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Posts Tagged ‘insomnia’

FAA Sleeps Through Calls to Reconsider Antidepressant/SSRI Ruling

Tuesday, August 10th, 2010

Antidepressants/SSRIs

The FAA announced in April ( see previous post) that its pilots could be permitted to fly while under the influence of certain antidepressants and SSRIs. The reversal of its own long established (70 year) ban against their use shocked pilots, passengers, and psychiatrists across the globe. As antidepressant/SSRI (selective serotonin reuptake inhibitor) use has decreased due to negative publicity, the manufacturers of Prozac, Zoloft, Celexa, and Lexapro cheered the move by Randy Babbbitt (FAA Administrator). The FAA, despite an increasing flood of calls to reconsider its ruling, appears to be sleeping through the irritating clamor; tired of hearing about their fatigued, sleepless pilots.

The Citizens Commission on Human Rights International / Mental Health Watchdog recently reprinted an article by Evelyn Pringle who described the FAA’s reversal as a “marketing coup” by the drug manufacturers who are “desperate to find new customers.” Her well documented article details the growing concerns of many experts that the “SSRIs Render Unfriendly Skies.”

The Citizens Commission on Human Rights called on the FAA to rethink its policy based on a recent finding by the NTSB that the February 1, 2008 plane crash in North Carolina, killing all six aboard, was caused by “a crazy acting pilot on Zoloft.” The cockpit voice recorder recorded the pilot singing: “Save my life I’m going down for the last time.” He then told his passengers, “If anybody back there believes in the good Lord, I believe now would be a good time to hit your knees.” The pilot descended below the minimum descent altitude, stalled, and crashed while circling after an aborted landing. The pilot, according to the NTSB report, had been on Zoloft for over a year and had been treated previously by other antidepressants for “anxiety and depression” and a history of “impatience” and “compulsiveness.”

The NTSB also blamed a 2003 crash killing two in Kingsport, Tennessee on a flight instructor found with Zoloft in his blood and liver.

Dr. Peter Breggin, a psychiatrist and an SSRI expert, in a Huffington Post article on April 10, 2010 said, “The FAA should reverse its ruling before it’s too late and hundreds of lives are lost when a pilot becomes impulsive, suicidal, or violent – or just loses his sharpness – under the influence of antidepressant medication.”

Bob Fiddaman, author of the website and blog “Seroxat Sufferers,” requested the FAA provide information on its change in policy just after the change in April. In 58 pages of reply the FAA made no mention of any prominent SSRI expert testimony of contrary views. The FAA supported their own views with copies of documents from a variety of sources. One of them actually showed consideration of a 2003 study of aviation accidents where “SSRIs were found in 61 pilot fatalities between 1990 and 2001.” “Psychological condition and/or the drug use was determined to be the cause, or a factor in 16 of the accidents, or 31%.”

Dennis Canfield’s study “Pilot Medical History and Medications Found in Post Mortem Specimens for Aviation Accidents” was totally ignored by the FAA. His study was conducted in 2006 and was published in the “Aviation, Space, and Environmental Medicine” journal. 4,143 pilots involved in fatal accidents between 1993 and 2003 were toxicologically examined for medications. One hundred of the dead pilots were found “with SSRIs in their systems including forty with Prozac, twenty-six with Zoloft, twenty-one with Paxil, and thirteen with Celexa.”

Matt Thurber, after citing many examples of accidents involving antidepressant usage, suggests that “pilots who use antidepressants without telling their medical examiners are willing to take greater risks when flying.” The FAA believes that SSRIs help “restore the balance of serotonin.” The FAA believes that their approval for use will result in truthful admissions by pilots; more vigilant tracking; and safer use, with fewer side effects than previous generations of antidepressants. The labels on the prescription bottles argue otherwise with warnings of “anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, and akathisia (psychomotor restlessness).

Dr. Breggin asks why pilots shouldn’t give up their airplanes since doctors are supposed to encourage their depressed patients to give away their guns. How can the FAA expect us to believe that we are safer in planes being piloted by depressed pilots on psychoactive drugs? They are dangerous enough when used alone. When combined with alcohol and benzodiazepines to counteract the insomnia side effects of the antidepressants, the elixir will inevitably cause a disaster.

Millions of innocent lives are at risk every day with sleepless and tired, or medicated and drowsy pilots at the stick. It is time for frequent drug testing of pilots. It is time once again to ground the pilots on antidepressants. A pre-flight test for alertness should also be mandatory. It is time for the FAA to turn off the “machine” and to answer the calls for repeal.

For related posts see:

Tags: airplanes, antidepressants, calls, Celexa, disaster, FAA, guns, insomnia, Lexapro, medications, NTSB, panic attacks, Prozac, psychoactive drugs, Randy Babbitt, ruling, serotonin, side effects, SSRIs, Zoloft
Posted in Appearances are Deceiving, Frozen in Fear, Sleepless and Tired, Worried and Stressed | No Comments »

Insomnia Cure Bred from Mother Nature and Israel

Tuesday, July 20th, 2010

Insomnia

Circadin® “not only improves the onset of sleep, but also improves the quality of sleep” says Nava Zisapel, company founder and Chief Scientific Officer of Neurim Pharmaceuticals. Dr. Zisapel, a Professor of Neurobiology at Tel Aviv University, reports that people who take the drug “have better daytime functioning and an improved quality of life.” The drug stimulates the body’s natural melatonin production. Her prolonged release formula of a mere 2mg dosage mimics the pineal gland’s production of the sleep inducing hormone. Melatonin production normally begins at dark, peaks at around 2am, and then gradually disappears at daylight. Dr. Zisapel began her work in 1992 and she received approval to market it in 2007. The European Medicines Agency (EMEA) at that time approved it for the short term (3 week) treatment of primary insomnia in patients over 55 years of age. The drug, unlike traditional sedatives, does not impair cognitive functions the following day, nor does it impair psychomotor skills. There are no abuse or dependency risks. Insomniacs, numbering nearly a third of the world’s population, will be cheered by the European Commission’s July, 2010 approval to expand the treatment duration from 3 weeks to 13 weeks. Circadin® is the first insomnia treatment approved for the extended length of time. It is currently marketed in Australia, Thailand, and Israel. US, Asian, and Latin American markets are in the registration process.

