for help. And the good news is that there are proven insomnia treatment options available to help you get better rest.

Most doctors will recommend that you start by assessing your sleep hygiene, a set of personalized routines and habits to help you get the best rest possible. Sleep hygiene practices are highly personalized and vary person-to-person.

Some may benefit from using over-the-counter sleep aids for help. Common sleep supplements include melatonin, valerian, Unisom sleep tablets, and antihistamines.

Even though these are all available without a prescription, you should still speak to a doctor before you start using them to make sure you’re taking them safely and properly.

If over-the-counter options don’t work, you do have the option to speak with your doctor about a prescription sleep aid. There are several different types of prescription medications available for this purpose, and you’ll need to work closely with a doctor to determine if any are the right fit for you.

Last but not least, CBT-i, or Cognitive Behavioral Therapy for insomnia, is another common option. CBT-i can be done alone or in combination with some of the other treatment options listed above.

When Grammy-nominated classical musician Blair Tindall thinks back to one of the first times she was struck by stage fright, she remembers being at the North Carolina School of the Arts.

In her best-selling book Mozart in the Jungle: Sex, Drugs, and Classical Music, she describes feeling paralyzed with performance anxiety, a doubt that was coming from just being a young, inexperienced musician combined with criticism from her conductor:

"Stop, stop!” Harsányi [the conductor] scowled as fifty pairs of eyes stared at me. “Louder. Don’t rush. Why you rush? How old you are?” I’d had stage fright before, but my pounding heart and quivering body were worse than ever now. I felt like a firecracker with its fuse spitting and jumping, about to rocket to the ceiling, explode, and shower ashes everywhere. I gulped, feeling faint.

“Fifteen,” I squeaked. Harsányi snorted. I noticed John, the concertmaster, trying to catch my eye.

“Again. Letter E.” This time, I played, but I was too nervous to remember anything about my eight-bar solo.”

From that moment on, performance anxiety followed Blair through the remainder of her music education, into big auditions, and performances in front of live audiences.

The stress from stage fright limited her career opportunities, robbed her of confidence, and took a toll on her overall mental health.

That is until she discovered Propranolol, a beta-blocker medication with a reputation for preventing anxious symptoms.

What Are Beta-Blockers?

Beta-blockers are a common medication approved by the Food And Drug Administration to treat conditions like high blood pressure, arrhythmia, angina, and other conditions.

But Propranolol, when taken in a smaller dose, has also been shown to stop adrenaline - and with it the physical symptoms of anxiety, like shakiness, rapid heart rate, and sweaty armpits. In short, it stops the body from going into fight-or-flight mode when there really isn't anything to fight or run away from.

While this may be a surprising revelation to most, it's a very well-known tactic for tackling pre-performance jitters by top performers including classical musicians, pop stars, and comedians.

It has precedence outside of the stage community too. Some athletes, most notably those in archery, billiards, and sport shooting, have been known to use beta-blockers to keep their hands steady in competitions or in front of an audience.

In some cases, Propranolol might be used alongside exposure therapy or cognitive behavioral therapy to help someone overcome social anxiety or certain phobias.

Recently, it's become a more common-place solution for treating public speaking fears amongst professionals.

Why Propranolol?

So why is Propranolol such a trusted solution, especially when there are other options available?

First, because it's an effective way to stop the physical symptoms of anxiety.

A cellist can keep her heart rate at baseline so it doesn't throw her off.  A comedian can deliver a joke without his voice shaking into the microphone. Golfers can stop their hands and arms from shaking when they're attempting a big shot that might win them the match.

Perhaps more importantly, beta-blockers tend to have fewer side effects than some other popular stage fright coping mechanisms like alcohol or Xanax. Most who use them don't experience the tiredness and brain fog that often comes along with these other alternatives.

It is important to point out, however, that beta-blockers aren't right for everyone and should be avoided by some, such as asthmatics, people with blood pressure abnormalities, or those with more serious anxiety disorders.

Let's take a closer look at some big names who turn to beta-blockers to stop their stage fright from getting the best of them.

Celebrities Who Use Propranolol For Anxiety

Katy Perry

Katy Perry has performed for literally millions of fans and has won acclaim for her electrifying performances. But despite years of experience, hundreds of live performances, and awards to prove just how talented she is - Katy is still affected by performance anxiety in the moments before she walks out on stage.

Talking about the type of pressure she puts on herself, she's said “I think, ‘I have to get through this. I can't let these people down.’ But mostly I can't let myself down.”

So, a little while before she takes the stage, Katy takes a beta-blocker to calm her body and keep her mind focused so she can deliver a performance her audience will never forget.

“I have to take beta-blockers [before each show], I get so nervous,” she's said.

Shawn Mendes

Shooting into sudden stardom at a young age, 22-year-old Shawn Mendes has been open about the toll fame has taken on his mental health.

During a performance on stage, he told his fans:

“As a performer, you get very nervous, sometimes you freak out and things can become a lot for you.”

But Shawn also went further, talking about how he has used beta-blockers to help him work through his performance anxiety and maintain his composure on stage:

“There’s a medicine called beta-blockers and basically it’s a very calm medicine, but what it does is it slows your heart rate down so you can be less stressed out and calm down and breathe…I want you guys to know that for the last year I’ve been taking the medicine that’s been slowing down my heart rate so that I can be calm on stage.”

Whitney Cummings

Having suffered from stress-induced migraines for her entire life, comedian and co-creator of the TV show Two Broke Girls, Whitney Cummings has been very open about her anxiety. She found that the stress of anticipating an event could trigger her migraines but has found ways to manage them.

In addition to keeping to a regular routine, she also occasionally takes beta-blockers. Far from hiding it, she has said “I take beta-blockers now, which help hugely.”

She went on to say, “I know if I have a big meeting, or a big audition, or a big performance, or anything where I know I’m going to be nervous, I just take one preemptively so that I’m not blasting my brain with adrenaline.”

Bobby Lee

Actor and comedian Bobby Lee spoke with Whitney Cummings on her Good For You podcast about how his performance anxiety had become severe enough that he had begun to experience panic attacks.

He noted this was particularly true for him in auditions, and it was something he was too embarrassed to talk to anyone about for a long time.

Bobby discovered beta-blockers after confiding in Whitney Cummings a few years back and has said they help him stay calm, noting:

“I did this pilot in Chicago, and I wouldn’t have been able to do it without beta-blockers.”

Blair Tindall

Oboist, TV producer, and author of the memoir Mozart in the Jungle: Sex, Drugs, and Classical Music, Blair Tindall has been very outspoken about the benefits of beta-blockers to performers who suffer from stage fright.

Blair experienced almost debilitating performance anxiety until she discovered beta-blockers:

“I remember going home and telling my roommate ‘Oh my god, I can’t believe it! This stuff really works!’”

Despite the relatively few celebrities who have opened up about their stage fright, it’s clear that people in the industry know about them.

“[Beta-blockers] have saved the careers of countless musicians,” according to Blair.

There's comfort in that even the most successful performers - the very people we think of as confident - also face the same self-doubt and insecurity the rest of us do. But perhaps even more comforting is knowing that there's a real solution out there that can help us overcome stage fright and perform at the level we know we can.

Photo Sources:

Jeff Denberg from Canada, CC BY 2.0 https://creativecommons.org/licenses/by/2.0, via Wikimedia Commons

Raph_PH, CC BY 2.0 https://creativecommons.org/licenses/by/2.0, via Wikimedia Commons

Alex42west, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

https://www.youtube.com/user/paulymshore, CC BY 3.0 https://creativecommons.org/licenses/by/3.0, via Wikimedia Commons

BlairTindall.com

Gabapentin and Lyrica have many similarities.

They are in the same class of medication (what’s known as an anticonvulsant). They have similar chemical makeups, they work comparably, and both have been FDA approved for certain uses.

