Wednesday, October 28, 2009

Have you ever experienced trouble falling or staying asleep, or even wake up feeling unrefreshed and unable to get a good night‘s rest? If you answered yes to any of these, then you may be suffering from insomnia. Insomnia is a symptom. It may be caused by stress, anxiety, depression, disease, pain, medications, sleep disorders or poor sleep habits. Your health habits and sleeping environment may also play a role in your sleep problems. In April 2006, the prestigious National Academy of Science’s Institute of Medicine released a report saying that sleep loss and sleep disorders were an "immense" public health burden in the United States.

NATIONAL SLEEP FOUNDATION INSOMNIA POLL DATA:

  • Forty-eight percent of Americans report insomnia occasionally, while 22 percent experience insomnia every or almost every night.
  • Women are 1.3 times more likely to report insomnia than men.
  • People over age 65 are 1.5 times more likely to complain of insomnia than younger people.
  • Divorced, widowed and separated people report more insomnia.


Some medications can lead to insomnia as well, including those taken for:

  • colds and allergies (some antihistamines & decongestants)
  • high blood pressure (antihypertensive)
  • heart disease (betablockers)
  • thyroid disease
  • birth control (hormones)
  • asthma
  • pain medications (containing caffeine)
  • depression (especially SSRI antidepressants)


According to the National Heart Lung and Blood Institute, a number of other conditions can also cause insomnia, such as:

  • Conditions that cause chronic pain, such as arthritis and headache disorders
  • Conditions that make it hard to breathe, such as asthma and heart failure
  • Overactive thyroid
  • Gastrointestinal disorders, such as heartburn
  • Stroke
  • Sleep disorders, such as restless legs syndrome and sleep-related breathing problems
  • Menopause and hot flashes


Sleep is as essential to a person’s health and wellbeing as diet and exercise. Inadequate sleep can result in fatigue, depression, concentration problems, and can contribute to health problems such as weight gain, high blood pressure, and a decrease in the immune system’s power which may lead to illness and injury. Treating insomnia with medication is the most common treatment for these sleep problems. Twenty-five percent of Americans take some type of medication every year to help them sleep.



INSOMNIA CONVERSATION WITH COACH McGUIRK


Related Links:

http://www.hci.utah.edu/patientdocs/hci/drug_side_effects/insomnia.html
http://www.emedicinehealth.com/insomnia/article_em.htm
http://www.merck.com/mmhe/sec06/ch081/ch081b.html
http://www.askdocweb.com/insomnia.html


References:

Gillin J.C., Roehrs T.,Roth T. (2009) Sleep Aids and Insomnia. National Sleep Foundation waking America to the importance of sleep. Retrieved on 1st October, 2009 from http://www.sleepfoundation.org/article/sleep-related-problems/sleep-aids-and-insomnia

U.S. Department of Health and Human Services. National Institutes of Health. National Heat lung and blood institute Disease and conditions index. What causes Insomnia? Retrieved on 1st October, 2009 from http://www.nhlbi.nih.gov/health/dci/About/index.html

Insomnia Overview Medications. (2008). New York Times. Retrieved from http://health.nytimes.com/health/guides/disease/primary-insomnia/medications.html?print=1

Michael,W., Smith. (2008, September, 14). What is Insomnia? Good Sleeping habits for beating insomnia Retrieved on 11th October, 2009 from http://www.webmd.com/sleep-disorders/insomnia?page=2

Side Effects and Strange Behaviors Associated with Prescription Sleep Medication



All sleeping medicines have side effects, may have the potential to cause dependency, and even worsen insomnia problems when abused, misused, or are taken too often. The side effects include daytime sleepiness, cognitive impairment, dizziness, unsteadiness, rebound insomnia, memory lapses, and hallucinations. Complex behaviors are a potential side effect of sedative-hypnotic products—a class of drugs used to help a person fall asleep and stay asleep.


Reported complex sleep behaviors include:
~ sleep walking
~ sleep-driving (individual drives when not fully awake)
~ making phone calls
~ eating or cooking while asleep
~ having sex
*Those effected have no memory of these odd events.





The Food and Drug Administration has said that the most widely prescribed sleeping pills can cause strange and bizarre behavior like driving and eating while asleep. Announcing that strong new warnings will be placed on the labels of 13 drugs. A review was prompted, in part, by queries to the agency from The New York Times, after some users of the most widely prescribed drug, Ambien, started complaining online and to their doctors about unusual reactions ranging from fairly benign sleepwalking episodes to hallucinations, violent outbursts, nocturnal binge eating and — most troubling of all — driving while asleep.