Insomnia, defined as the “difficulty to initiate or to maintain sleep,” affects almost all adults at one time or another. Transient (symptoms less than a week) insomnia and short term insomnia (one to three weeks) can occur as a result of jet lag, indigestion, shift work schedule changes, noisy sleep environments, stress, and recent medical situations. Long term (more than 3 weeks) or chronic insomnia is usually caused by psychological or medical conditions such as depression, pain, heart disease, acid reflux, asthma, sleep apnea, Parkinson’s disease, Alzheimer’s, brain tumors and strokes. Delayed or untreated insomnia costs America $42 billion dollars a year in healthcare costs. The seriously sleep deprived insomniacs have been limited to prescription sleep aids with their risks of dependency and abuse, or to over the counter antihistamines with their residual drowsiness hazards. The FDA has consistently discouraged natural supplements since they have no jurisdiction over them. They have issued warnings against the use of the natural alternatives of valerian, melatonin, and kava.

Circadin® is now in use in over 33 countries. It is naturally preferable to prescription sleep aids and their over the counter competitors. It’s time for the FDA to approve it for the sleepless and tired insomniacs of the USA. Everyone deserves a good night’s rest!

Tags: Circadin, FDA, good night's rest, insomnia, Israel, melatonin, Mother Nature, Nava Zisapel, Nerium Pharmaceuticals, prescription, sleep, sleep apnea, sleep deprived, sleepless and tired, stress
Posted in Our Amazing Brain, Sleep Deprived, Sleepless and Tired | No Comments »

Blue Light and Yellow Goggles: Essential Equipment for Sleep and Mood?

Tuesday, May 18th, 2010

Blue Light Box

Yellow Goggles

Blue light therapy and yellow goggles are becoming essential equipment for sleep disorders, for depression, and for seasonal affective disorder. Advanced sleep phase syndrome, delayed sleep phase syndrome, periodic insomnia, shift work sleep disorders, and jet lag are all related to circadian rhythm interruptions. Photoreceptor cells in the retina have been discovered that are directly linked to the “circadian pacemaker” of our brain: the pineal gland. The pineal gland produces melatonin which is the hormone responsible for our sleep-wake cycle. Daylight suppresses melatonin production and darkness stimulates its production, increasing sleepiness. Kate Le Page, in a recent article, traced the birth of light box therapy to the sanatoria of Europe in the 1870s. Sunlight was found beneficial to the treatment of bacterial diseases common at the time. Scandinavian countries, where the sun is in short supply for much of the year, have taken light therapy more seriously than the rest of the world. A light “shot” can be found on the menu in Finland cafes where you can drink your coffee while receiving your light therapy at the table. Sweden has equipped many cold war bomb shelters with full spectrum lights for therapy purposes. Russia is using light therapy to reduce worker sick days and to increase productivity. Their research has found a link between light therapy and an increase in the body’s ability to cope with pollutants and to boost immunization effectiveness.

Steven Lockley, Charles Czeisler, and George Brainard have done extensive studies on the utilization of blue light to combat sleep issues. They have found that blue light contains more energy than white light and it can be more efficient utilizing less time and energy to alter the sleep-wake cycles. Lockley, in the Harvard University Gazette, suggests that blue light “may be a powerful countermeasure for the negative effects of fatigue for people who work or study at night.” Blue light proved more beneficial than green light in reducing sleepiness, speeding reaction times, and focusing attention.

Dr. Joshua Gooley, in Annals Academy of Medicine, details more specific prescriptions:

For later sleep-wake times and phase delay shift:
- Evening bright light therapy before bed, dim light after wake time.
For earlier sleep-wake times and phase advance shift:
- Morning bright light therapy after wake time, dim light prior to bedtime.
For entrainment of sleep-wake cycle and phase advance shift:
- Morning bright light therapy after wake time, when sleep episode occurs during night.
For adaptation to shift work and large phase delay shift:
- Bright light therapy in evening/night, dim light after work, strict adherence to regular sleep-wake times.
For jet lag, eastward travel, and phase advance shift:
- Morning bright light therapy after wake time (home time), dim light prior to bedtime.
For jet lag, westward travel, and phase delay shift:
- Evening bright light therapy before bedtime (home time), dim light after wake time.

Blue light boxes are available from many sources. The time required to affect a shift should be 15 to 30 minutes over a period of a couple of days. The light source should be placed 1 to 2 feet above the subject and not directly in line with the eye. The photoreceptors linked to your circadian pacemaker detect the light from the bottom of the retina. During dim light periods yellow goggles should be worn for 1 to 2 hours in order to filter out the blue light spectrum.

The best information I found on light therapy for treating depression and seasonal affective disorder (SAD) comes from psycheducation.org. Light therapy was proven to be as effective as antidepressant medication therapy with far fewer side effects. Its use, however, for depression and SAD should take place under a doctor’s supervision. Treatments were initiated at 30 minutes a day and decreased to 15 minutes for maintenance through the winter months. If you are a night owl, your treatment should occur as late as 8 or 9 am. If you are a lark, your treatment should occur as early as 5 am. The therapy works best when applied 8 to 9 hours after the onset of melatonin secretion. The time will be relative to your particular circadian rhythm. An excellent quiz to help determine your rhythm and optimum treatment times and durations can be found at cet-surveys.org.

Get ready for the blue lights and the yellow goggles. Before too long they will be mandatory equipment for our sleep deprived and depression plagued world. Until then, enjoy the sun and the natural cheer it brings!

Tags: blue light, circadian rhythm, depression, fatigue, insomnia, jet lag, light box, light therapy, melatonin, pineal gland, retina, SAD, Seasonal Affective Disorder, sleep, sleep deprived, sleep disorders, sleep-wake cycle, sleepiness, sunlight, therapy, yellow goggles
Posted in Appearances are Deceiving, Our Amazing Brain, Shop for Sleep, Sleep Deprived, Sleepless and Tired | No Comments »

Simple Remedies for Worry, Stress, Sleep Deprivation, and Insomnia

Thursday, May 13th, 2010

Worried and Stressed?

A recent NCERx poll, detailed on sleep-deprivation.com, of over 4000 people disclosed some alarming statistics relative to the vicious pandemic afflicting our stress filled and sleep deprived world. 74 per cent of the respondents said that they received less sleep than they needed. Even more alarming is the fact that 46 per cent of those “missed their requirement by 3 or more hours.” 93 per cent of them agree that driving while sleep deprived is as dangerous as driving while intoxicated and 29 per cent admit that they themselves are “driving dangerously when sleep deprived.” The majority (65%) said that stress was the most common cause of their sleep problems. A Better Sleep Council survey found the same percentage of Americans losing sleep due to stress, 32% losing sleep at least one night a week, and 16% reporting “stress-induced insomnia.”

Worry and its resulting stress unleash serious effects on our body, our feelings, and our behavior. According to the Mayo Clinic your body may experience headache, back pain, chest pain, heart disease, heart palpitations, high blood pressure, decreased immunity, upset stomach, and sleep problems. Stress can influence our thoughts and feelings moving us toward anxiety, restlessness, irritability, depression, sadness, anger, insecurity, lack of focus, burnout, and forgetfulness. Stress can alter behavior resulting in overeating, under eating, angry outbursts, drug or alcohol abuse, increased smoking, social withdrawal, crying spells, and conflict.