That being said, they aren’t exactly the same and are usually prescribed by doctors for different purposes. Below, we take a closer look at each.

What’s Gabapentin?

Gabapentin is an anticonvulsant, a type of medication used to stop or prevent seizures. Additionally, it’s been FDA approved to treat nerve pain, often after shingles. And though it is prescribed for both of these purposes, doctors also regularly use it for other reasons as well.

Some of the most common off-label uses for this prescription include:

• Migraines
• Restless Leg Syndrome
• Hot flashes
• Teeth grinding
• Anxiety
• Insomnia

In the case of the sleep disorder insomnia, this medication is shown to improve deep sleep and prevent frequent wake-ups in the middle of the night.

Gabapentin is considered a safe medication in many cases and isn’t listed federally as a controlled substance. It may be listed as a controlled substance in certain states though.

Some may experience side effects after trying this medication. Most often, these include drowsiness, dizziness, or feeling spacey.

More rare but still possible side effects can also include:

• Unsteadiness
• Memory loss
• Lack of coordination
• Difficulty speaking
• Viral infections
• Tremors
• Double vision
• Fever
• Unusual eye movements
• Jerky movements
• Changes to mood

Several of these side effects, including unusual eye movements and jerky movements, are more common with Gabapentin than Lyrica.

Additionally, those taking Gabapentin can experience withdrawal symptoms. To help avoid this, your doctor will likely decrease your dose gradually at the end of your treatment rather than having you stop abruptly.

This is a prescription medication and should only be taken after speaking with a doctor. To minimize your chances of experiencing any side effects or withdrawal symptoms make sure to provide your doctor with a complete medical history and take your prescription according to the directions provided.

What’s Lyrica?

Lyrica is also an anticonvulsant and is often prescribed to treat both seizures and nerve pain.

Notably, some studies suggest that this medication is more effective than Gabapentin for both of these uses as it’s a more potent medication.

However, Lyrica is more likely to cause certain side effects including dry mouth, constipation, and weight gain.

Other side effects associated with this prescription can include:

• Headache
• Drowsiness
• Blurred vision
• Increased appetite
• Back pain
• Flu-like symptoms
• Red, itchy eyes
• Gas and bloating
• Poor coordination
• Shortness of breath
• Wheezing
• Chest pain
• Rash
• Memory problems

Research has shown that Lyrica is absorbed faster and acts more quickly than Gabapentin. Because of this, it is believed by some that Lyrica might have a higher potential for abuse or dependence. It is listed as a controlled substance.

This medication can lead to symptoms of withdrawal. So always be sure to follow the directions as provided by your doctor when ending your treatment to avoid any negative effects.

Which Medication Is Right For Me?

To find out if either of these prescriptions is the right treatment option for you, you’ll need to consult with your doctor.

Though both medications share several similarities, they are prescribed by doctors for different reasons, may cause different side effects, and also may interact differently with other medications you’re taking.

To help your doctor determine the right option for you, make sure to provide a full medical history and a list of all of your medications.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Public speaking has long been noted as one of the most common fears. This is true regardless of whether you're a seasoned speaker or if it's your first time in front of an audience.

What’s interesting is that it’s not necessarily the act itself that so many find scary. Instead, it’s the overwhelming whirl of “what ifs” and frightening scenarios that tend to build up in our minds.

What if I forget what to say?
What if I trip walking across the stage?
What if the audience finds me boring?

Just as with all other parts of public speaking- speaking articulately, engaging an audience, storytelling – confidence is a skill that needs to be developed and learned over time.

But even the most experienced speakers still find themselves jittery at times. To help keep their nerves in check, they turn to a dependable routine, a trusted method, or even a quick trick to get their fix of confidence.

And if you think about it, public speaking is more than just standing in front of a conference room giving a speech.

It takes place during a job interview when you're answering questions in front of a recruiter panel. Students engage in public speaking when they are called upon by a professor in a classroom.

Public speaking even takes place in our personal lives. Have you ever been asked to give a toast at a dinner table? Even worse, perhaps you've been expected to give a speech at a wedding or during a family reunion.

The point is:

As much as we'd like to avoid the public speaking moments that scare us, the truth is that it's nearly impossible to do.

So how can you get better at speaking in front of others?

How To Improve At Public Speaking

If you've had a bad experience or two with trying to muddle your way through a presentation or speech, it's easy to feel like you'll just never be good at public speaking.

But that isn't necessarily the case. In fact, there are plenty of options available to help you overcome your performance anxiety and perform at your full potential.

A few things you can try:

• Sign up for a local improv class
• Drop into a Toastmasters meeting in your area
• Talk to a healthcare provider about a Propranolol prescription
• Volunteer to speak as often as you can
• Ask a trusted co-worker to help you prepare
• Follow-up for feedback after each presentation you give

12 Public Speaking Tips To Help You Prepare For Your Next Presentation

We’ve spoken with dozens of entrepreneurs, speaking coaches, and everyday professionals to learn more about the critical public speaking tips they rely on to feel more confident during a presentation.

Here are a few of our favorites:

Practice Your Opening Lines

The one thing I do before speaking at an event to calm my nerves is to go over my first 60 seconds of content again, and again, and again. It helps me calm the delivery of my first words and focus on the audience.”

Troy Hazard, Certified Speaking Professional

Create A Personal Success Mantra

The fear of public speaking is really just internal thoughts we’ve allowed to run rampant. Our logical mind is fighting to push through the irrationality and worry. To master this fear, I slow my breathing and repeat (either silently to myself or aloud): ‘I have everything I need to do this’. This mantra reminds me that I have prepared for this moment, I know my material well, and I have the tools I need to be successful.”

Alison Haselden, SEO Consultant at Can I Rank?

Phone A Friend For Support

Speaking to 300 tech CEOs, all of whom make millions more a year than me, left me feeling intimidated. So I called home and told my husband about my insecurity. He said: ‘Remember you have something to offer that they don’t have or you wouldn’t be there in the first place’.  Then I talked to my mom and she told me to ‘Say a prayer’. Finally, I talked to my dad, who said: ‘Give ‘em hell’. All of these were supportive conversations, even if from different angles. But I walked in feeling a little more confident, and the audience loved my presentation.”

Debra Benton, Executive Coach at CEO Whisperer

Reframe Your Nerves Into Excitement

Change your mindset. Reframe your thinking to see a different side of the situation, highlighting the positive aspects. In essence, when stress and nerves occur before making a speech, try this:

1. Notice what’s going on in your body: sweaty palms, fast heartbeat, or a lump in your throat.

2. Begin to tell yourself that these nerves and stress are preparing you to do something great, rather than focusing on how they may trip you up.

3. Continue to tell yourself that these nerves are preparing you to give a great speech and you’ll notice a calming feeling over your palms, heartbeat and that lump in your throat.

4. Repeat if necessary."

Jacob Kountz, Marriage and Family Therapist Trainee at Kern Wellness Counseling

Go Back To Your Childhood Self

Sniff Crayola crayons prior to speaking! The scent has been proven to lower blood pressure and relax nerves.”

Holly Dowling, Global Keynote Speaker

Arrive Early

I make sure I get to the event exceptionally early in order for me to set up and network amongst the attendees. This allows me to become comfortable with the environment as well as the people. In addition, it helps with engagement. I’ve noticed more people are inclined to participate when I need hands raised or a volunteer to come on stage. Attendees also enjoy it when I am able to state their name and story in my presentation. It becomes a win for everybody!”

Michelle Ngome, Connection Enthusiast & Podcast Host

Imagine Yourself Succeeding

Close your eyes, take a deep breath in and visualize yourself energetically delivering your last two or three lines, then receiving a standing ovation. Imagine yourself giving your audience just what they need.”

