Thursday, 5 November 2009

Trouble sleeping

Sleep - we can't live without it and we spend a third of our lives getting our fill of it. Or not, as the case may be for a few unlucky people that I've seen this week. For them, this is a huge problem, leaving them feeling exhausted, frustrated and miserable. Given my seemingly complete incompetence in dealing with it, I am left feeling much the same.

The conversation seems to go the same way each time. It starts
with me explaining that by suggesting that they try and improve their 'sleep hygiene' I don't mean that they need to wash more before bed. This is the part where we talk about not eating too late, cutting out caffeine and alcohol, having a warm drink before bed, reading a book etc etc etc.

Whether or not this works for anyone I don't know. If it does, those must be the people who don't end up going to their doctor, because the ones who see me are rarely interested. No, the people I see want sleeping tablets, and thus the next part of the conversation involves me trying very hard not to give them what they want. I usually fail.

As far as I'm concerned, going on sleeping tablets is, more often than not, a one way track to a monthly prescription for life, and one which I will feel very guilty about signing. It's not just that some of them are physically addictive drugs, but it's their complete psychological addiction that worries me. How do you stop taking them once you've started? You'll lie in bed and think to yourself, 'I'm not going to sleep tonight, I haven't taken a tablet'. And then of course you won't.

I suppose the question to ask is; does it matter? I cheerily commit Mrs Smith to a lifetime of blood pressure medication, so why not sleeping tablets? (I'm certain that this is what my patients must be thinking when I meanly try and hold them back)

I think for me it's because its 'medicalising' the non medical. To have to take a tablet each night to do something that should come so naturally seems wrong. It's ignoring an underlying problem and just treating the symptom.

Of course that's easy for me to say, I happen to be rather good at sleeping, but I'm sure there must be a better way at helping people who aren't, and I'm busy looking for it....

1 comment:

  1. I'm not a doctor, but my views:
    Shouldn't healthy blood pressure 'come naturally'? Insomnia is not 'non-medical' in my opinion. Poor sleep can lead to all kinds of other problems. I'm prone to hallucinations from it.

    I do agree the underlying cause should be looked at, though. It's not good to just focus on a symptom or give nasty drugs when something less harmful may work.