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- $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}
- $Log{}
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- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- 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.
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