Robert Kennedy III, Professional Speaking Coach at RK3

Remove Any Distractions

Take a moment just prior to beginning to take care of all the items on your list, no matter how elementary. For instance, remove jangling coins from your pockets. Get rid of your name badge (it reflects light). And turn off your phone. These actions increase the feeling of control, which is critical to calming frayed nerves.”

Matt Gambino, Professional Speaking Coach at PROPEL Skills Development

Make Friends With Your Nerves

Understand that your nerves are not your enemy. Reframe your thinking to not only accept your nerves but harness them for good. Acknowledge that your nervousness is a product of wanting to deliver high-quality information to the audience.”

Sunny Lake Hahn, Management Consultant at 7D Associates

Take A Moment For Yourself

The one thing that I always do before I speak is to take time alone. I will take a few breaths and ask that I am able to serve the group to their highest good. I have found the only time I am not successful is when I do not take the time alone before I speak.”

Kerry Wekelo, HR Director at Actualize Consulting

Trust That You’ve Prepared Yourself Enough

I avoid thinking about any specifics in the presentation in the moments before I step on stage, much less any direct mental recitation. I do not run through it “one last time” because it has the tendency to worsen the butterflies and further can reinforce any negative feelings or anxieties. If there is a specific slide or section that was hanging me up in any of my practice runs, that is fair game to address; otherwise, I just let the presentation be what it is going to be.”

Gregory Bullock, Marketing Manager at Theraspecs

Move Around (Or Jump!)

There is the one unusual thing I always do before a speaking event to calm my nerves: I jump up and down. I learned this from the late Robin Williams. During his stand-up comedy days, he would do jumping jacks before going on stage. Research also suggests that we perform better when we turn anxiety into excitement. I like to jump up, jump up, and get down.”

Ron Tsang, Professional Speaker & Business Communication Coach

Which of these public speaking tips will you try before your next big presentation?

Trazodone and Zoloft are both often prescribed to treat depression; however, they are very different medications.

Trazodone is classified as an antidepressant, and Zoloft is classified as a type of medication known as a selective serotonin reuptake inhibitor (SSRI).

Here we’ll take a closer look at the differences between each of these prescription drugs and why they’re prescribed by doctors.

What’s Trazodone?

Though Trazodone is an antidepressant, a medication known for reducing the symptoms of depression, it isn’t necessarily always prescribed by doctors for that use.

In fact, many doctors will only prescribe this medication for depression in the instance that other treatment options haven’t been effective. And some studies have shown that it isn’t always as effective in treating depression as some other medications.

More often, Trazodone is prescribed off-label for insomnia. Though it’s not fully known how this medication can help you sleep better, it’s been shown to increase levels of serotonin in the brain leading to a calming effect.

In other cases, it may be prescribed for anxiety, pain caused by Fibromyalgia, and headaches.

It’s available in capsule form.

One of the benefits of this prescription is that it isn’t a controlled substance and doesn’t have a high risk of dependency.

That being said, in some cases, you may experience withdrawal symptoms. Your doctor may lower your dose to wean you off the medication at the end of your treatment rather than having you stop to help prevent these symptoms.

Additionally, this prescription can cause some possible side effects. The most common include:

• Drowsiness
• Dizziness
• Numbness or tingling
• Sweating
• Shortness of breath
• Uncontrolled muscle twitching
• Blurred vision
• Changes in blood pressure

In some cases, your doctor may be able to adjust your dose to minimize Trazodone's side effects. Additionally, this medication should never be taken with alcohol as it can cause negative side effects.

What’s Zoloft?

Zoloft is classified as an SSRI and is most often prescribed for:

• Depression
• Postpartum Depression
• Panic Disorder
• Obsessive-Compulsive Disorder
• Post Traumatic Stress Disorder
• Social Anxiety Disorder

It isn’t known for as severe of a drowsy side effect which in some cases may make it a better option for treating depression. In fact, it’s been shown to increase mood and energy while decreasing fear and negative thoughts. It does this by increasing levels of serotonin in your brain.

It’s available as either a capsule or in liquid form.

This medication isn’t listed as a controlled substance. However, it should only be taken under the supervision of a healthcare expert as it isn’t right for everyone.

Possible common side effects from this prescription can include:

• Drowsiness
• Dizziness
• Diarrhea
• Fatigue
• Insomnia
• Nausea
• Headache
• Loss of appetite
• Weight gain
• Increased heart rate

This medication shouldn’t be taken with alcohol as it can increase your chances of experiencing negative side effects.

Other SSRIs approved by the FDA to treat depression include Celexa, Lexapro, Prozac, and Paxil.

Which Is Right For Me?

To find out if either Trazodone or Zoloft is right for you, you’ll need to first speak with a doctor.

If you're interested in finding an effective treatment to help you improve your sleep, you can complete an online consult with a primary sleep doctor.

As we mentioned above, while both medications are similar, they’re beneficial for different uses. You’ll need to discuss your current condition with your doctor and provide a full medical history.

Also be sure to give a full list of other medications you're currently taking to avoid the risk of any negative drug interactions.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

If you’ve ever picked up a box of antihistamines, a drug that treats itching and other symptoms of an allergic reaction, you’ve likely noticed a warning on the box that the medication may cause drowsiness.

While this side effect can be less than desirable during the day, it’s actually something that makes antihistamines a go-to option as a sleep aid for short-term sleeplessness.

But not all antihistamines are created equal. Here, we’ll go over the similarities and differences between two of the most popular options: Hydroxyzine and Benadryl.

What’s Hydroxyzine?

Hydroxyzine is a prescription antihistamine that is often used to relieve itchiness and other symptoms of an allergic reaction.

However, doctors have found that the medication has a calming effect on the brain along with a drowsy side effect.

Though it’s not completely understood why this is the case, research does suggest there is a connection between the levels of histamine in your body and how sleepy you feel. Too much histamine may contribute to wakefulness.

Because of its calming effects, this medication is often prescribed for anxiety, the sleep disorder insomnia, and in some cases is even used in anesthesia.

In addition to drowsiness, possible side effects can include:

• Fast or pounding heartbeat
• Headache with chest pain
• Severe dizziness
• Fainting
• Seizure
• Skin redness or rash
• Drowsiness
• Headache
• Dry mouth

It's possible that some of these side effects, sleepiness in particular, can carry over into the next day. Make sure and let your sleep doctor know if this is the case for you.

There are two types of Hydroxyzine available: Hydroxyzine Hydrochloride (Atarax) and Hydroxyzine Pamoate (Vistaril). Though both work very similarly, Vistaril is prescribed more often to treat insomnia.

In most cases, a prescription is given in capsule form; however, it may also be available in liquid form or as an injection given at your doctor’s office.

This prescription isn’t the right option for everyone; for instance, it’s not always a safe choice for older patients as it may increase the chances of falling. As it’s a prescription medication, you should always speak with a healthcare expert first before giving Hydroxyzine a try.

Finally, it's important to point out that this medication is meant to be a short-term solution only; in fact, research suggests that using the medication long-term can actually reduce your sleep quality.

What’s Benadryl?

Benadryl is also an antihistamine; however, it’s available over-the-counter rather than requiring a prescription from a doctor.

It's very commonly used for allergies and is also known for having a drowsy side effect which may cause you to be sleepy.

Some research suggests that this medication may be better than other antihistamines, including Hydroxyzine, to treat allergies. However, it’s also known to make you more drowsy than other over-the-counter options.

In addition to allergies, Benadryl is sometimes used to relieve motion sickness, hives, and even mild cases of Parkinson’s disease.

Besides drowsiness, other side effects are possible, including:

• Dizziness
• Lack of coordination
• Constipation
• Dry mouth
• Difficulty urinating
• Nausea or upset stomach
• Blurred vision
• Tremor
• Loss of appetite
• Headache

Benadryl isn’t the correct option for everyone. For instance, it shouldn’t be given to children under the age of two. Even though this is an over-the-counter medication, you should still speak with a doctor before using it as a sleep aid.

