Saturday, 10 March 2012

To sleep perchance to ...sleep?

Like much else in life, sleep is something we take for granted until we no longer have it.

As a GP I've become increasingly convinced of the importance of sleep, and of asking patients about their sleep habits. I guess I've had many consultations over the last 30 years where 'early morning wakening' has been flagged up and has often been an indicator of an underlying depression. But it wasn't until I read Counting Sheep:The science and pleasures of sleep and dreams by Paul Martin that I began to appreciate just what impact sleeplessness has. From  events of international significance, such as Chenobyl, the Shuttle disaster and the Exxon-Valdez oil spill, to personal irritability, fatigue and premature death!

Today's Times has a feature, 'Valium pills, Temazepam and melatonin: I've tried them all'. It's mainly a tale of caution about the over prescription of sleeping tablets. There's  also the usual criticism of GP's along the lines of,  GPs don't know enough about....(if I had a fiver for every time I heard that). Thus Professor Young from the Royal College of Psychiatrists,
'many family doctors fail to look more deeply at the physical or mental troubles that cause adults to suffer from insomnia'
I'm  not sure how Professor Young came to that conclusion. I've never had a psychiatrist sit in with me in my surgeries and I do my best to unpack the reasons for insomnia. I freely admit however that the subject is complex and is hardly amenable to the 10 minute appointments that we work to. Good sleep hygiene is a start. The open access web site for patients has quite a helpful article.

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