Sex­ual vi­o­lence haunts women for years

The Borneo Post - Nature and health - - Front Page - By Carolyn Crist

PEO­PLE who have trou­ble fall­ing asleep and stay­ing asleep may want to seek ad­vice from a doc­tor and avoid long-term use of sleep­ing pills, med­i­cal ex­perts ad­vise. Good sleep hy­giene and a spe­cific kind of talk ther­apy may help peo­ple cre­ate good bed­time habits and fig­ure out why they’re not sleep­ing well, the ex­perts say in a new re­source for pa­tients pub­lished in JAMA In­ter­nal Medicine.

Re­cent re­search has shown that use of sleep­ing pills is very com­mon and that the drugs are linked with se­ri­ous side ef­fects, such as falls and death, said Dr Michael Incze of the Univer­sity of Cal­i­for­nia, San Fran­cisco, who co-wrote the one-page primer.

In 2017, the Amer­i­can Academy of Sleep Medicine rec­om­mended a form of psy­cho­log­i­cal coun­selling called cog­ni­tive be­havioural ther­apy (CBT) as a first treat­ment for in­som­nia, fol­lowed by pre­scrip­tion and over the-counter medicines. CBT fo­cuses on iden­ti­fy­ing pat­terns of think­ing and be­hav­iour that pre­vent good sleep.

Peo­ple who of­ten take sleep medicine “should feel en­cour­aged to talk to their doc­tor about look­ing deeper into why they may be hav­ing in­som­nia,” Incze told Reuters Health by phone. Avail­able for free, the new pa­tient page of­fers prac­ti­cal tips about in­som­nia diag- no­sis and treat­ment. It in­cludes a vis­ual scale of ther­apy op­tions, rang­ing from “safe and proven to work” on one end to “po­ten­tially dan­ger­ous” on the other end.

“Safe and proven” in­cludes sleep hy­giene, CBT and short-term use of sleep­ing pills. “Dan­ger­ous” in­cludes com­bin­ing sleep­ing pills with opi­oids or al­co­hol, use of sleep­ing pills by older adults and con­tin­u­ous long-term use of sleep­ing pills. “It’s not al­ways easy to find doc­tors who do CBT for in­som­nia right now, even in a big city, and in­sur­ance doesn’t of­ten cover it,” Incze added. “That’s where tele­health and mo­bile apps could come in.”

Incze and co-au­thors rec­om­mend start­ing with good sleep hy­giene, that is, cre­at­ing a peace­ful en­vi­ron­ment for sleep. This in­cludes go­ing to bed at the same time every night and get­ting up at the same time every morn­ing.

In­stead of stay­ing in bed ly­ing awake, get up and do some­thing re­lax­ing un­til you’re tired enough to fall asleep, they ad­vise. Also, avoid al­co­hol and caf­feine, and cre­ate a dark, quiet en­vi­ron­ment for sleep­ing with min­i­mal dis­trac­tions, which means turn­ing off screens on elec­tronic de­vices and dark­en­ing win­dows.

We see in­som­nia every day in var­i­ous ages and walks of life, and it can lead us to con­sider other con­cerns such as de­pres­sion, anx­i­ety and med­i­ca­tion is­sues,

“We see in­som­nia every day in var­i­ous ages and walks of life, and it can lead us to con­sider other con­cerns such as de­pres­sion, anx­i­ety and med­i­ca­tion is­sues,” said Dr Ada Ste­wart, a fam­ily physi­cian in Columbia, South Carolina who was not in­volved with the new pub­li­ca­tion. “Most sleep­ing medicines should only be used for a limited amount of time, usu­ally a week or two, and can be ad­dic­tive and lead to bad out­comes when mixed with al­co­hol or other drugs,” she told Reuters Health by phone.

Side ef­fects can be stronger in older age groups, so these pa­tients should be par­tic­u­larly care­ful about sleep medicines, es­pe­cially if mix­ing with other pre­scrip­tions, she added. Sleep stud­ies in­clude overnight tests to mon­i­tor sleep and look for med­i­cal con­di­tions such as ob­struc­tive sleep ap­noea. Con­di­tions such as stress, anx­i­ety and breath­ing is­sues can also af­fect sleep. The amount of sleep re­quired by dif­fer­ent peo­ple varies at dif­fer­ent points in life, but the av­er­age is six to eight hours per night.– Reuters

*All ma­te­ri­als are only for your in­for­ma­tion, and should not be con­strued as med­i­cal ad­vice. Where nec­es­sary, ap­pro­pri­ate pro­fes­sion­als should be con­sulted

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