Which Is Right For Me?

Consulting a doctor is the best way to determine whether Hydroxyzine or Benadryl is a safe and effective option for you.

Both medications may interact with other medications, so be sure to let your doctor know all current medicines and supplements you’re currently taking to help avoid any negative drug interactions.

There are other off-label prescription drug options for sleep aids, including Trazodone (an antidepressant) and Gabapentin. Your doctor might explore these or other over-the-counter supplements, including melatonin.

Additionally, a sleep doctor might recommend non-medication therapies including sleep hygiene and cognitive behavioral therapy to help improve your sleep.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

We’ve all experienced moments of performance anxiety.

That realization that we’re about to face a room full of people who will, inevitably, wind up staring at us, expecting us to say something profound, or clever, or at the very least informative.

Performance anxiety can push our biological panic button, which floods our system with adrenaline. Our heart rate increases, we experience breathing problems, and we start sweating like we’re in a Bikram yoga studio.

We all have different strategies for coping with that anxious response.

We try to breathe through it. We try to focus on our notes. We try to imagine our audience or interviewers naked (I’m not sure why, as it never seems to help).

Even more frustrating is the fact that as soon as we notice those physical symptoms, they cause even more anxiety, creating a downward spiral.

Propranolol can help prevent the physical response to performance anxiety that reacts to a room full of people the same way it does to mortal peril.

This means you can get through delivering your big presentation during the quarterly meeting or answering a recruiter's questions during a job interview without your nerves hijacking your body in the process.

A 10-20mg dose of this beta-blocker drug one hour before a stress-inducing event can keep your heart rate level, your breathing steady, and your trembling (and sweating) hands subdued for several hours.

It's an alternative to many of the other options that are frequently turned to when managing pre-performance jitters, including alcohol or anxiety medications like Xanax.

How Long Does Propranolol Last For Anxiety?

For most patients, Propranolol’s half-life is around 4 hours.

Half-life is the time it takes for the medication in our bodies to be reduced by 50%. So, your prescription should give you at least 3-4 hours of relief from the physical symptoms of performance anxiety.

The effects of Propranolol are most potent within the first 4 hours, so you’ll want to time your dosage correctly. If you take it too close to your event, it may not have kicked in yet. Too early, though, and the effects might wear off by the time you get up on stage.

Taking your prescribed dosage one hour before your pivotal moment is the general recommendation from doctors to ensure you get the most benefit from your beta-blocker prescription.

So for instance, if you're using this for public speaking, try taking your medication an hour before your presentation start-time. You might even feel Propranolol work as you begin to warm up and review your notes before your big moment.

How Long Does It Take Propranolol To Leave Your System?

Once this medication is in your system, it takes roughly 1-2 days for your body to completely clear it. Its half-life is short, so it metabolizes quickly, and the Propranolol dosage for anxiety is fairly low.

In order to lower the risk of interactions or side effects, you should wait until Propranolol exits your system completely before taking another medication. And always be sure to review your treatment plan or check with your doctor about possible interactions and side effects before taking this medication.

This is is a prescription drug and may not be right for everyone. A consultation with one of our board-certified doctors can help you decide if it is the right choice in your case.

Though this is generally considered a safe medication, it isn't right for all. Our doctors will review your medical history and personalized needs to determine if this treatment option is right for you in overcoming situational anxiety.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Most of us have experienced performance anxiety at least once.

Speaking up in a meeting to deliver an opposing opinion you know you'll get pushed back on. Promising to deliver a killer best man's speech, even though public speaking is secretly your biggest fear.

The realization that a roomful of people is waiting to watch us speak or perform can be flat-out alarming.

Rapid heartbeat, sweaty palms, rushed breathing, flushed cheeks - the list of physical symptoms that scream out to everyone around us that we're scared is endless.

Many people assume that it takes a major intervention to relieve performance anxiety during these crucial situations.

For instance, it's not all that rare to see someone sneaking in a shot of whisky before they pick up the mic. In some cases, people will even turn to anxiety medications, like Xanax, to help them keep their cool.

The problem with these "treatment options", however, is that they come with side effects that blur your concentration and make it even more impossible to focus on the delivery of your content.

Beta-blockers, on the other hand, offer short-term relief without having to sacrifice your clarity and focus.

In fact, many are surprised to learn that the typical Propranolol dosage for anxiety is actually quite low, with most doctors recommending taking a small dose of 10–20 mg one hour before a pivotal moment like a presentation, job interview, or crucial exam.

This is a fraction of the normal dosage recommended for other conditions beta-blockers are used for like migraines, high blood pressure, and heart conditions.

How Does Propranolol Work For Anxiety?

When your body goes into fight-or-flight mode as a response to stress, norepinephrine (what you probably know as adrenaline) kicks in. It sends your heart rate through the roof, makes your breathing short and shallow, and, in some of us, produces upsetting amounts of sweat.

Unfortunately, as humans, our bodies have not yet adjusted to our modern environment.

Our physical response to stress is the same, whether we’re nervous about presenting to a room full of people or facing down a hungry lion.

The physical processes designed to keep us alive and uneaten in the animal world are obstacles in a human world that rewards crisp, relaxed performances.

A high heart rate can further elevate anxiety, resulting in a negative spiral. Shallow breathing or trembling can spoil a performance, regardless of how practiced a speaker or performer is.

When you take your Propranolol dose for anxiety, however, it blocks adrenaline from impacting the way your body feels.

That helps prevent many of the physical responses to stress like high heart rate, labored breathing, and excessive sweating. The elimination of those physical symptoms helps calm many people as they prepare to perform at their peak.

How Do I Know The Right Dosage For Me?

Like we mentioned above, doctors tend to prescribe 10-20 mg of Propranolol as an off-label prescription to be taken an hour before a big moment. This micro-dose, taken only when needed, is usually enough to achieve the relief from performance anxiety that beta-blocker prescriptions provide.

However, it’s important to give your doctor a full medical history as well as an updated list of any medications and supplements you’re taking to help figure out the right dosage for you.

As with any medication, the exact dosage will vary based on your height, weight, body composition, and a variety of other factors.

Though beta-blocker medications can cause some common side effects, taking the correct dosage recommended by your doctor can help minimize or eliminate them altogether.

Be sure to read through your treatment plan to make sure you're following full instructions from your doctor.

Though Propranolol is largely considered to be a safe medication, it simply isn't the right solution for everyone. You can complete an online visit with a board-certified doctor to discuss your performance anxiety and understand if a beta-blocker prescription is right for you.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Doctors widely consider beta-blockers to be a safe class of medication. They have comparatively few side effects and are not prone to abuse or dependence.

Nevertheless, beta-blockers like Propranolol are prescription medications and can interact negatively with some other types of drugs.

Certain drug interactions may decrease the effectiveness of the medications you’re taking and in some cases can even lead to harmful effects.

As a result, you should always tell a healthcare provider about anything else you take before starting a new prescription medication, including beta-blockers

How Does Propranolol Interact With Other Drugs?

There are different categories for the likelihood of interactions between medications as well as how serious those interactions can be. These include:

• Contraindicated: The risk of negative interaction is very high. You should never take medications with contraindications as they can lower the effectiveness of your medication and leave you at high risk for negative effects.
• Serious: Risk of negative interaction is high. You should only take drugs with serious interaction under the close supervision of a doctor.
• Significant: There is a likelihood of negative interaction. You should only take drugs with significant interaction under the supervision of your doctor.
• Minor: The likelihood of negative interaction is low.

Propranolol isn’t known to have severe interaction with any other medications; however, it can carry serious, significant, and minor interactions with other drugs.

Any prescription medication that slows your heart rate like this medication may interact with other drugs that affect your heart, circulatory system, or blood pressure.

