Hello and welcome to Healthcare Magic. Thanks for your query.

Tylenol PM is a combination medication containing acetaminophen (an analgesic) and diphenhydramine (an antihistamine, with sedative properties). I would advise you to double check the ingredients of the medication, because cetain other compositions of Tylenol (like Tylenol 3) contain codeine - which is an opioid medication. Naltrexone is an opiod antagonist and hence can cause a bad reaction if codeine or other opioid containing medication are taken concurrently. So, please be extra-careful in taking any over-the counter sleep formulas or cough medication, since many of them contain codeine.

Disturbed sleep is a common symptom of alcohol withdrawal, but it usually settles down in about 2 to 3 weeks. It is a better idea not to get used to taking additional non-prescription medication for sleep, since some of them can be habit-forming and can have withdrawal symptoms when attempting to stop them after a prolonged period. You can advise your brother to follow strict sleep hygiene techniques which will help him regularize his sleep pattern soon:
- Fix a specific bedtime and an awakening time. Do not allow bedtime and awakening time to drift.
- Avoid napping during the day.
- Avoid coffee, tea or any caffeinated drinks or alcohol 4 hours before bedtime.
- Avoid heavy, spicy, or sugary foods for dinner. Have a gap of at least 1 hour between dinner and bedtime.
- Exercise regularly, preferably in the early evening, at least 4 hours before bedtime.
- Set up a comfortable environment which is dark, quiet and disturbance-free. Block out all distracting noise, and eliminate as much light as possible.
- Reserve the bed for sleep only. Don't use the bed for studying, working or for other rectreational activities.
- Try a light snack before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
- Practice relaxation techniques before bed. Relaxation techniques such as yoga, XXXXXXX breathing and others may help relieve anxiety and reduce muscle tension.
- Don't take your worries to bed. Leave your worries about studies, work, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues.
- Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.

I hope this advise is both informative and beneficial to you.

Best wishes,
Dr. Jonas Sundarakumar
Consultant Psychiatrist

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