Sleep No More

News of Whitney Houston’s death was shocking. Moreover it was it was sad to think she drowned in a bathtub of all places. The toxicology report listed a variety of substances including, cocaine, a muscle relaxant, Xanax, Benadryl and marijuana, which more than likely contributed to her death. The first question that came to mind when I read the story was why did Houston take a bath after having ingested a sedative, a muscle relaxer, antihistamines and a hallucinogenic? Worse still, there were reports that Houston had been drinking alcohol. Over and over it was reported that she was extremely anxious and was trying to quell her nerves with alcohol and prescription medication. It would seem reasonable to a sober person that taking a bath in this state wouldn’t be a wise decision. Of course, Houston wasn’t sober and her lack of judgment led to this fatal outcome.

In light of Michael Jackson’s recent death related to the administration of propofol, an anesthetic that should only be used for surgical purposes, I wondered if these two celebrities were victims of an even bigger issue related to sleep and anxiety.

According to a new study in the Journal BMJ, people who took sleeping pills were nearly five times more likely to die over a two and a half-year period that those who didn’t.

This left me stunned especially when it occurred to me that I write prescriptions daily for Ambien, Lunesta, Ambien CR and Xanax. The addiction potential for sleeping pills and sedative hypnotics are well-known, and so are the risks. Sleep medications can adversely affect memory and coordination, especially in the elderly. Sleep medication can be addictive and tolerance may develop over time.

But what about the alternative – insomnia?

Loss of sleep is associated with lower levels of growth hormone, increased levels of stress hormones like cortisol, and impaired immune systems. The University of California published a study that showed sleep deprived individuals had significantly reduced white blood cell activity (WBC), which are known to aid the body against infection. This cell line is crucial especially in individuals who have chronic diseases like HIV or diabetes. The drawbacks of sleep deprivation also include an inability to focus, loss of creativity, motivation and poor judgment.

The study of sleep has emerged as a growing field particularly as the number of prescriptions for sedatives and sleeping aids rises. The same can be said for stimulants like those prescribed for Adult Attention Deficit Disorder. Combining them has become popular and as in the case of Whitney Houston, the results can be disastrous.

The Spanish artist, Goya, created a famous etching in the late 1700′s called, The Sleep of Reason Breeds Monsters. Thought to be a commentary about the suppression of reason so that emotions, enlightenment and even demons could arise for the sake of creativity, Goya’s iconic work has often been misunderstood. Sleep for the sake of rest often yields productivity. The argument that using sleep medication to function the next day is understandable yet, we have to acknowledge that in this 24/7 society, keeping up doesn’t necessarily equate with staying awake. We have to learn to shut down and taking sleep medication doesn’t always provide recuperative sleep.

Modifiable factors that could contribute to sleep include avoiding stimulants, particularly coffee later in the day, limiting alcohol consumption and avoiding nicotine. Behaviorists recommend going to bed around the same time each night to establish a pattern. If you do use prescription sleep medication, try to avoid them on days off or weekends. Give you body a rest so that you won’t develop tolerance or resistance.

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