What Drugs Does Propranolol Interact With?

Patients can safely take many types of drugs with a Propranolol prescription. However, it does interact with certain classifications of medicine.

For starters, because this drug is itself a beta-blocker medication, it should not be taken with other beta-blockers.

Also, because this drug is often used to treat high blood pressure, angina, and other heart conditions, it's important to let your doctor know if you're taking any other medications for these conditions so you don't experience negative drug interactions or serious side effects.

Your doctor will determine whether or not a beta-blocker prescription is right for you based on your health history and the information you provide them.

So always be sure to alert your doctor to any changes in your health as well as provide a full list of all medications and supplements you take.

Drugs that can cause dangerous interactions with this medication include:

• Blood pressure drugs, such as:
• Angiotensin-Converting Enzyme (ACE) Inhibitors
• Other Beta-blockers
• Alpha-blockers
• Anesthetics (Drugs that block sensation), such as:
• Lidocaine
• Mepivacaine
• Dobutamine
• Drugs used to increase heart rate and blood pressure, such as:
• Epinephrine
• Isoproterenol
• Dobutamine
• Asthma drugs, such as theophylline.
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Blood-thinning drugs, such as warfarin
• Drugs for stomach ulcers, such as cimetidine
• Antacids with aluminum hydroxide

You should always err on the side of caution with prescription medications. Please check with a healthcare provider before combining your prescription with any other medication, even those not included on this list.

Propranolol is commonly prescribed off-label to minimize the physical symptoms that result from performance anxiety often experienced before a big moment, such as a presentation, performance, or job interview.

When given in a small dose, usually around 10-20 mg, it prevents the symptoms of anxiety by blocking the production of norepinephrine, more commonly referred to as adrenaline, from being produced when you're under pressure.

In some cases, it may be prescribed to treat social anxiety.

Get started with an online consultation now and connect with one of our board-certified doctors to learn if this treatment option is right for you.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Can’t remember the last time you got a full night of sleep without waking up at least once in the middle of the night?

You’re certainly not alone.

Struggling to stay asleep for a full seven to nine hours is a hallmark of insomnia, the most common sleep disorder reported by adults.

And while briefly waking up and immediately rolling over to fall back asleep isn’t that big of a deal, experiencing multiple wakeups throughout the night or being unable to fall back asleep when your rest is interrupted is a problem.

After all, interrupted sleep means the quality of your sleep is suffering. And you’ll certainly feel this during the daytime.

Gabapentin is one treatment option offered by doctors to not only help you fall asleep faster but stay asleep for a full night of rest – without those disruptive wakeups.

How Does Gabapentin Help You Sleep?

Gabapentin is a prescription anticonvulsant, a medication meant to stop or prevent seizures.

But studies have shown this drug is helpful for more than just that, and it’s commonly prescribed to treat:

• Nerve pain
• Migraines
• Hot flashes
• Teeth grinding
• Anxiety
• Restless leg syndrome
• Insomnia

This medication boosts deep sleep, the stage of sleep known for improving memory consolidation. It’s also been shown to improve sleep efficiency, or the time spent asleep while you’re in bed, as well as preventing sleep interruptions.

It's believed the medication helps due to the calming effect it promotes, which causes drowsiness.

When used for insomnia, Gabapentin is an off-label prescription. Other common off-label prescriptions doctors turn to to help their patients get back to better sleep include the antihistamine Hydroxyzine and the antidepressant Trazodone.

However, Gabapentin has been approved by the FDA to treat another sleep disorder, known as restless legs syndrome.

This medication is not considered a controlled substance by the federal government; however, it may be listed as one in certain states.

How Is Gabapentin Dosed?

When used for insomnia, most doctors will write a prescription for 100-400 mg of Gabapentin. This should be taken once a day right before you’re ready to go to bed.

In some cases, your doctor may start you off with a lower dose and adjust as needed.

Always be sure to take your prescription as written. Do not change your dosage without first speaking with your doctor.

Some people do report feeling groggy the following morning after taking their medication. Because of this, your doctor will likely recommend that you start your prescription when you don’t have to be anywhere first thing the next morning.

Do not drive or do any activities until you have an understanding of how this medication affects you and what side effects you experience, if any.

How Do I Know What Amount Is Right For Me?

To understand what dose of Gabapentin is best for you, talk with a sleep expert.

During your discussion, your doctor will ask you important questions to determine the right sleep treatment for you, including your medical history and your current medications.

Once given a prescription, or any other sleep aid, always be sure to follow the directions provided.

Your doctor will also likely add non-medication components to your sleep treatment plan to improve your chances of long-term success. These might include improving your sleep hygiene or undergoing CBT.

If your doctor isn't sure that a prescription sleep aid is right for you at this time, they may suggest giving an over-the-counter option a try first, including a supplement like melatonin.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Insomnia is more than just struggling through tiring days and finding yourself wide awake in the middle of the night.

It’s a sleep disorder that can have far-reaching effects on your life, sapping your energy levels, testing your mood, and decimating your productivity levels.

In some cases, it can even leave you more prone to making mistakes or having an accident.

The good news:

Insomnia isn’t something you have to be stuck with.

To help you get back on a path of healthy, recuperative sleep, your doctor may recommend a Trazodone prescription as a treatment option.

Let’s take a quick look at how this medication works and the recommended dose needed to get you back to sleep.

How Does Trazodone Help You Sleep?

Trazodone is an FDA-approved antidepressant that changes the levels of serotonin in your body, which can improve your mood, calm your nerves, and promote drowsiness - ultimately helping you fall asleep.

It's most often used as a sleep treatment to treat short-term insomnia that's the result of stressful life changes.

Serotonin’s relationship to the sleep-wake cycle is a bit complex as it's a hormone that’s been shown to both keep you awake and help you sleep. However, research does show that serotonin is needed in order for your body to produce melatonin, a hormone that signals your body it's time for rest.

Doctors often prescribe Trazodone off-label to help with insomnia as studies show it to be an effective option. Additionally, it’s a medication with a low risk for dependency and isn’t considered a controlled substance.

Other off-label prescriptions commonly turned to for insomnia include Gabapentin and Hydroxyzine.

How Is Trazodone Dosed?

When used for insomnia, doctors prescribe this medication at a lower dose than they would otherwise. In fact, research has shown that taking too high a dose of the drug can have the opposite effect of keeping you wide awake.

In most cases, your prescription will be between 50-150 mg to be taken once a day shortly before bed.

Only take your prescription if you’re ready for bed and have at least seven hours to sleep. It’s also important that you not drive or engage in any activities that require you to be alert right after taking your prescription.

This medication does carry a risk of possible side effects, including feeling groggy the next morning.  So your doctor will likely recommend that you start your prescription when you don’t need to be anywhere early the next day so you can understand how the medication affects you.

How Do I Know What's The Right Amount For Me?

To find out what dose of Trazodone is right for you, be sure to reach out to a doctor.

The exact dose given to you will depend on several factors, including your medical history and your experience with insomnia. In order to help your doctor determine what dose is right for you, always be sure to provide them with a completely up-to-date medical history as well as a list of all other medications you’re currently taking.

Once given a prescription, be sure to follow the directions provided. Never adjust your dose without first speaking with your doctor.

In addition to exploring sleep prescriptions, your doctor may recommend you add sleep hygiene practices as well as cognitive behavioral therapy (CBT) exercises to increase your chances of long-term success.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Exercise is a very common, not to mention a healthy, way to burn off nervous energy when your stress levels are starting to feel out of control.

In fact, research has shown that even just five minutes of aerobic exercise can lessen anxiety levels and help you start feeling calmer.

But what if you turn to beta-blockers to quell the physical symptoms of situational anxiety before an important presentation, job interview, or test?

Is it still safe to exercise?