The biochemistry of stress takes the nervous system from a state of normal into an adrenalin pumped state of overdrive. The adrenal gland, the pituitary gland, the hypothalamus, and the brain stem are the primary participants in our response to stress. They are responsible for the production and release of cortisol, norepinephrine, and epinephrine. These three hormones are critical to our survival. They promote the proper functioning of the brain. Cortisol directly affects our sleep/awake cycle and keeps our inflammatory and immune systems under control. Norepinephrine and epinephrine work together to control the “fight or flight response,” glucose levels, cholesterol levels, increased memory, and increased blood pressure, heart rate, and muscle response. These stress responses all take place very quickly and they should last only one to two hours.

The stresses of modern society tend to last much longer than the stresses of past societies. Our schedules are packed more tightly. The recession has tightened our budgets to the breaking point. The electronic media draw more attention than ever to the problems, tragedies, and crimes occurring every day. Our stress levels are not likely to be relieved after one to two hours. The stress results in a lack of sleep. We talk to our associates and friends about how we can’t sleep. They console us and talk to us about their similar difficulties. Soon we believe that this is “normal.” One of the startling statistics in the NCERx poll was the finding that more than a third of the respondents “suffered in silence and had never sought any treatment to help them sleep.” Caffeine during the day and sleeping pills at night offer temporary relief. Our society has become addicted to caffeine and energy drinks. Unless the underlying stresses are relieved, the dangers of sleep deprivation are increased, and the pandemic spreads.

Here are some simple and effective remedies to attack the stressors:

Dark chocolate. It helps reduce the blood pressure. Only 1 oz per day!
Sunlight. Whenever possible, sit in the sun; or, even better, take a walk in it.
Exercise. Schedule it at least three hours before bedtime.
A family discussion every night after dinner. Discuss the day’s trials and solutions.
Quiet time for reading. Reading before bedtime, instead of TV, works wonders.
Laughter is a great stress reliever. Rent a good comedy movie or play some games.
Music soothes the soul. Keep it calm and relaxing!
A warm bath, shower, or massage will divert your attentions.
Positive motivational quotes will inspire confidence, persistence, and determination.
Time with the pets. They sometimes offer better therapy than humans.
Hugs, love, and sex provide great stress relief.
Napping during the day for 30 minutes is more beneficial than the extra 30 minutes in the am.
Daydreaming of your favorite vacation spots or experiences will lift your spirits.
A good mattress is essential to a good night’s rest.
A healthy diet, focusing on tryptophan rich foods, high carbohydrates and low to medium proteins.
A bedtime snack of apple pie and vanilla ice cream. Keep it high in carbohydrates and calcium and low in protein. Make it an hour before bedtime.
A prayer before bedtime to thank God for another day of the blessings of life and the gifts He has given you.

These remedies cost virtually nothing. Implementing them will reward us with a good night’s rest and a happier life!

Tags: brain, depression, good night's rest, insomnia, napping, pandemic, remedies, sleep, sleep deprivation, sleep deprived, stress, worry
Posted in Diet, Sleep Deprived, Sleepless and Tired, Worried and Stressed | No Comments »

Pilot Fatigue/Sleep Monitoring Program Largely Ignored by FAA/NTSB

Wednesday, April 14th, 2010

Another runway miss

With more than 250 air crashes in the last 15 years linked to pilot fatigue or sleep deprivation issues, it seems our own Federal Aviation Agency (FAA) as well as the National Transportation Safety Board (NTSB) have been asleep in their administrative duties. A March 11, 2010 article from WBZTV discloses that data “collected from NASA, the FAA, and the NTSB showed that “over the past five years there have been 689 incidents where pilot fatigue caused a safety concern or a crash.” Documents tell of pilots nodding off on approaches and even landing on the wrong runways or taxiways. Pilots are sometimes allowed to work 16 hours in a day, though only eight can be in the cockpit. One retired commercial airline pilot admitted, “I can remember more than one time waking up while we were in route. I had been asleep, looking at the clock, looking at the watch, I had been asleep for 20 minutes, 30 minutes.”

Despite the uptick in reports of fatigue and sleep linked accidents, all we continue to hear from the FAA and the NTSB are empty promises of coming changes. In June of 2009 Randy Babbitt (current FAA Administrator) pledged to change pilot regulations, most of which have been in effect since the 1940s. He told reporter Nancy Cordes in her article for CBS News, “We’re gonna have a tough decision to make and I don’t mind making it.” The only recent change to policy has been his approval for pilots to use antidepressant medications on the job. The most common side effects of antidepressants are drowsiness, dizziness and sleep problems, including insomnia. Mr. Babbitt feels that “culture change” and tolerance for those afflicted with depression are more important than the safety of the millions flying the skies. The FAA’s mission statement is “to provide the safest, most efficient aerospace system in the world.” The FAA’s vision statement is “to improve the safety and efficiency of flight. We are responsive to our customers and are accountable to the taxpayer and the flying public.” The recent antidepressant policy change as well as the continued delay in amending pilot work hour regulations seriously conflict with the FAA’s stated mission and vision objectives.

While our own FAA and NTSB are asleep at the “stick”, allowing the airlines to continue to overwork their pilots, most of the international safety boards are joining them in the bunkhouse. The CBC in Canada reported in a March 2010 article that “Twenty-eight people have died in a dozen plane crashes across Canada over the past decade in which fatigue was cited as a possible factor.” The Canadian Transportation Safety Board reports note “pilot-fatigue-related issues in six deadly crashes and in an additional six accidents – including the Air France crash in Toronto – where all on board survived.” Canadian regulations allow pilots to be on duty for 14 hours, or 17 in “unforeseen circumstances.” Barry Wiszniowski, a pilot and expert with the Air Canada Pilots Association, says this about regulations in Canada, “Ours haven’t been modified since 1995 and prior to that in the ‘40s.”Martin Eley, head of civil aviation at Transport Canada, after initially dismissing pilot fatigue complaints from unions, says, “we’ve certainly moved on…in June, we are tabling the terms of reference for a working group to actually start looking at the current science and looking at where we need to update our regulations.” He noted that “it will likely take a couple of years before the rules change.” A 2001 study recommended six changes to work regulations. Four of the six were ignored by Transport Canada. The changes were to address duty schedules relative to circadian rhythm effects on sleep.

Drew Dawson, an expert on fatigue in the workplace, makes the frightening statement:

“There’s nothing like a smoking hole in the ground to address attention.”

