1-1banner
 
medpundit
 

 
Commentary on medical news by a practicing physician.
 

 
Google
  • Epocrates MedSearch Drug Lookup




  • MASTER BLOGS





    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov




    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.




    "Opinions are like sphincters, everyone has one." - Chris Rangel



    email: medpundit-at-ameritech.net

    or if that doesn't work try:

    medpundit-at-en.com



    Medpundit RSS


    Quirky Museums and Fun Stuff


    Who is medpundit?


    Tech Central Station Columns



    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews

    Review


    Medical Blogs

    rangelMD

    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc

    richard[WINTERS]

    code:theWebSocket

    Psychscape

    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It

    medmusings

    SOAP Notes

    Obels

    Cut-to -Cure

    Black Triangle

    CodeBlueBlog

    Medlogs

    Kevin, M.D

    The Lingual Nerve

    Galen's Log

    EchoJournal

    Shrinkette

    Doctor Mental

    Blogborygmi

    JournalClub

    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House

    .PARALLEL UNIVERSES.

    SoundPractice

    Medgadget
    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day

    BioEdge

    The Business Word Inc.

    Point of Law

    In the Pipeline

    Cronaca

    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station

    Blogcritics

    Overlawyered.com

    Quackwatch

    Junkscience

    The Skeptic's Dictionary



    Recommended Reading

    The Doctor Stories by William Carlos Williams


    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn


    Intoxicated by My Illness by Anatole Broyard


    Raising the Dead by Richard Selzer


    Autobiography of a Face by Lucy Grealy


    The Man Who Mistook His Wife for a Hat by Oliver Sacks


    The Sea and Poison by Shusaku Endo


    A Midwife's Tale by Laurel Thatcher Ulrich




    MEDICAL LINKS

    familydoctor.org

    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info

     



    button

    Wednesday, September 29, 2004

    To Sleep: A little bit of therapy is more effective than pills for treating insomnia:

    A handful of therapy sessions does more to help chronic insomniacs get to sleep than the top-selling sleeping pill, according to a new Harvard Medical School study, suggesting that doctors are relying too heavily on medications to treat Americans' increasingly restless nights.

    ...Therapists' advice typically includes such basics as going to bed only when drowsy and getting up at the same time every day, even after a poor night's sleep. The objective is to get insomniacs to unlearn bad habits such as paying bills in bed, worrying instead of sleeping, and keeping themselves awake at night with coffee and strenuous exercise.

    ...In the new study, published in today's edition of the Archives of Internal Medicine, Jacobs and his colleagues divided 63 chronic insomniacs into four groups receiving either Ambien, five therapy sessions, a combination of the two, or a placebo. The patients kept a sleep diary for eight weeks, recording such factors as how long it took to fall asleep and how long they were awake during the night. Researchers acknowledge that such diaries are subjective, but as long as the patient is consistent, they are useful for comparison purposes.

    The researchers found that therapy was most effective for shortening the time it took patients to fall asleep, from 67.9 minutes a night on average to a near-normal 34.1 minutes after eight weeks. The Ambien patients, by contrast, reduced sleep onset time only from 71.5 minutes to 58.7 minutes. Likewise, after therapy patients awoke much less frequently in the night, sleeping 83.5 percent of the time they were in bed compared with 67.2 percent for those taking Ambien.


    This is welcome news. Now, how do I get my patients to believe it? In my experience, people just want "something to help me sleep." I have a hand-out I give patients that describes the steps to improve sleep, which is basically an exercise in retraining bad habits. I go over it with them, but most of the time, they aren't listening. ( I can't tell you how many times I've found it in the trash after they've left.)

    Sometimes, when I'm going over it with them, I feel like the Jack Nicholson character in One Flew Over the Cuckoo's Nest trying to explain Black Jack to the Danny Devito character, who keeps saying over and over "hit me," "hit me," even though he's already at 20. I just keep hearing over and over "give me a pill," "give me a pill." This is one time, though, when I don't give in. In the long run, it does far more harm than good. (Sleeping pills are sedatives, and addictive, no matter what the drug reps say.)
     

    posted by Sydney on 9/29/2004 08:35:00 AM 0 comments

    0 Comments:

    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page

    Ads

    Home   |   Archives

    Copyright 2006