Night eaters said they woke up to find Tostitos and wrappers of Snickers in their beds, missing food, kitchen counters overflowing with flour from baking sprees, and even lighted stoves.
Sleep-drivers reported frightening episodes in which they recalled going to bed, but woke up to find they had been arrested roadside in their underwear or nightclothes.


At the University of Minnesota, Dr. Carlos Scheneck and Dr. Mark Mahowald, Professor of Neurology and Director of the Minnesota Regional Sleep Disorders Center at Hennepin County Medical Center; said that they had been studying the cases of nearly 30 Ambien users who developed unusual nighttime eating disorders. In some cases, the patients had gained more than 100 pounds.


For some patients, the strange side effect of sleep walking and sleep eating is unacceptable. They may gain a significant amount of weight, or worry about operating kitchen appliances while asleep. For others, like Rebecca Wiseman, 26, of Sumter, S.C., sleep eating happens only occasionally—and according to her it is a small price to pay for the relief that medication can bring. Mrs. Wiseman is hoping that by only taking it twice a week she'll keep her nighttime side effects to a minimum and be able to get back on a more regular schedule without medication. "But for now—even with the night eating and walking—a full night's sleep is still worth it all when you hit those lows," she says. "People don't realize what no sleep can do to you."



Related Links and References:

“Ambien Sleep Walking Turned Me Into a Midnight Binge Eater”. Health.
9 May 20008. Time Inc. 1 Sep. 2009.
http://www.health.com/health/condition-article/print/0,,20189024,00.html

Saul, Stephanie. “Warning: Side effects may include sleep-driving”. SignOnSanDiego.com by the Union-Tribune. 15 March 2007. Union-Tribune Publishing Co. 18 Sep. 2009
http://www.signonsandiego.com/uniontrib/20070315/news_1n15sleep.html

Ambien CR. (2009, September). Ambien CR side effects. Retrieved on 11th October, 2009from
http://www.ambiencr.com/using-ambien/ambien-cr-side-effects.aspx

VIDEO - SLEEPING PILL ALERT:

Is the popular drug Ambien causing people to binge eat in their sleep?

http://abcnews.go.com/video/playerIndex?id=1727387

Bizarre Sleep Medication Experiences

The New York Times wrote an article called "Some Sleeping Pill Users Range Far Beyond Bed," telling the surprising story of a registered nurse who took Ambien before going to sleep one night in January 2003. Sometime after falling asleep, she went out into the Denver winter night wearing only a thin nightshirt, even though the temperature was only 20 degrees. She got into her car, caused an accident, urinated in the middle of the intersection and then got into a violent altercation with the police officers who came to arrest her. In the matter of one night and one sleeping pill, her traffic record went from exemplary to tarnished with a reduced charge of careless driving. Interestingly enough, she says she remembers nothing of what happened during that Ambien-influenced night.

DRIVERS THAT SHOULDN'T BEDRIVING WHILE ASLEEP - VIDEO
http://abcnews.go.com/video/playerIndex?id=1707379


Watch CBS News Videos Online




Another Ambien user (initials MH) posted the following on AskDocWeb.com :
“Just one 10 mg dose of Ambien resulted in prolonged, horrible hallucinations for me, and I still have no memory of the month prior to my taking it. In fact, I ended up in a mental hosptial, where they continued giving me Ambien for I don't know how long, until they figured out that this drug was the problem! If I had found the website AskDocWeb.com before when I was checking out the drug info, I would never have taken it. I believe this drug should be removed from the market- any "medication" that makes people hallucinate or crazy is not beneficial. In fact, my doctor tells me that he no longer prescribes Ambien at all now, based upon my experience. Good for him!"

Everyday, an increasing number of people are experiencing the strange, sometimes terrifying effects that common sleeping pills can create. On AskDocWeb.com, a number of everyday people have posted their Ambien experiences.


Read further ambien stories:

http://www.askdocweb.com/ambien.html

WHAT’S BEING DONE?


FDA Orders Stronger Label Warnings On Products

To make known the risks of these products, the FDA ordered the makers of 13 sedative-hypnotic drug products to strengthen warnings on their labels about two rare but serious side effects: allergic reactions and complex sleep-related behaviors.