Pilot Kent Wien, inGadling.com, accused the NTSB of “glossing over fatigue” as the cause of the Colgan Air crash in Buffalo, New York last year. They placed total blame on the pilot’s inabilty to properly handle a stall. The crash killed 50 people and the NTSB overlooked the fact that both the pilot and the co-pilot had little sleep in the 24 hours prior to their flight. They placed total blame on inadequate flight simulator training. Robert Sumwalt, one of the NTSB investigators in the case, refused to allow fatigue as a contributing factor saying, “just because the crew was fatigued, that doesn’t mean it was a factor in their performance.” Sleep deprivation studies have proven that performance levels and response speeds for sleep deprived individuals are equivalent or worse than blood alcohol levels of 0.05%. A British Medical Journal study concluded that fatigue does affect performance, finding that, “getting less than 6 hours a night can affect coordination, reaction time, and judgment” and poses “a very serious risk” to drivers.” The NTSB , like the FAA, chooses to ignore the fatigue and sleep deprivation issues jeopardizing the air safety they are charged to protect.

While air transport safety boards and accident investigators overlook fatigue and sleep deprivation as a cause of human error disasters, Air New Zealand has been monitoring and analyzing fatigue, sleep, and fatigue countermeasures since 1998. “Air New Zealand was one of the first airlines in the world to introduce a policy for controlled rest on the flight deck (cockpit napping).” The policy was supported by the Civil Aviation Authority of New Zealand. It allows for a fatigued crew member to take a 45 minute nap after a briefing of the crew members as to time of waking. “No course changes, altitude changes or fuel transfers are permitted during this period.” The napping is only permitted for 2, 3, and 4=person crews. The fatigue management program has full support of airline management and union groups. Fatigue report forms from pilots detailing excess fatigue, possible causes and remedies are passed to Flight Operations management for possible action or comment and are then analyzed by a Flight Crew Fatigue Study Group (FCFSG) monthly. The group looks for patterns and problems with particular duties and routes.

Pilots participating in studies wear a “Sleepwatch” on the wrist. The sleepwatch measures wrist activity. It provides information on “timing and quality of sleep.” Three questionnaires are utilized in-flight. Fatigue Visual Analogue Scales rate how pilots feel. A Profile of Mood States asks pilots to score certain words based on their moods. The Stanford Sleepiness Scale scores word pictures of the individual’s fatigue feelings. The questionnaires are short and only require a few minutes of their time. The pilots then take a quick test called the Psychomotor Vigilance Task in which they have to extinguish a randomly flashing light in a small box by pushing a button using his or her thumb. The notebook sized black box measures and records performance and alertness rankings. More importantly it measures “lapses” which took more than 500 milliseconds to accomplish. The FCFSG has taken the data from these studies and has modified “flight and duty time limitations that are considered safe and acceptable on the basis of reliable data.” The group hopes to go pro-active in the future to advise tours of duty before they are introduced instead of modifying them after studies and reports have been completed. The FCFSG has decided to forgo the marketing of their system and they have opened it to the public domain “for the betterment of flight safety in the International Aviation Community.”

On March 22, 2010 the United States Senate unanimously passed the FAA Air Transportation Modernization and Safety Improvement Act (S.1451) by a margin of 93-0. Chairman Rockefeller made airline safety a “top priority in the bill.” It requires the FAA to “revise the flight and duty time regulations for commercial air carrier pilots and issue the final rule within one year to address pilot fatigue. The existing FAA guidelines on flight time and duty limitations were established in the 1940s without significant modification.” Chairman Rockefeller in a press release of December 2009 said, “Addressing pilot fatigue is an issue for which it has taken far too long to achieve meaningful reform. The travelling public deserves a better effort to make certain any plane on which they fly has an alert and well rested flight crew.”

Fatigue, sleep deprivation, and their effects on our safety in the air have been sufficiently documented. It is time for the FAA, the NTSB, and their partnered agencies across the globe to wake up and to follow the lead of New Zealand Air. Millions of lives are at stake. They should not need any more “smoking holes in the ground” to wake up from the sleep paralysis that’s been plaguing them for years.

Your comments are welcomed.

Tags: accidents, antidepressant, asleep, circadian rhythm, crashes, depression, FAA, fatigue, human error, insomnia, medications, napping, NTSB, pilot, safety, side effects, sleep, sleep deprivation, slep paralysis
Posted in Appearances are Deceiving, Frozen in Fear, Sleep Deprived, Sleepless and Tired, Worried and Stressed | No Comments »

Sleep Replacement Miracles on the Way for Narcoleptics and Sleepless World

Thursday, April 8th, 2010

Asleep at work

Two miracle drugs for narcoleptics and the sleepless and tired world are in the testing stages. Arena Pharmaceuticals announced on March 24, 2010 that they will be doing Phase 1 clinical trial testing of APD916. APD916 is an oral drug that targets the histamine H3 receptor in the brain and, as an agonist, it stimulates histamine production which increases arousal. The second drug, already in testing, is Orexin-A, which is a naturally occurring brain hormone which increases arousal and cognitive functions. Approximately one in every 2,000 Americans are narcoleptic and more than 70% of Americans get less than the recommended 8 hours of sleep a night. Until these drugs are approved the sleepless and tired will be endangering themselves as well as the millions of people on the road with them every day.

Narcolepsy, as described by Wikipedia, “is characterized by excessive daytime sleepiness (EDS) in which a person experiences extreme fatigue and possibly falls asleep at inappropriate times, such as while at work or at school.” The narcoleptic usually has problems sleeping at night and, unlike most of us, they “generally experience the REM stage of sleep within 10 minutes; whereas most people do not experience REM sleep until after 30 minutes.” These rapid transitions into deep sleep can lead to extremely dangerous situations if they happen at work or on the road. Other symptoms that often accompany narcolepsy are cataplexy (muscle function loss), sleep paralysis, hallucinations, and “automatic behaviors” (normal waking functions performed while asleep, but not remembered when awakened).

The protein, Orexin, produced in the brain, is responsible for appetite control as well as the regulation of sleep patterns. The direct cause of narcolepsy has not been found yet, but there appear to be links to gene defects in one or more of the chromosomes responsible for the production of the hypocretins (orexins) in the brain. Orexin production peaks during the hours of wakefulness. Findings published by genome.cshlp.org have shown that dogs born without functioning hypocretin genes develop many symptoms of narcolepsy. Similar links have been found in mice.