As with most questions related to prescription medications, the answer is: well, it depends.

Your personal health history, the Propranolol dosage you take, and a whole host of other factors can impact whether or not exercise and your medication are safe for you.

To be safe, you should always check with your doctor.

However, for most people who are taking a small dose of Propranolol on an as-needed basis for performance anxiety, exercise is safe and is in fact, recommended by doctors for all the benefits to the heart, lungs, muscles, and brain that it provides.

Generally, our doctors recommend taking between 10-20mg of Propranolol one hour prior to your event, including public speaking, interviews, or other performances. And chances are you aren’t fitting in much exercise within one hour of a big presentation or job interview anyway.

Still, if you plan to exercise on beta-blockers, there are a few things you should know.

How Does Propranolol Affect Your Heart Rate?

Beta-blockers block the effects of epinephrine (adrenaline) on the body, lowering your heart rate and, with it, your blood pressure.

In the short term, exercise raises your heart rate. So if you’ve taken your prescription prior to exercise, the medication may limit how high your heart rate can go.

Over time, exercise causes similar effects to this type of medication, decreasing your resting heart rate and blood pressure.

How Do Beta-Blockers And Exercise Interact?

There are two main risks to exercising after taking beta-blockers: dehydration, and over-exertion.

Dehydration is characterized by:

1. Excessive thirst
2. Fatigue
3. Diminished sweating

You should be alert for any of these side effects. And always be sure to keep a water bottle nearby if you’re exercising!

Over-exertion is more likely something to look out for in those who use a target heart rate to exercise. As we mentioned above, beta-blockers can limit how high your heart rate can go meaning you may not reach the target heart rate you normally would if you hadn’t taken your medication.

And it’s important you don’t push yourself more than you should.

In fact, doctors generally recommend taking caution not to overdo anything if you’re exercising while taking your prescription.

Warning signs that you might be pushing yourself too hard include:

• Chest pain
• Shortness of breath
• Lightheadedness
• Inability to talk

As with any prescription medication, trust your body. Speak with your doctor before you begin an exercise regimen, especially if you plan on taking Propranolol first.

And if something feels off, tell your doctor.

Propranolol can be an effective treatment option for people looking to overcome performance anxiety, stage fright, and social anxiety. Start an online consult with a board-certified Kick doctor today to learn if this beta-blocker medication is right for you.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

Beta-blockers are one of the most common medications and are prescribed by doctors to help with an irregular heartbeat (arrhythmias), chest pain (angina), and high blood pressure (hypertension).

They’re also often prescribed for quite a few off-label uses including migraines, glaucoma, essential tremor, and performance anxiety.

This class of medication works by blocking the hormones norepinephrine and epinephrine (more commonly known as adrenaline) from binding to beta receptors.

Beta receptors live on the surface of your cells and when activated, cause a response like increased heart rate or trembling.

When adrenaline doesn’t connect to beta receptors, the fight-or-flight response isn’t activated.

Think of it like this:

Adrenaline is like an electrical plug, a device that brings energy. Beta receptors are the electrical outlet, the thing that activates that energy.

If a plug and outlet don’t connect, nothing happens.

If adrenaline doesn’t bind to beta receptors, there’s no effect on your body. Your pulse doesn’t race, your palms don’t sweat, your stomach doesn’t turn.

Your physical body simply remains calm.

There Are Different Types Of Beta-Blockers?

There are indeed. And while they generally work the same way, different types of this kind of medication prevent adrenaline from binding to different beta receptors.

And by binding to different beta receptors, they affect different areas of the body.

The two main types of beta-blockers are called selective and non-selective.

Selective Beta-Blockers

Selective beta-blockers are cardioselective. In other words, they “select” the beta receptors located in the heart tissue, known as your beta1 receptors.

This type of beta-blocker decreases activity around the heart and can help reduce your heart rate and your systolic pressure, the pressure your blood vessels experience when your heart beats.

They’re often used to help people experiencing conditions like chest pain, irregular heart rate, and high blood pressure.

Common selective beta-blockers include atenolol, metoprolol, nebivolol, and bisoprolol.

Non-Selective Beta-Blockers

Non-selective beta-blockers, on the other hand, block the beta1, beta2, and beta3 receptors, helping to address even more physical symptoms of performance anxiety.

So instead of only targeting the beta receptors in your heart, they also target those in your blood vessels, GI, and lungs as well.

This kind of medication can help slow your breathing, prevent your hands from trembling, or your palms from sweating.

Common non-selective beta-blockers include nadolol, pindolol, among others.

And Propranolol Is What Type Of Beta-Blocker?

Propranolol is a type of non-selective beta-blocker.

Performance anxiety can cause uncomfortable side effects throughout your entire body, including:

• Shaky hands
• Headaches
• Muscle tension
• Chest pains
• Sweaty palms
• Rapid heartbeat
• Shallow breathing
• Sweating
• Blushing

Propranolol blocks the effects of adrenaline, preventing these physical symptoms from happening when you’re under intense pressure.

It’s important to note that beta-blockers don’t address the psychological symptoms of anxiety. You may still feel nervous before your big moment even with your prescription.

But minimizing the physical symptoms and getting your body back on your side can help you stay focused and ultimately feel more in control.

While Propranolol is generally considered to be a safe medication, it isn’t right for everyone. Some might experience some adverse effects while others should avoid the medication altogether due to their medical history.

Consult with a doctor to find out if it’s the right option for you.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

When you’re facing a particularly stressful situation such as a huge presentation or an important job interview, it can be tempting to reach for a drink to help calm your nerves.

But what if you’ve already prepped for your big moment with a beta-blocker?

Generally speaking, doctors will advise against drinking alcohol while taking any beta-blocker medication, including Propranolol. Here’s a quick rundown of why.

How Do Beta-Blockers And Alcohol Interact?

Beta-blockers work by blocking the physical effects of norepinephrine (adrenaline).

Practically, that means that Propranolol helps your heart beat slower. Others in this class of medication also help your blood vessels open up, which increases blood flow.

A single alcoholic drink can lower blood pressure by making blood vessels larger. It also acts as a blood thinner, preventing blood cells from sticking together.

People who combine beta-blockers and alcohol may find they experience headaches, dizziness, lightheadedness, change in heart rate, or even fainting.

Additionally, increasing the number of alcoholic drinks can even reduce the effects of Propranolol on the body.

In fact, two or more alcoholic drinks can:

1. Increase levels of norepinephrine
2. Elevate your heart rate
3. Increase the amount of blood the heart pumps out

If you take beta-blockers for performance anxiety, increased norepinephrine and an elevated heart rate are exactly the negative effects of stress you’re trying to avoid in the first place. And for those who are relying on beta-blockers to reduce their risk of heart attack or to treat arrhythmia, those effects can be downright dangerous.

Please be sure to consult with your doctor first if you plan to take Propranolol and drink alcohol at any point.

Does The Dosage Of Propranolol Matter?

Dosage does make a difference in alcohol’s combination with beta-blockers.

Beta-blockers like Propranolol metabolize quickly. Therefore, the longer you wait between taking beta-blockers and drinking alcohol, the lower the chances of overlap.

A low dosage of Propranolol (like the 10mg dosage generally prescribed for performance anxiety), will:

1. Leave the system more quickly
2. Lower the risk of side effects

If you plan on drinking, you should absolutely speak with your doctor about the potential risks and side effects of mixing beta-blockers and alcohol.

Start an online consultation today with one of our board-certified doctors to learn more about beta-blockers and whether or not they’re the right option for you.

Reviewed by Dr. Alex Dimitriu

Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.

We all know sleep is a crucial part of maintaining a healthy lifestyle. But here’s the thing:

Most of us don’t get enough sleep.

It’s simple: if you’re not giving your body the time to recover energy, repair muscle, and do all of the other really important things that happen when you’re asleep, you’re doing yourself a huge disservice.