The revised labeling and other actions to make risks known affect these sedative-hypnotic products:

  • Ambien, Ambien CR (zolpidem tartrate)
  • Butisol sodium
  • Carbrital (pentobarbital and carbromal)
  • Dalmane (flurazepam hydrochloride)
  • Doral (quazepam)
  • Halcion (triazolam)
  • Lunesta (eszopiclone)
  • Placidyl (ethchlorvynol)
  • Prosom (estazolam)
  • Restoril (temazepam)
  • Rozerem (ramelteon)
  • Seconal (secobarbital sodium)
  • Sonata (zaleplon)

In addition to the labeling changes, FDA has requested that manufacturers of sedative-hypnotic products:


  • send letters to health care providers to notify them about the new warnings. (Manufacturers sent these letters beginning in March 2007.)

  • develop Patient Medication Guides for the products to inform consumers about risks and advise them of precautions that can be taken. (Patient Medication Guides are handouts given to patients, families, and caregivers when a medicine is dispensed. The guides will contain FDA-approved information, such as proper use and the recommendation to avoid ingesting alcohol or other central nervous system depressants.)

  • conduct clinical studies to investigate the frequency with which sleep-driving and other complex behaviors occur in association with individual drug products.


Related Links:

http://usgovinfo.about.com/b/2007/03/15/fda-calls-for-stronger-warnings-on-sleep-drugs.htm
http://fmsglobalnews.wordpress.com/2007/03/14/fda-requests-label-change-for-all-sleep-disorder-drug-products


Resources:

U.S. Department of Health and Human Services. U.S. Food and Drug Administration. (2009, July 22). Side effects of Sleep Drugs Retrieved on 1st October, 2009 from
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107757.htm

U.S. Department of Health and Human Services. U.S. Food and Drug Administration. (2009, October 27) Sleep Disorder (Sedative-Hypnotic) Drug information Retrieved on 29th October, 2009 from
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm101557.htm

VIDEO - SLEEPING PILLS WARNINGS NOT ENOUGH?

http://abcnews.go.com/video/playerIndex?id=2952195

Precautions for Sleep Aid Medications: Prescription and OTC’s

Precautions should be taken for people who use prescription and OTC sleep aid drugs. Those who are more vulnerable to harm, are children, elderly, pregnant women, and extremely ill people. Since sleep medications do not cure insomnia, they may cause worse situations if taken for a long period of time.

Recommended guidelines and precautions to follow if you are using sleeping pills:
  • Talk to your health care provider before you start these medications and if you have any questions or concerns.
  • Read the Medication Guide, when available, before taking the product.
  • Follow directions closely and as instructed by your physician. Do not change frequency or increase the dose prescribed by your health care provider. Complex sleep-related behaviors are more likely to occur with higher than appropriate doses.
  • Inform your doctor of all medications you are consuming. Drug interactions can occur between both prescription, nonprescription, and herbal supplements; and cause dangerous effects.
  • Be sure to discuss other medical conditions and symptoms with your physician. Certain drugs might cause side effects.
  • Do not discontinue the use of these medications without first talking to your health care provider; stopping abruptly can cause rebound insomnia, severe withdrawals, and other symptoms.
  • Only take sleep medication when you are ready to go to bed. You need at least 7-8 hours of sleep to have a full night’s rest.
  • Avoid drinking alcohol, it will disrupt your sleep and interact with your sleeping medication.


Related Links:

http://www.sleepeducation.com/Article.aspx?id=316
http://helpguide.org/life/sleep_aids_medication_insomnia_treatment.htm#guidelines
http://www.articlesnatch.com/Article/Restrictions-And-Precautions-One-Needs-To-Follow-When-Using-Insomnia-Medications/283194


References:

“Guidelines for Taking Sleep Medications”. Buy Sleeping Pills UK. 2009.
sleeping-pills.org.uk. 1 Oct. 2009.
http://www.sleeping-pills.org.uk/sleep-medications-Guidelines.html

“Prescription Sleep Aids”. Deprivation of Sleep. 2009. Deprivationofsleep.com.
8 Sep. 2009.
http://www.deprivationofsleep.com/prescription-sleep-aids.html

Hussar PhD., Daniel A. “ Precautions With Over-the-Counter Drugs”.
The Merck Manuals-Online Medical Library. April 2007. Merck & Co., Inc.
5 Sep. 2009.
http://www.merck.com/mmhe/sec02/ch018/ch018b.html

Schroeder, MS, RD., Karen. “Sleep Medications” Third Age. 1 July 2008.
ThirdAge Inc. 19 Sep. 2009
http://www.thirdage.com/sleep/sleep-medications-0