Amphetamines are the current solution offered to sleep deprived individuals. They are often given to pilots, to truck drivers, and to military personnel on critical missions. These stimulants have many harmful side effects and they are also addicting. The more serious physical side effects are: headache, tachycardia, increased breathing rate, increased blood pressure, fever, diarrhea, blurred vision, dizziness, uncontrollable movements or shaking, insomnia, numbness, palpitations, arrhythmia, convulsions, and heart attack. The negative psychological side effects are: irritability, aggression, power and superiority feelings, obsessive behaviors, paranoia, and amphetamine psychosis. The side effects are frightening, the addiction problem is well documented, and the withdrawal problems can be even more problematical.

Modafinil (Provigil), manufactured by Cephalon, is another stimulant used to treat narcolepsy and sleep deprived individuals. It was approved by the FDA in 1998 and it has been used effectively by the US, the French, the British, and the Canadian militaries. Our Air Force refers to it as the “Go Pill,” and it is used in aircraft where there are two pilots. Modafinil stimulates histamine production and it does not have the drastic side effects of the amphetamines. Nausea, dizziness, and vertigo have been reported in much lower frequency. The long term effects are still in question. Abuse potential is minimal, as is the cardiovascular stimulation found with the amphetamines.

Neither amphetamine treatments, nor modafinil treatments attack the orexin deficiencies linked to narcolepsy. A study presented to the Associated Professional Sleep Societies in 2007 showed that histamine producing neurons and orexin producing neurons have direct roles in the control of wakefulness. The research concluded that both neurons have “synergistic and complimentary” roles. APD916, from Arena Pharmaceuticals, assists the histamine producing neurons and Orexin-A is a naturally occurring peptide in the brain. Both attack the deficiencies responsible for our sleepless and tired feelings and the symptoms of narcolepsy.

A study conducted at Wake Forest University School of Medicine found that the effects of sleep deprivation were reversed when Orexin-A was administered to monkeys in either intravenous or intranasal formats. The intranasal spray produced superior results when compared to the intravenous injections. When the monkeys were not sleep deprived the Orexin-A did not have any effect on their performance levels. The potential for the intranasally administered Orexin-A is reported in Molecular Interventions. The spray’s potential is far greater due to its ease of application and its quick results.

Jerome Siegel, professor of psychiatry at UCLA, and a co-author of the study reported in the Journal of Neuroscience, says “It reduces sleepiness without causing edginess.” “If the underlying deficit is a loss of orexin, and it clearly is, then the best treatment would be orexin,” he adds.

Orexin-A and APD916 are a long way from reaching our shelves. The testing and approval process can take years. Many people will be falling asleep waiting.

The world is waiting.

The entire sleepless and tired world may be snorting Orexin-A or taking ADP916 in the future. The prospects look “stimulating.”

Tags: ADP916, amphetamines, brain, drugs, EDS, fatigue, histamine, hormone, hypocretins, insomnia, miracles, modafinil, narcolepsy, narcoleptic, Orexin-A, Provigil, REM, side effects, sleep, sleep deprived, sleepiness, stimulants
Posted in Sleep Deprived, Sleepless and Tired | No Comments »

Sleepless and Tired Pilots Given Okay for Antidepressants on the Job!

Friday, April 2nd, 2010

Northwest Crash

In an unbelievable reversal of policies, the FAA is now allowing the already sleepless and tired pilots to take antidepressants on the job. The new policy takes effect on Monday, April 5^th. The announcement in CBS News from the Associated Press today, April 2^nd, had to have been delayed a day to avoid the April Fools tradition that would have had no one believing it! Our stress filled world has been plagued by many catastrophic tragedies that have been linked to sleep deprivation. Now, we can look forward to pilots, suffering from “mild to moderate depression,” under the influence of prescription medications like Prozac, Zoloft, Celexa, Lexapro, and their generic equivalents.

The FAA officials said that “the old rule was based on outdated versions of antidepressants that could cause drowsiness and other side effects.” The FAA Administrator, Randy Babbitt, now considers the side effects much less of a risk than they once were. The new policy is meant to encourage the pilots to report their use instead of keeping their use a secret. The threat of losing their licenses, until now, has kept the pilots from the disclosure. Babbitt says, “We need to be able to change the culture and remove the stigma associated with depression. Pilots should be able to get the medical treatment they need so they can safely perform their duties.” The stipulation of the new policy is that they have to have been treated successfully “for a year without side effects that could pose a safety hazard in the cockpit.”

The critical question here is how these pilots can be judged to be free of those side effects. All four of these drugs, and their generic equivalents, have the same dangerous side effects listed in all of their disclosures as well as on drugs.com:

Drowsiness, dizziness, tired feeling
Mild nausea, stomach pain
Fast or uneven heartbeats
Overactive reflexes, hostile, aggressive impulses
Mood changes
Concentration problems, confusion, hallucinations
Insomnia
Suicidal thoughts

All of these are also extremely dangerous when combined with alcohol, blood thinners, and secondary antidepressants.

Who is going to determine whether these side effects have ever been experienced by the pilots? Who is to say that if they have not been experienced before they will not happen in the future? Our psychiatrists and our psychologists have done a great job of keeping the criminals off our streets and the pedophiles away from our children, haven’t they? Many reports are written to affect the viewpoint desired by the responsible party, similar to our legal system today. Every major criminal trial today is muddled by opposing proof from differing psychiatrists and psychologists. Who determines the accuracy? Here there will be no judge and no jury. Mr. Babbitt and his competent staff at the FAA will be their judges. And we will become the victims?

How many of our lives will now be endangered because the FAA and Mr. Babbitt feel that our need to “change the culture” is more important than the safety of millions of Americans flying the skies. Sleep deprived pilots have been a problem in the past and they will continue to be a problem due to their grueling schedules. Now we can look forward to our pilots being sleep deprived and “under the influence.” How many new disasters and lost lives will be required before this “culture changing” and naive policy is replaced by the “common sense” approach of the past?

Please feel free to comment below and/or rate this post below.

Tags: antidepressants, depression, drugs, FAA, insomnia, medications, pilots, prescription, psychiatrists, psychologists, side effects, sleep deprived, sleepless and tired, stress
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Mattress, Stress, Food, and Tryptophan: How They Relate to Sleep

Tuesday, March 16th, 2010

Good Mattress Leads to Good Rest

I have spent quite a bit of time discussing the retail mattress world. Several posts have featured stress and how it negatively affects sleep. The sequence of mattress, stress, and food in the title reflects the specific order of importance in your quest for a “good night’s rest.” Of the three, your mattress is the most important factor to a quality sleep. A bad mattress will cause backache, tossing and turning, loss of REM sleep, stress, insomnia, depression, and many other negative consequences that could ultimately lead to death.