So how can you make sure you’re incorporating sleep into your healthy lifestyle?

We sought out answers to that exact question from 50 of the top wellness influencers. And the tips they provide are total game-changers.

Keep reading to find out what they say.

How Can Sleep Improve Your Fitness Results?

Optimizes Your Physical And Mental Health

“Taking your sleep seriously is one of the best things you can do to optimize your physical and mental health. In fact, there are some incredibly important functions that take place during sleep including muscle regeneration, restock of energy reserves, emotional regulation, toxin removal, and memory and learning consolidation. There is also evidence to support that sleep supports a healthy immune system and increases performance in sport and training."

- Dr. Kianoush Missaghi, Freeletics

Boosts Results From Exercise

"What sleep does to your body will boost the results from every single hour of exercise. During sleep your muscle tissue will be restored, and your HRV will increase. It’s simply the easiest hack."

- Matteo Franceschetti, Eight Sleep

Improves Muscle Hypertrophy

"Sleeping has a profound impact on recovery and is a factor which is often overlooked when considering the best approach to muscle hypertrophy. Research suggests that the body is able to: restore organs, bones, and tissue; replenish immune cells, and circulate human growth hormone. In fact, 60% to 70% of daily human growth hormone secretion occurs during the early stages of sleep, which is typically when the deepest sleep cycles occur."

- Jacky Anderson, Sport Fitness Advisor

Decreases Daytime Fatigue And Increases Stamina

“A Stanford University study found that college football players who tried to sleep at least 10 hours a night for seven to eight weeks improved their average sprint time and had less daytime fatigue and more stamina. The results of this study reflect previous findings seen in tennis players and swimmers."

- Alyssa Sparacino, Health Magazine

Helps You Stay Motivated During Workouts

"Sleeping less than the minimum six hours will lead you to cut short your workouts if you can even get yourself motivated to go to the gym in the first place. And get this – once you begin skimping on your workouts, you’ll be in a cycle of impaired sleep as well.”

- Dr. Michael Mantell, Total Gym Pulse

Keeps You Happier, Stronger, And Smarter

"I challenge you to make sleep your number one priority for one week. Put aside any preconceptions you might have about sleep—particularly if you’re that type-A person who has a number of hot irons in the fire (career, family, athletics, etc) and cuts back on sleep to make time for more—and make getting a long, deep night of sleep your number one goal of each day for seven days, and see what happens. This is what I want to happen and expect to happen: That you’ll be happier, healthier, faster, stronger, and smarter."

- Dr. Kirk Parsley, Robb Wolf

Gives Your Body Time For Recovery And Growth

“The longer and better you sleep, the more time your body has for recovery and growth. So you see, your muscles do grow in your sleep."

- Tina Sturm-Ornezeder, adidas Runtastic

Allows Your Mind To Refresh

“Just by sleeping your 7-9 hours a night, you are allowing your mind to refresh and your body to rest, allowing you to wake up feeling healthy and aware."

- Lisa Gulley, Workout Mommy

Improves Your Chances For Weight Loss

"Without the proper amount of sleep, the chemicals that send signals to your brain telling it you are full after eating a meal will not be balanced…When this happens, nighttime snacking is usually involved, so sleep is essential when it comes to weight loss."

- Tess Dinapoli, The Art of Healthy Living

Acts As Your Foundation For Recovery

"Sleep is the foundation of recovery…You cannot out-train or out eat poor sleep habits coupled with a lifestyle of constant physical and emotional stress. These place a heavy strain on the CNS (Central Nervous System) over extended periods of time."

- Kevin Masson, Dr. John Rusin Blog

Helps You Grow

"You don’t grow in the gym. You grow while you recover…While a great many of us build our schedules around workouts, fewer of us offer the same deference to our sleep."

- Justin Grinnell, Muscle and Fitness

Increases Your Melatonin Production

"Working out balances your hormones and produces chemicals that are critical to how you sleep. The biggest of these is Melatonin. Melatonin is a sleep chemical that your body creates naturally to help you sleep. When you exercise not only does it help your body produce this chemical, but it helps your body produce it at the right time.”

- Bre Brimhall, Vasa Fitness

Causes Your Body Temperature To Rise

“Physical exercise causes our body temperature to rise, which can help create peace in our minds and calm the chaos many of us live with. This has the excellent side effect of letting you fall asleep quicker."

- Sharath Narayan, Fitso Blog

What Happens When You Don’t Get Enough Sleep?

You'll Miss A Vital Part Of Maintaining Health

“According to the CDC and numerous studies, not getting enough sleep is associated with a number of chronic diseases, such as diabetes, cardiovascular disease, obesity, and depression. Together, these four health conditions prove a powerful case that sleep isn’t just beneficial, it’s vital."

- Jennifer Walters, Fit Bottomed Girls

Your Body Won't Get What It Needs Done

"It makes sense that if the body is chronically under-rested, these valuable and necessary processes are disrupted. The body then cannot adequately repair tissues and blood vessels, produce and release hormones efficiently, or remove waste.”

- Dr. Erin Nitschke, Ace Healthy Living

You Might Throw Your Hormones Off

“Researchers from the University of Chicago found that sleep loss causes decreased glucose tolerance and insulin sensitivity (those processes that cause your body to shuttle nutrients into fat cells instead of muscle cells) as well as elevated levels of ghrelin—the hunger hormone—and cortisol, the stress hormone that encourages your body to store fat.”

- Dr. Joel Seedman, Advanced Human Performance

You'll Risk Decreasing Your Testosterone Levels

"Sleep deprivation will not only sap energy from your lifts, it will negatively impact you on a hormonal level by decreasing the release of testosterone (1) and increasing cortisol (2), an especially nasty combo when trying to gain strength, muscle mass, or lose body fat and even worse for males interested in having sex past the age of 35.”

- Tony Gentilcore, Tony Gentilcore

Your Optimum Body Temperature Will Be Thrown Out Of Whack

“When you lack sleep, this can affect your core temperature, which in turn causes reduced energy expenditure and even more fatigue."

- Jeff Mann, Roman Fitness Systems

You Can Say Hello To Increased Inflammation

"When you are trying to build muscle, not getting enough sleep is destructive because you are depriving your body of the rest that it needs to be able to recover, repair, and grow."

- Dan Fries, Corpina Nootropics

Your Efforts Quickly Become Severely Limited

"Studies show that restricting sleep to 5 hours per night for just one week can lower testosterone by 10-15%. And, not only does it limit your testosterone production, but sleep restriction has also been shown to cause a similar reduction in Insulin-like Growth Factor 1 (IGF-1)… If these hormones are comprised, then it doesn’t matter what you do at the gym, your ability to build muscle will be severely limited.”

- David de las Morenas, How To Beast

You'll Feel Tired And Hungry More Often

"A study by Cedars-Sinai Medical Center shows that a single night of sleep deprivation can cause as much insulin resistance as six months on a high-fat diet. This leaves you feeling tired and hungry more often than you should.”

- Nahida S., HealthifyMe

You'll Snack More Than You Should

"In addition to more junk food cravings, a lack of sleep could also cause you to snack more in general, therefore leading to a higher calorie intake the next day. This could be problematic if you’re looking to lose weight by cutting down on calories.”

- McKel Kooienga, Nutrition Stripped

You Can Say Goodbye To Your Motivation

“If you don’t get enough sleep, you will fail at changing habits; and if you have a lack of sleep, your motivation will drop tremendously...If you find yourself lacking motivation or having trouble changing any habits, check your sleep levels.”

- Leo Babauta, Zen Habits

You'll Become More Vulnerable To Getting Sick

"Studies have shown that people who sleep less than six hours a night are at a greater risk of catching the common cold than people who sleep at least seven hours."

