When Popping Pills [Sleeping Pills] Won't Help

By on May 24, 2011

JOHN TIONG finds out how people suffering from sleeping problems can get a handle on it.

SLEEP is gold. That’s why there are people who are willing to pay for a good night’s sleep, says Dr Yen Teck Hoe, consultant psychiatrist at Brain Mind Specialist Clinic in Petaling Jaya. These are people who pop tablets each night just to be able to sleep, he adds. For instance, an insomniac may pop a pill at eight in the evening and continue to do so every hour until he falls asleep. Those with serious sleep problems, like the late Michael Jackson, may require the medication to be injected.

Yen has helped many chronic insomniacs cut down their medication by half through counselling.

Medicine is not the first choice for treating chronic insomnia, he says. The psychological problems must be addressed so insomniacs can feel better about themselves and hopefully sleep better.

Yen claims that psychiatrists, often times, have to deal with the cases after many doctors fail to treat insomniacs the right way. Doctors who indiscriminately dispense sleeping pills, sedatives and even cough syrup are doing their patients a great disservice, he says.

These people would eventually be dependent on medication, which not only drains their income but also has an effect on their health. Many sleep medications have side effects and contribute to low blood pressure, nausea and anxiety. Doctors recommend taking sleeping pills sporadically and only for a short time.

Yen says insomnia affects more women than men, and about 50 per cent of the population. About 10 per cent of the population suffer from chronic insomnia at some stage in their lives.

Insomnia is often due to excessive pressure to excel in studies or work. This leads to a constant struggle for recognition. Those who don’t measure up are susceptible to depression and insomnia if they fail to find solace in the family. If not treated properly, this can lead to more complications – poor immune system, obesity and increased risk of long-term illnesses such as blood pressure, diabetes and heart disease. As the cause of insomnia is diverse, getting the right treatment is important, says Yen.

The entrenched psychological factors have to be weaned off one by one before the sufferer can help himself. Medication should be used only to help patients deal with their psychosis and other contributing factors, says Yen.

Dr Bharathi Vengadasalam, consultant psychiatrist at Pantai Hospital Kuala Lumpur, says there are people who are constantly sleepy because of obstructive sleep apnea. They are usually obese with too little oxygen entering the blood stream because of a narrowed air passageway. There are also people who cannot sleep because of neurochemical abnormalities in their body. Their treatment is different from those who suffer from insomnia because of depression. Bharathi says the most difficult to treat are old people suffering from dementia. This is because people with cognitive impairment disease usually find it hard to get to sleep. They may also suffer from parasomnia and sleep disorders such as sleepwalking and talking in their sleep. In their confused state, they may wake up in the middle of the night and do odd things such as shake the door grille or even try to cook. The family has to cope with the stress of looking after them. Another difficulty about treating people with dementia, says Bharathi, is that doctors cannot prescribe too many sleeping pills as the patients are prone to falling.

Nursing homes are the last resort, but these patients must be looked after 24 hours a day. Another group of people susceptible to insomnia are those who work shifts because their biological clock is affected by irregular hours. Barathi says: “They will need to make their rooms dark to give the impression that it is night if they go to bed in the day.” These people also need to avoid drinking too much coffee, tea or alcohol before going to sleep. Psychoactive drugs such as amphetamines, cocaine, nicotine and methylphenidate also contribute to sleep problems. One must learn to develop good bedtime habits such as not eating late, exercising regularly and not watching television to wind down. The temperature in the bedroom, if using the air-conditioner, is best set at between 22ºC and 26ºC. But a key rule to follow is to avoid self-medication, says Bharathi. Other factors to look into are proper lighting and ventilation, and a comfortable mattress that can induce sleep. Bharathi’s best advice: Live a healthy life – rise with the sun and exercise in the morning because our body clock takes its cue from sunlight to release hormones and to function well.

She also advises those with sleep problems to do meditation and practise mindfulness and deep breathing techniques for calmness before sleep.

Yoga instructor Surya Tay Siew Leng says hatha yoga can help insomniacs because the physical exercises and meditation help with inner restoration. The meditation can be so relaxing. Doing it just 10-15 minutes can impart the benefit of having slept one to two hours, she says. Tay, who studied yoga from master G. Manisekaran, founder of Malaysian Yoga Society, used to suffer from insomnia but found yoga to be effective in helping her sleep. The body posturing, stretching and joint exercises as well as breathing methods guide the body to return to its originally healthy condition. Sometimes, insomnia is the result of a body which we have abused without even realising it.

“Proper breathing makes a person more aware of his constituents, and that is the first step towards helping the body restore itself,” says Tay.

Source: New Straits Times

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