$Unique_ID{BRK01276}
$Pretitle{}
$Title{Is it Possible to Get a Decent Night's Sleep Without Taking Medication?}
$Subject{sleep medications mental emotional conditions disorders medication
benzodiazepines sleeping pills barbiturates nonbarbiturate hypnotics insomnia
insomniacs hygiene bedtime tryptophans slumber condition disorder
benzodiazepine barbiturate}
$Volume{E-1}
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Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Is it Possible to Get a Decent Night's Sleep Without Taking Medication?


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QUESTION:  Can you comment on the constant use of pills to achieve a decent
night's sleep.  Isn't possible to get results without taking dangerous
medication?  Please put your answer in the column so I can show it to my
husband.

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ANSWER:  During the last decade, there has been a great deal of research into
sleep disorders and sleep promoting medications.  There is a new class of
drugs called benzodiazepines, involving lower risks than previous "sleeping
pills" which included drugs such as barbiturates and nonbarbiturate hypnotics.
     Although benzodiazepines are prescribed by many physicians when
medication is necessary, most doctors are attempting to employ methods other
than drugs to help their patients get a decent night's sleep.
     The National Institutes of Health discovered that a full third of the
American population reports some degree of insomnia.  A recent survey found
that half of those with insomnia considered their problem serious and said it
caused emotional distress.
     In order to treat insomnia, doctors begin by assessing the medical,
psychiatric, or other factors that are the root cause of the insomnia.  Most
doctors agree that insomnia is merely a symptom of another problem.
     When prescribing sleep promoting medication, doctors divide insomniacs
into categories--those with transient insomnia, short-term insomnia, or
long-term insomnia.  People with transient insomnia are generally normal
sleepers who are in a stressful situation that may last a few days.  Such
situations may include travel to a new time zone or hospitalization for
elective surgery.  Some sleep experts say that in these situations, sleep
promoting medications are fine.
     Other doctors feel, however, that such patients should either just
tolerate the sleep loss, or observe "good sleep hygiene."  Reducing caffeine
intake and regulation of one's time in bed is what sleep hygiene is all about.
     Doctors use caution instead of simply writing out a prescription, because
there are side effects to almost all sleep promoting pills.  The most common
risk associated with medications is that the patient's daytime performance
will be diminished as a result of carryover effects.  People who have jobs
requiring high levels of visual motor coordination must be extremely cautious
when using any medication even on a short-term basis.
     When patients are found to have a short-term insomnia problem, doctors
may employ sleep hygiene or suggest extra exercise for the patient.  A
relaxing walk after dinner or before bedtime both helps the digestion and
removes some of the stressful thoughts occupying our minds that have been
left over from a day of toil.  Add that to a glass of warm milk before bedtime
(milk contains the natural tryptophans which can help induce peaceful slumber)
and the problem may be solved without unnecessary medications.  If those
methods fail, sleep-promoting medications are usually an option.  Short-term
insomnia may last up to 3 weeks and is related to situation stress related to
work and family life or a serious personal loss.  The trick is to abandon the
medications once a normal sleep pattern has been restored.  Taking medications
when they are not needed ranks well up on my personal list of no-nos and is
always to be avoided.
     The most controversy comes into play when doctors must treat long-term
insomniacs.  Up to half of the patients in this group may have underlying
psychiatric conditions.  Others are chronic users of drugs or alcohol, which
can lead to insomnia.  Yet others suffer from medical conditions or sleep
apnea leading to chronic insomnia.
     Many doctors try to avoid drugs in these cases and use behavior therapy
instead.  In addition to having patients reduce caffeine intake and eliminate
alcohol and drugs, doctors try biofeedback or relaxation and other
stress-reduction techniques.
     Sometimes a prescription is given for a short period, say a month, while
the behavior treatment begins to help the sleep disorder.
     Insomniacs who don't respond to the behavior and mild drug therapies and
who don't have any major medical or psychiatric disorders may then be referred
to a sleep disorders clinic.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.