- Brittany Risher, myfitnesspal

You're More Likely To Overindulge

“There is evidence that lack of sleep enhances areas of the brain associated with the drive to consume food. The effect of sleep on weight loss here is to moderate how much we eat."

- Hannah Kemish, Shredify

You'll Undermine Any Training Progress

"When it comes to sleep, poor quality, short duration, and poor efficiency all undermine training progress and athletic performance."

- Chris Carmichael, CTS

Your Mental Health Will Be Put At Risk

"One impact that is often overlooked is sleep’s effect on mental health. Sleep deprivation can cause serious mental health problems which can cause a huge toll on your life if not effectively addressed."

- Dennis Relojo-Howell, Psychreg

How Can I Make Sure I’m Getting Enough Sleep?

Eat A Light Dinner

“Evening meals often consist of a light serving of easily digestible, cooked vegetables. When I am away at a yoga retreat and eating this way, I sleep like a baby."

- Bethany Eanes, Breaking Muscle

Stick To A Consistent Bedtime

"Sticking to a bedtime is so key. I consistently get less REM and deep sleep than recommended…but those numbers were always higher on nights when I went to bed before 11:30.”

- Emma Loewe, mindbodygreen

Incorporate A Yoga Practice

"Yoga has been a big part of my sleep getting better, as with other parts of my life. On days when I skip yoga, I have more difficulties falling asleep. Why? Because I'm simply not tired enough, my body needs to move.”

- Erin Motz, Bad Yogi

Focus On Your Breath

"[Spiraling thoughts] can prevent us from getting the quality shut-eye we so badly need in order to maintain optimum health. Thankfully, strategies like breathwork for sleep can help put the swirling thoughts in your mind to sleep so you can doze off peacefully...Put both hands on your belly and slowly close your eyes. Let your naval inflate as you inhale and shrink as you exhale. As you inhale, count three seconds, and then as you exhale, count six seconds. Do this breathwork for sleep exercise for about five minutes, and you’ll be dozing off in no time."

- Kayla Hui, Well + Good

Don't Over-Hydrate

"Good hydration is an essential component of your health, but too much drinking before you sleep can severely disrupt a restful night of sleep, and even cause a disorder known as nocturia.”

- Adam Bornstein, Born Fitness

Never Go To Bed Hungry

"Don’t go to bed hungry…If you’re hungry your body just won’t let you get that quality rest it deserves. This isn’t a free pass to an all-you-can-eat. Just a light meal which helps you feel satiated is cool.”

- Chad Stan, Spot Me Bro

Stay Away From Screens At Night

“The LED and OLED screens used for most modern devices emit a type of light known as “blue light.” This bright, blue light tells your body it’s still daytime, which encourages your body to suppress melatonin production. Melatonin is the hormone that tells your brain it’s time to sleep. Thus, more blue light = less melatonin = a harder time falling asleep."

- Barney Moore, Legion Athletics

Take A Hot Bath

“Stepping out of a warm shower or bath into a naturally cooler bedroom causes a drop in your body temperature. This drop in temperature is shown to naturally trigger feelings of sleepiness because it slows down metabolic functions.”

- Chris Freytag, Get Healthy U

Avoid Heavy Protein Before Bed

“You’ll probably want to avoid having whey protein shakes right before bed, especially on an empty stomach. In that case, the protein can be digested so quickly that it interferes with our ability to produce melatonin."

- Shane Duquette, Outlift

Exercise Earlier In The Day

“Make sure you’re not exercising very close to bedtime, as exercise is stimulating and can keep you from falling asleep. Try moving your workout to the morning or midday if you’re feeling overly wired at night.”

- Laura Schoenfeld, Girls Gone Strong

Exercise Regularly

“Studies have shown that exercising three to four times each week can improve your sleep more effectively than supplements. It was also found that high-intensity workouts where you exert yourself more can improve sleep."

- Kayla Itsines, Kayla Itsines

Use The Sun

“Time outside in the sunlight affects our circadian rhythm and can help our bodies to recognize that when the sun is up, we’re up, and when it’s down, we should be crashed. It’s helpful to open the blinds or curtains as soon as you’re awake to let natural sunlight in, and start to turn down lights and stimuli as it gets later."

- Gina Harney, The Fitnessista

Try Resistance Band Training

“Resistance band training, especially when performed later in the evening, can help reduce your overall stress levels and reverse some of these key indicators. You’ll take deeper breaths, your blood pressure drops, your metabolism stabilizes, and your cortisol levels decrease. All of these factors have the effect of promoting drowsiness and contribute to a deeper and more relaxed sleep."

- Jenn Mitchell, The Comeback Momma

Wake Up Naturally

“If you need to wake up to an alarm, you’re not sleeping long enough. Your goal should be to wake up naturally every morning, with an alarm reserved for rare occasions when you NEED to be up earlier or go to sleep later than normal – this should be the exception, not the rule."

- Greg Nuckols, Stronger By Science

Find Your Ideal Sleep Schedule

“Focusing on doing what it takes to get a solid 7 hours nightly (I’d say 8, but let’s not get ahead of ourselves) – whether that means going to bed earlier, waking up later (if possible), or a combination of both will make a monumental difference to your rate of change from a muscle development and fat loss perspective, and also from a performance perspective, strength and energy-wise."

- Lee Boyce, Lee Boyce

Avoid Intensive Workouts At Night

“As little as fifteen minutes of walking, biking, or other cardio exercises can have a significant effect on one’s sleep quality. It is recommended to avoid intensive or strenuous workouts just before bedtime."

- Amy Occhipinti, AFPA Fitness Blog

Only Use Your Bedroom For Sleep

“Your bedroom should be a place just for sleep to convince your brain to rest at appropriate hours. Using your bedroom for anything else is considered poor sleep hygiene and can affect the quality of your sleep drastically."

- Maryam Zahid, ActiveMan

Find Your Right Time To Exercise

"While exercise at all times of day is generally considered good for sleep, exercising at the right time can be even better. If the evening is your optimal exercise window, try working out at least 2 hours before bed; this gives your brain and body time to wind down."

- Meghan Crowley, Move It Monday

Practice Sleep Hygiene

“Avoid electronics and digital screens 1-2 hours before bed, keep your room cool and consider blackout curtains (or a comfortable eye mask!), steer clear of caffeinated beverages in the afternoon, and try to stick to a regular sleep schedule, even on weekends."

- Elisa Snyder, Jenny Craig

Embrace Your Own Internal Clock

“You hear that we need 8 hours of sleep per night, but we want to stress that you need to find what works best for you. Though you feel guilty sleeping until 7 am while your mentor posts 4:30 am wake-up pictures, just know that you need to find your own sleep schedule. We all are on different internal clocks and our body will react differently. Find the routine that helps you be as productive as possible – this will take some trial and error – and you will be able to optimize your fitness and lifestyle!"

- Sara Westgreen, DIY Active

Establish A Wake-Up Routine

“I have a fantastic morning ritual where I launch into a challenging sequence of mobility, flexibility, core and leg strengthening exercises as soon as I wake up every single day.”

- Brad Kearns, Two Meals A Day

End Your Day With Gratitude

"End each day with positivity/gratitude. When I read something positive before bed and/or think about what I’m grateful for when I hit the pillow, I fall asleep faster and sleep consistently better.”

- Scott Christ, Pure Food Company

Ask For Help

"If you’ve tried everything you can on your own, and you’re still struggling to sleep properly, it may be time to see your doctor. You may need to use a prescription sleep aid for a while to break the cycle; or you could have a bigger issue like sleep apnea, depression, or anxiety that you need professional medical help to resolve."

- Cathy, Avocadu

And there you have it!

50 game-changing tips from top wellness influencers on how sleep improves fitness, what happens to your workout progress when you skip rest, and how to incorporate regular sleep into your lifestyle.