"THE AMERICAN SLEEP DEBT"; 60 TO 70 MILLION AMERICANS SUFFER SLEEP PROBLEMS BUT MANY GO UNDIAGNOSED AND SELF-MEDICATE
NEW YORK, July 28 /PRNewswire/ -- Today's briefing on sleep disorders by the American Medical Association calls renewed attention to the consequences of inadequate sleep and reviews current thinking in the areas of research, diagnosis, and treatment. Forty million Americans suffer chronic sleep disorders and an additional 20 to 30 million experience intermittent problems due to lifestyle factors, according to a Report of the National Commission on Sleep Disorders Research entitled "Wake Up America: A National Sleep Alert,"(1), which was submitted to Congress in January. According to the report, our total average nightly sleep time has declined 20 percent in this century because of our 24-hour society, the globalization of the economy, and factors such as the stress of recession and unemployment, longer work hours, and the aging of the population. Consequences of this "American sleep debt" include reduced productivity and quality of life and greater likelihood of accidents. The nation pays a direct toll of $16 billion a year, according to the report, not including the cost of catastrophic disasters in which sleep deprivation played a role, such as the Exxon Valdez oil spill.(1) Results of two recent Gallup surveys reveal that 95 percent of insomnia sufferers go undiagnosed. Confusion about available treatments is widespread. Many forego any medical attention for their problem, while four in 10 self-medicate, without benefit of physician advice, by using over-the-counter remedies, alcohol, or both.(2,3) Due to myths and misinformation, many people assume "insomnia" means chronic sleep problems. But in fact, insomnia refers to difficulty sleeping, regardless of frequency. An occasional sleepless night is insomnia; so are sleep problems for a short period of time, due to the stress of temporary changes in situation such as a new job or family illness. People whose difficulties occur only occasionally tend to believe the problem doesn't warrant seeking advice from a physician.
The Consequences of Poor Sleep
According to one of the Gallup surveys, individuals who experience occasional insomnia reported a laundry list of daytime functioning problems and compromised well-being compared to normal sleepers. Problems included significantly impaired ability to concentrate during the day and accomplish needed tasks, memory problems, difficulty coping with minor irritations, less ability to enjoy family and social relationships, and feeling generally unwell physically.(2) Insomnia affects both sexes and all age and socioeconomic groups, but it is most prevalent among women and older Americans. Sleep disturbances increase with age, due to factors such as medical problems and changing social and sleep patterns. Approximately 40 percent of women suffer sleep difficulties. Particularly vulnerable are those juggling a career and children -- and increasingly, caring for elderly parents as well.
Low-Dose Therapy Offers A Safe and Effective Approach
Until recently, women and the elderly haven't had many options for relief of occasional sleepless nights or short-term insomnia. Prescription sleep therapies have been available in doses higher than many women and elders really need, given their generally smaller frames and lower body weight. But now, better choices are available to consumers, including more prudent management of established sleep drugs. There's a trend toward treating insomnia with low doses of benzodiazepine hypnotics, which not only may be appropriate for some female and elderly sufferers, but also for individuals who suffer occasional insomnia precipitated by outside events. A panel of sleep disorders specialists and psychopharmacologists convened by the National Institutes of Health concurs that when drug therapy is warranted, benzodiazepines are the therapy of choice. Their recommendations also state that patients, especially the elderly, "should receive the smallest effective dose (of a hypnotic) for the shortest clinically necessary period of time."(4) Preliminary results from recent research may bring even greater significance to low-dose therapies. These studies suggest that transient and short-term insomnia -- sleepless nights brought on by excitement or stress -- can be effectively treated with lower doses of hypnotics.(5) This new understanding of the efficacy of more conservative therapy calls attention to the recent introduction of the most widely prescribed sleep therapy in a new, effective low-dose form. The drug is RESTORIL(R) CIV (temazepam) 7.5 mg Capsules, manufactured by Sandoz Pharmaceuticals Corp. and designed to induce sleep gently in patients with short-term and transient insomnia.(a) In one recent study of Restoril, 201 healthy adults were admitted to a sleep laboratory to simulate a night's sleep in an unfamiliar environment -- a common cause of transient insomnia well-known to business and vacation travelers. Patients were treated with placebo or with Restoril at a 7.5 mg, 15 mg, or 30 mg dose. At all three strengths, Restoril induced sleep significantly better than placebo, and 7.5 mg was shown to induce sleep as well as 15 mg.(6)
When Sleeping Pills Are Appropriate
Used properly -- and in consultation with a doctor -- today's low- dose sleep medications can provide safe and effective therapy. Yet, according to the Gallup surveys, four in 10 insomnia sufferers self- medicate with drug store remedies, and 28 percent have used alcohol to help them fall asleep.(2,3) Alcohol may help people feel relaxed enough to fall asleep, but it disrupts and fragments sleep after it's metabolized. Over-the-counter cold and pain remedies contain antihistamines that cause drowsiness; but while they may induce sleep, they often leave the individual feeling groggy the next morning. These strategies, in essence, defeat the individual's purpose in adopting them -- i.e., getting to sleep in order to wake up alert and refreshed the next day. Consultation with a doctor can prevent misuse of medications and alcohol, ensure appropriate therapy, and identify underlying problems, such as depression, that may be connected with insomnia. Doctors also can educate patients about lifestyle choices that promote better sleep, such as giving up caffeine and tobacco.
1. "Wake Up America: A National Sleep Alert," Volume One, Executive Summary and Executive Report, Report of the National Commission on Sleep Disorders Research, Submitted to the United States Congress and the Secretary U.S. Department of Health and Human Services, January, 1993. 2. "Sleep in America," The Gallup Organization, Inc., for the National Sleep Foundation, June 1991. 3. "The Gallup Study of Sleep and the Use of Sleep Aids," Multi- Sponsor Surveys, Inc., under a license agreement with The Gallup Organization, Inc., November 1992. 4. National Institute of Mental Health, Consensus Development Conference, Drugs and insomnia: The use of medications to promote sleep. "Journal of the American Medical Association." 1984; 251:2410-2414. 5. Vogel, G., Clinical uses and advantages of low doses of benzodiazepine hypnotics. "J Clin Psychiatry." 1992; 53:6(suppl); 19-22. 6. Rochrs T, Vogel G, Sterling W, et. al. Dose effects of temazepam in transient insomnia. "Drug Research" 1990; 40(11); 859-862. /NOTE TO EDITORS: (a) While Restoril has a favorable safety profile, patients should not take Restoril or any other benzodiazepines during pregnancy; in combination with alcohol or other CNS depressants; or with a history of depression or suicidal tendencies./ -0- 7/28/93 /CONTACT: Matt Lindley or Maree Gaetani, of BBK, 617-734-4400, or Jill Goodwin of Sandoz Pharmaceuticals Corp., 201-503-5392/
CO: Sandoz Pharmaceuticals ST: New Jersey IN: HEA SU:
DJ -- NE012 -- 7274 07/28/93 11:48 EDT
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|Date:||Jul 28, 1993|
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