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SLEEPING DISORDERS: TAKING PILLS
Most experts advise avoiding sleeping pills except for those emergencies when you cannot get to sleep and you must be rested for some important reason the next day. Taking pills long-term leads your system to tolerate them – they stop having an effect.
Besides being a bad habit, insomnia has many causes, including serious illness. If Dr. Bootzin’s do’s and don’ts are no help, go to a sleep center.
At the other end of the scale, 300,000 Americans have narcolepsy – they fall asleep without warning at any time, in any place. Says Joe Piscopo, a computer executive, “I slept through just about all of college and barely graduated in 1965 from the University of Illinois with a degree in computer science. From ages 16 to 25,1 was in 15 car accidents – I fell asleep at the wheel. It was sheer luck that no one was hurt.”
In 1969, doctors at the Mayo Clinic in Rochester, Minnesota, diagnosed his narcolepsy. They gave Mr. Piscopo a strong stimulant, which he still takes. It enabled him to found a successful software company and retire at age 42. He is chairman of the American Narcolepsy Association, which helps narcoleptics learn about their disease and find help.
Scientists have made rapid progress in helping the nation’s 3 million or so night-shift workers, who must get their sleep during the day. Many arrive on the job at midnight and spend the next 8 hours trying to work while fighting sleep.
They can’t synchronize the wall clock with their biological clock. This is dangerous and inefficient.
Dr. Charles A. Czeisler and others at Brigham and Women’s Hospital in Boston have scored a major triumph: In just 4 days, using sun-bright light therapy, they actually shifted workers’ biological clocks, allowing them peaceful sleep during the day and productive work at night. Light therapy possibly could solve night-shift problems forever, reducing accidents and poor work.
In 1993, Dr. Al Lewy and colleagues at the Oregon Health Sciences University in Portland achieved similar effects on volunteers by giving them capsules with an artificial form of melatonin, a chemical produced naturally in the brain’s pineal gland.
It long has been known that the gland produces melatonin only in the dark at night, but when the artificial chemical was given to humans at night, it seemed to create no reaction. When Dr. Lewy’s team gave it to the volunteers during the day, however, the chemical shifted their internal clocks.
Dr. Lewy says melatonin can help jet lag. It also may aid those who need to sleep in the day and stay up at night, or go to bed very early and rise at or before dawn. Once tested, melatonin also might help those with delayed- or advanced-sleep problems or those who get “winter depression” from waking up in darkness. Dr. Lewy says when melatonin is taken in the afternoon, the body behaves as if it had wakened to a bright dawn.
Because melatonin can be classified as a dietary supplement, it has hit the so-called health food stores in a big way. It’s OK for Dr. Lewy to do experiments, it’s another thing to offer it to the public before extensive testing has been done.
If you think melatonin may help you, you may want to ask a sleep expert before you start popping pills.
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