Stress and Your Brain

Stress ranks second in its relevance to sleep. If you cannot relax, you cannot sleep. The factor we have not yet discussed is food. What we eat has a tremendous affect on how well we sleep. Tryptophan is the main ingredient often missing from our diet. The shortage of tryptophan in the diet leads directly to stress, psychological disorders, and sleep problems. Tryptophan is the “dietary raw material for serotonin manufacture.” Serotonin affects melatonin production in the pineal gland and, ultimately, helps regulate our sleep and wake cycles.

Brain in Serotin's Hands

James South, in his article for the Offshore Pharmacy, calls tryptophan “nature’s answer to Prozac.” He describes the serotonin deficiency syndrome as “one of the most common and widespread disorders of human psychobiology in the modern world.” Studies have proven that serotonin assists the nerve circuitry to “promote feelings of well being, calm, personal security, relaxation, confidence, and concentration.” Serotonin negates the negative effects of dopamine and noradrenaline which “encourage over-arousal, fear, anger, tension, aggression, violence, obsessive-compulsive actions, over-eating (especially carbohydrates), anxiety, and sleep disturbances.”

Tryptophan is the least plentiful of the eight essential amino acids in the human diet. As one of the eight essentials it “must be gotten preformed from food or supplements.” It is the amino acid directly responsible for the manufacture of serotonin. According to South, “a typical diet provides only 1 to 1.5 grams per day, yet there is much competition in the body for this scarce tryptophan.” It is used by the body to make other proteins. It is used by the liver to make niacin. Some of it is bio-degraded. Some of it does not make it through the “blood brain barrier.” Much of what goes in gets lost in the process.

High protein diets will not help increase the tryptophan supply because they “increase the intake of the 5 competing amino acids,” which already outnumber tryptophan by 8:1 in the “competition to secure its transport through the blood brain barrier into the brain.” South claims “the only dietary strategy that increases brain tryptophan supply is to eat a high carbohydrate diet.” The price paid though is higher stored body fat and possible obesity. The better choice is a tryptophan supplement. The lowest dose, according to South, “that successfully alleviates serotonin-deficiency symptoms is the most efficacious.” Some say 500mg is enough, but that sounds like a pretty high dosage. My recommendation would be to consult your doctor before beginning your test. Starting with 100mg to 200mg makes more sense.

Elizabeth Walling, in her blog, “The Nourished Life,” and in NaturalNews.com, discusses tryptophan supplements for treating depression. She discusses all of the effects of the tryptophan-serotonin relationship and how tryptophan is a natural alternative to the traditional anti-depressant drugs. She also talks about the world-wide scare regarding tryptophan supplements in 1989. Tryptophan was actually banned for a while because of impurities linked to a contaminant in the tryptophan supplement manufactured by Showa Denko K.K., of Tokyo between 1988 and 1989. Details of the scare were reported by A. S. Gissen in his article from VRP’s Nutritional News.

The UK reversed its ban against tryptophan supplements in November 2005 as long as dosage was limited to 220mg. David Adams, the director of the Institute for Optimum Nutrition added that the new law “compares unfavorably with that of other markets, such as the Netherlands that permits dosages of up to 600mg, and Japan that allows 1g to be consumed in supplement form.” More information regarding the UK’s re-entry into the tryptophan supplement ruling can be found on nutraingredients.com. The same web site has a great article titled, “Sleep-inducing food may boost mood.” The article is strong support for tryptophan’s mood and memory enhancing benefits.

The U.S. allowed tryptophan back into our marketplace in 2001, and it is available on almost all supplement shelves.

If you prefer to avoid the supplements and want to increase your intake of tryptophan in your diet, here are the foods to look for:

Poultry
Dairy products
Beans
Rice
Sesame seeds
Shellfish
Soy products
Hazelnuts and peanuts
Hummus
Lentils
Eggs
Bananas

One of the best bedtime snacks, according to AskDrSears.com is apple pie and ice cream, “high in carbohydrates and calcium, and medium-to-low in protein.” He also suggests having your bedtime snack about an hour before going to bed because it takes that long for the tryptophan in the food to reach the brain.

In summary, if you’re having trouble sleeping, take a good look at your mattress first. Consider whether or not it is supporting you properly. If not, it’s time to shop for a new one. Focus next on your stress levels. Work on slow breathing techniques, conversation, exercise, or just going for a walk. Finally, watch the foods you are eating. Pay particular attention to the foods you eat for dinner. Make it a lighter meal. Keep the fat content down. Cut down on the seasonings. Dinner should be high in carbs and low to medium in protein, with the focus on tryptophan containing foods. Bedtime snack should be an hour before bed and make mine:

Apple Pie and Ice Cream

Good Night and Sleep Tight!

Please remember to rate the article and/or leave comments below.

Tags: amino acids, carbohydrates, depression, diet, food, good night's rest, insomnia, mattress, memory, mood, retail, serotonin, sleep, stress, tryptophan
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Wonder Drug of Dreams Set to Sweep Gold in 2012 Olympics of Sleep

Thursday, March 11th, 2010

Dream on

Those in the know are forecasting a sweep of the gold for the Swiss pharmaceutical company Actelion in the coming 2012 Olympics of Sleep. Their candidate, Almorexant, has been in serious training since his discovery in 1998. He is expected to take gold medals in all of the following events:

Swiss Dreams

Prescription for Insomnia
Enhancer for Dreams
Catalyst for Memory
Stimulant for Creativity
Accelerant for Performance
Depressant for Obesity

No single country, nor any sleep medication currently available has come close to winning in all categories. Most have left participants sluggish, depressed, agitated, confused, and complaining of muscle aches during the day.

Almorexant, already in Phase III testing and development, will probably take home the gold in the competition for sleep in 2012. The testing now is to determine low dosage levels, effects of increasingly higher dosage levels, and side effects compared to currently used sleep medications. Amorexant, was discovered and developed by the Swiss pharmaceutical company, Actelion. The company has already signed exclusive agreements with GSK for “worldwide rights to co-develop and co-commercialise almorexant for primary insomnia as well as to explore its potential in other orexin-related disorders.” Imagine the worldwide market for a drug that will help insomnia victims, that will improve REM sleep and therefore enhance your dream state, that will act as a catalyst to improve memory consolidation, that will stimulate your creativity through reorganization of memory parcels, that will accelerate performance, and will also depress the brain’s feeding regulation and therefore depress obesity. The drug has already shown that it can improve all of the above. Orexin, a neuropeptide produced by the hypothalamus affects the body’s sleep-wake cycle as well as feeding regulation or appetite. Almorexant’s main ingredient acts as an antagonist to the orexin receptors in the brain. “It penetrates the blood-brain barrier where it induces transient and reversible blockade of the orexin receptors OX1 and OX2.”

