Problems with your “Z’s”: New research on treatment of persistent insomnia – help is more than just medication.

The May 20th issue of JAMA (Journal of the American Medical Association) includes an article on treatments for persistent insomnia. Insomnia is the most common of all the sleep disorders and is described as having problems with the ability to gain sufficient sleep or to feel rested and characterized by difficulty getting to sleep or staying asleep. Insomnia may be situational, recurrent, or chronic. Most people know if they have problems with sleep, and most of us have had personal experience with occasional bouts of insomnia.

Lack of adequate sleep over time, or persistent insomnia, can have a very big impact on daily functioning; it will lower your quality of life and can contribute to various health and emotional problems. When untreated, insomnia can also contribute to major depression and other physical problems. When you get behind the wheel with not enough quality sleep, you not only put your life at risk, but those around you as well. A large number of auto accidents are attributed to driving while drowsy. Although it may be tempting to use alcohol as a sleep aid, it will work in the opposite way and create insomnia and other health-related issues as well. And…of course this will not help your driving either!

Here are some sleep-promoting tips that can work well to help you get into a healthy sleep routine:

1. Maintain a regular bedtime and awakening time schedule including weekends. Get up about the same time every day, regardless of what time you fell asleep.
2. Establish a regular, relaxing bedtime routine. Relaxing rituals prior to bedtime many include a warm bath or shower, aroma therapy, reading, or listening to soothing music.
3. Sleep in a room that is dark, quiet, comfortable, and cool; sleep on comfortable mattress and pillows.
4. Use your bedroom only for sleep and sex. Have work materials, computers, and TVs in another room.
5. Finish eating at least 2-3 hours prior to your regular bedtime.
6. Avoid caffeine within 6 hours; alcohol & smoking within 2 hours of bedtime.
7. Exercise regularly; finish a few hours before bedtime.
8. Avoid naps.
9. Go to bed only when sleepy. Lay in bed only for sleeping, not for work or watching TV.
10. Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime.
11. After 10-15 minutes of not being able to get to sleep, go to another room to read or watch TV until sleepy.

This latest research in JAMA shows that CBT (Cognitive Behavioral Therapy), a structured form of psychological treatment that focuses on modifying thoughts and behavioral patterns, was effective for treating persistent insomnia. The addition of a sleep medication to CBT treatment like zolpidem (generic name for a prescription sleep medication) produced some benefits, although such benefits were modest to treatment outcomes. Such findings suggest CBT may provide an added benefit in treatment of insomnia.

Since you are awake anyway, sign on and leave a comment about how your sleep is going. All comments from those who are sleep-deprived and others are always welcome. Sweet Dreams!

Do You Live Your Life in Bullets?

You’ve seen bullet formatting - they show up everywhere; those little abbreviated lines creating a quick and easily skimmed list of the most important highlights of information. But are we living our lives in this abbreviated form as well? Are we losing the ability to stop and smell the roses?

We tend to live our lives in the fast lane, squeezing as much in a day as we can. We power walk, power lunch, have power meetings, and power our way through the day until we collapse and have to power nap before moving on to the next item on our busy agenda.

My blogs recently have revolved around the recession and how it has affected our general mental health. With these added stressors of layoffs, rising prices, and dwindling opportunities it is more important than ever to protect the mental health of ourselves and our loved ones.
This is often hard to do when we feel the need to push ourselves even harder to beat out the next round of layoffs or take on that second job to keep the house out of foreclosure. Patience flies out the window. When we speed up our own personal production, we tend to get frustrated by those who are still running at normal speed.

Here are a few warning signs of living life in bullet format:

You find yourself getting short with coworkers who take their time in getting to the point

You grumble as you speed around people in the “slow lane” of hallways just as you do on the roadways as you calculate which would be faster, the elevator or the stairs

Everyone but you is working in slow motion

You are moving at such a fast pace that quality work takes a back seat to just getting the job done so that you can move on to the next four or five jobs on your list

You begin to lose the ability to successfully multitask and prioritize, and feel the need to speed up even more to compensate

You take this sped-up version of yourself home to your family and expect them to bullet their time with you as well

You find it hard to unwind and let go of the hyper speed you have achieved

You forget to smile

Your caffeine consumption skyrockets; at the end of the day you always feel you need one more drink

What can you do if too many of these examples describe you? A friend or loved one shouting, “slow down” seems too simple a fix, but it may be just that simple. Slowing down won’t fix the amount of work you have to do and it won’t pay the mortgage. But it could save your life.
We all know behavioral and physical health are linked. Unhappy, over-stressed people tend to live shorter lives than their counterparts. So in the midst of the hyper-fast, bulleted life you lead, don’t forget to schedule time for you.

Ways to rewrite the bullets of your life:

Take time to notice those around you. Are you wearing that same pinched look of stress you see in others? Relax your face and try on a smile. Compliment that person and watch as they startle out of hyper speed.

Schedule time for meditation. You don’t need a special place or special equipment to get started. Just close your eyes and breathe deeply and evenly for 2 minutes. Concentrate on how far you can expand your lungs, and how slowly you can inhale and exhale. Steal a few of these moments for yourself throughout the day. If you prefer guided instructions, check out Soft Belly Meditation, a free four minute guided breathing relaxation meditation exercise available over the internet.

Pause for a moment to appreciate the little things in your life: You may find the little things are really what’s important to you! BE in the moment. Stop and just do one thing at a time!

After work, take the time to reconnect with the special people in your life. Say “Hi” to your neighbor across the backyard fence. Reconnect with the lost art of the long-winded yarn Grandpa’s across the country made famous. And above all, take time to smell the roses while they are still in bloom.

Finding Quality Mental Health Treatment: Voodoo Science

The Wall Street Journal posted an article reporting that primary care physicians have difficulty getting mental health services for patients. One blogger rightly mentioned that mental health treatment is still considered a ‘voodoo science’ even in the medical community. Great Point! Let’s face some other hard facts.

Overburdened PCP’s have been asked to handle mental health issues for too long

Mental health treatment has the stigma of a second class citizen in the medical community

Many educated persons can’t tell you the difference between a psychologist, psychiatrist, and a social worker

Mental health treatment is shunned by insurance companies

Few patients can pay for mental health services

It is no wonder that services are under-funded and quality mental health providers are hard to find. Based on these facts, anyone going into the mental health field should have their head examined.

We need to face the fact that relationship problems, community violence, job loss, financial stress and depression are increasing along with mortgage foreclosures. There is a lot more to do in dealing with these problems than reaching for Prozac! Most mental health patients get very little in the way of targeted treatment, and often receive a treat ‘em and street ‘em approach characterized by promiscuous prescribing practices and embarrassing treatment outcomes if not outright fraud.

The Mental Health Parity Act promises better days ahead, but it is no bail-out. In fact, it will be a while yet before anyone can receive help. The parity act has been delayed until 2010.

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