The active ingredient, orexin-RA-1, when given to rats, was found to stimulate sound sleep and peak performance in maze tests the following morning. They outperformed all of the rats given conventional sleep medications, suggesting improved memory capacity. “Measurements of muscle tone and brain activity revealed an increase in the dream phase of sleep. The dream phase of sleep is when memory is hardwired in the brain,” says Actelion CEO Jean Paul Clozel.

Medicalnewstoday.com reports “Shahrad Taheri, a lecturer in medicine at the University of Bristol and one of the first people to experiment on orexin, says that a drug acting on this system could have beneficial effects other than inducing sleep.” He believes that blocking the orexin system would result in a decrease in appetite and therefore a decrease in obesity.

Studies have shown that the orexin neurons of the brain are active during waking hours and that they are silent during sleep. The orexin antagonist, orexin-RA-1, has been proven to be much more effective than melatonin, benzodiazepines, opiates, and histamines in brain penetration, increasing total sleep time, REM stage sleep time, acceleration time to fall asleep, and it does not cause motor impairment like the other sleep medications.

Isaac Kobrin, M.D. and previous Head of Clinical Development at Actelion and now Chief Medical Officer at Actelion, concluded in Medicalnewstoday.com “Special emphasis will be put on profiling effects related to the unique mode of action of almorexant, such as positively affecting REM and non-REM sleep and improvement of next-day performance compared to medications targeting benzodiazepine receptors.”

Jean Paul Clozel, M.D. and CEO of Actelion, says “Our research efforts have led to this highly innovative compound with the potential to transform how sleep disorders might be treated in the future.”

So far there have been no reports of adverse effects or safety issues in the tests that have been completed. With over 80 million Americans suffering from sleeplessness and 25 million or more of those with chronic insomnia, almorexant is poised to take the gold medals expected in 2012 and to become one of the top ten drugs of the future. According to drugs.com, in 2008 the most popular sleep aid, Ambien CR, was #43, recording $865,719 in retail sales and a decrease of 1.2% from 2007. The second most popular sleep aid, Lunesta, was #47, recording $771,019 in retail sales and an increase of 8.2% from 2007. Just to compare #’s, the #1 prescribed drug in 2008 was Lipitor, the cholesterol depressor, which recorded $5,880,128 in retail sales, and that was a decrease of 4.6% from 2007. Ambien CR and Lunesta can both have serious side effects such as sluggishness, depression, memory problems, agitation, rapid heartbeat, confusion, decreased coordination and muscle aches, and more.

Michael Phelps and the gold

Almorexant, after testing and approval, will become the 2012 Olympic Champion of Sleep, the Wonder Drug of Dreams, and its name will become as familiar on television as Michael Phelps. The millions of sleep deprived people in the world will finally obtain the “good night’s rest” they deserve as well as the sweet dreams to improve memory, creativity, and performance.

Dream on

Good Night and Sweet Dreams!

Tags: Ambien CR, brain, Dreams, drugs, gold, good night's rest, insomnia, Lunesta, performance, pharmaceutical, prescription, REM, sleep
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Insomnia, a Symptom of the Pandemic: Are Drugs the Answer?

Wednesday, March 3rd, 2010

Insomnia, as defined by Wikipedia, is “a symptom which can accompany several sleep, medical and psychiatric disorders, characterized by persistent difficulty falling asleep and/or staying asleep despite the opportunity.” The U.S. Department of Health and Human Services reported in the year 2007 that “approximately 64 million Americans regularly suffer from insomnia each year. Insomnia is 1.4 times more common in women than in men.” Most all of us have, at one time or another, suffered the effects of insomnia. One can hardly watch an hour of television nowadays without being bombarded with ads for Paxil, Zoloft, Ambien, and Lunesta. The market is huge and ever growing as we suffer the effects of the Pandemic of the 21st Century: Sleep Deprivation.

According to the National Prescribing Service “data from 2006-08 shows medication was prescribed for 95.2 per 100 insomnia problems*, however research from the Agency for Healthcare Research and Quality in the US has shown non-drug therapies have comparable effectiveness to hypnotic medicines.” With the increasing stresses of today’s unemployment rate, the faltering economy, and the crippling effects of sleep deprivation everyone wants a “quick fix.” The “quick fix” does not come free. The consequences of sleep medications are many, and they are fraught with many dangers. Consider the following dangers listed by Helpguide.org:

Drug tolerance. You may have to take more and more of the sleep aid for it to work, which can lead to more side effects.

Drug dependence. You may come to rely on the medication to sleep, and will be unable to sleep or have even worse sleep without it.

Withdrawal symptoms. If you stop the medication abruptly, you may have withdrawal symptoms, such as nausea, sweating and shaking

Side effects. There are several side effects to sleep medications, such as drowsiness the next day, confusion, forgetfulness and dry mouth. These side effects can be severe.

Drug interactions. If you are taking other medications, sleeping medications can interact with them. This can worsen side effects and be dangerous with medications like prescription painkillers and other sedatives.

Rebound insomnia. If you need to stop the medication, sometimes the insomnia can become even worse than before.

Masking an underlying problem. There may be an underlying medical or mental disorder, or even a sleep disorder, that if treated would provide more relief from insomnia.

The big question is whether the reward is worth the risk. The drug companies want you to believe that the answer is a big “yes.” After reading the 32 pages of warnings provided by Sanofi, the makers of Ambien CR, I would have to wonder:

Need to evaluate for co-morbid diagnoses: Revaluate if insomnia persists after 7 to 10 days of use (5.1)

Severe anaphylactic/anaphylactoid reactions: Angioedema and anaphylaxis have been reported. Do not rechallenge if such reactions occur (5.2)

Abnormal thinking, behavioral changes, complex behaviors: May include “sleep-driving” and hallucinations. Immediately evaluate any new onset behavioral changes (5.3)

Depression: Worsening of depression or, suicidal thinking may occur. Prescribe the least amount feasible to avoid intentional overdose (5.3, 5.6)

Withdrawal effects: Symptoms may occur with rapid dose reduction or discontinuation (5.4, 9.2)

CNS depressant effects: Use can impair alertness and motor coordination. If used in combination with other CNS depressants, dose reductions may be needed due to additive effects. Do not use with alcohol (2.3, 5.5)

Elderly/debilitated patients: Use lower dose due to impaired motor, cognitive performance and increased sensitivity (2.2, 5.6)

Patients with hepatic impairment, mild to moderate COPD, impaired drug metabolism or hemodynamic responses, mild to moderate sleep apnea: Use with caution and monitor closely (5.6)

Those dangers should not be taken lightly. My research on this subject took me to an excellent article, which I have been given permission to reprint in full. Gayle Greene, PhD, author of “Insomniac“ and author of the popular blog, sleepstarved.org published “To Med or Not to Med” in Psychology Today. Her article is informative and well researched:

Ambien

To Med or Not to Med

How to sort through the hype and hysteria around sleep medications

Published on December 13, 2009

As someone who’s struggled with insomnia all my life, I face this question on a nightly basis, whether it’s better to reach for a sleep med or tough it out without sleep. Advertising assures us that there’s little danger from sleep meds, but the scare stories of Michael Jackson and Heath Ledger suggest otherwise. How to sort through the hype and hysteria?

As the author of “Insomniac“, a first person account of living with insomnia, I spent six years researching sleep meds, and concluded that these are not demon drugs, but neither are they harmless. They require thought and attention. No sleep med on the market today is problem-free. None gives deep, natural sleep through the night and keeps on working indefinitely. All interfere with the structure of sleep, so that if we take them continuously, we may be robbing ourselves of the restorative benefits of sleep. Most have adverse effects on memory and coordination. Some may be addictive.

I say, turn to medications as a last resort, after you’re tried everything else, as a final line of action rather than a first. But since I find living on the 2-4 hours sleep that’s my usual lot is just too terrible, I turn to them-quite a bit.If you decide to go this route, find a doctor who will work with you- no mean feat, since doctors are caught in the same hype and hysteria that infects so much thinking about medications. There’s the pill-happy doctor, on the one hand, who whips out a prescription pad before you’ve stopped talking, and sends you out of the office with a drug that may or may not be right for you; and there’s the censorious doctor, at the other extreme, who makes you feel like a junkey for asking for a sleep aid. It may help to know that hypnotics, as FDA-approved sleep meds are called, are regulated in a way that makes many doctors shy away from them; if your doctor seems irritated with your request, it may have more to do with these regulations than with you. Hypnotics are regulated by the Controlled Substances Act, which categorizes substances according to their medical uses and potential for abuse and dependence. They’re “schedule IV” drugs, which is less restricted than I, II, or III, but still, these are controlled substances, under the jurisdiction of the Justice Department and the Drug Enforcement Administration. FDA guidelines suggest limiting the use of most hypnotics to seven to ten days up to a maximum of a month, yet many of us take them for much longer. Prescribing them for more than a month may put the doctor at legal risk.

Antidepressants -which include the older drugs like Elavil, Deseryl (trazodone), and the newer SSRIs, Paxil, Zoloft- are not “controlled substances,” which may be one reason they’re so often prescribed for sleep. They don’t work for me: they fog my brain, speed my heart, and don’t help my sleep. But they do work for many people. No two people react to a drug the same way-even antihistamines, the staple of most over the counter sleep remedies and of cold medicines like Benedryl, are unpredictable, acting like a soporific for some people and like speed for others. Someday, perhaps, a doctor will be able to take a blood test, assess your DNA, and with this information, be able to tailor a prescription precisely to you. But for now, no doctor can guess how a drug will work for you-only you can be the judge of that. You have to be willing to come back and say, can I try something else? And for that, you need a doctor who’s willing to trouble shoot.

Then, find out what you’re putting in your body. Read the package insert, get on the web and find out all you can about it. Know what category of drugs the medication belongs to, the effects it’s likely to have. (There are user-friendly, reliable Web sites that have information on drugs, listed below, and also sites like Sleepnet and TalkaboutSleep and Sleepstarved.org -my own site-where people talk about their experiences with drugs.)

The longer acting drugs, the benzodiazepines (Ativan, Valium, Restoril), are more likely to get you through the night, but may also leave you hungover the next day, since they hang around the system longer, and may also be more addictive. The shorter-acting, so-called non-benzodiazepines (Ambien, Lunesta, Sonata), may be out of your system so fast that they don’t get you through the night. But at a low dose, these may help you get back to sleep when you wake up after a few hours. (That’s how I use Ambien. But if you use a med in the middle of the night, be sure you’ve left time for the effect to wear off before you have to swing into action the next day.)Then, if you continue taking a med for any length of time, keep tabs on yourself. Make sure it’s not affecting your personality or mood. If you begin to feel not yourself, consider that it may be the med. Ambien, though it agrees with me, can have some pretty weird effects: people waking up to find candy bar wrappers and crumbs in their bed, having telephone conversations they don’t remember, driving with no recollection of it. Sometimes this happens because they’ve taken too much of the drug, or have taken it over too long a time, or have mixed it with alcohol, or because they took it before they left the office or the party and drove home. (Never take a sleep med anywhere but in bed, when you are about to go to sleep!) Sometimes it happens simply because they have a bizarre reaction to this drug. “These drugs do things we do not understand,” as Daniel Kripke says, whose website, The Dark Side of Sleeping Pills, may put you off them forever.

So try around to find out what works, then monitor yourself-then manage the drug. Take as little as you can to get by with, even if the bottle tells you to take more. The smallest dose is always the best dose. Drugs lose their effect over time, and if you start at a high dose, you’ll habituate faster -and be more likely to become dependent. Try taking a break from the med; consider alternating it with another type of drug, say, a short-acting non-benzo with an antihistamine. Make sure the dose doesn’t creep up. Beware of creative combinations: that’s what did in Jackson and Ledger.The good news is that there’s a wider choice of drugs than there used to be: the several kinds of antidepressants, the older and newer benzos and non-benzos, the over the counter antihistamines-and this increases the likelihood of your finding something that works. The bad news is that nobody knows what any sleep med does over time-none of these medications has been tested for long-term effects. Only two FDA approved sleep meds, Lunesta and Rozerem, have been okayed for indefinite use, and even these have not been tested for anything like the duration many of us take them.

We’re between a rock and a hard place, when it comes to meds. Lack of sleep is bad for mood, health, and memory; sleep meds may be bad for memory, health, and sometimes bad for mood. Only you can do the risk benefit calculations to decide whether the risk is worth the benefit to you. But if you’re careful, and lucky, you may find a med that turns some wasted, wakeful hours into sleep.

The answer to this critical question is deeply personal and the answer must be explored in conversations between you and your doctor. The risks and interaction dangers are too complicated for anyone to answer without professional advice.

I thank Gayle Greene for her excellent article and recommend further exploration of her blog and her book. Future articles on this topic are in the works.

Thanks for listening. Good night and sleep well.

Tags: Ambien, cognitive performance, confusion, depression, drowsiness, drug therapy, hypnotic medicines, insomnia, medications, sleep, sleep deprivation, stress, suicidal tendencies
Posted in Dazed and Confused, Sleep Deprived, Sleepless and Tired | No Comments »

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