Posted by Cam W. on January 17, 2001, at 10:27:08
In reply to SLS, JohnL, stjames, Cam W, Judy1, allisonm, JahL, posted by Ron Hill on January 17, 2001, at 0:16:55
Ron - Reasons for insomnia are varied and multifactorial. One should try to discover the physiologic reason for insomnia, rather than just good sleep hygiene and hypnotics, even non-addicting one's. Algorithms, as the one you have compiled, must be arrived at through controlled clinical trials in order for them to be validated and reliable. Metanalysis, when analyzed using the appropriate statistical measures, can give some guidelines; even then there are limitations.
The approach that you mention may work for your situation, but not for someone else. This algorithm of sleep control should be talked over with your doc (including all OTC/herbal use). The list of options you give may be a good alternative to other approaches, but it really depends on a person's reason(s) for insomnia, medical history, current diagnoses, etc.
Still, many of the approaches that your mention are "bandages", not "fixes". The best approach may be being referred to a sleep clinic to try to discover the reason for the insomnia and to resolve the insomnia that way, rather than just by using sleeping pills.
Hypnotics are recommended for short-term (10-14 day) use only. This may not be true for the newer hypnotics, such as trazodone (Desyrel), zopilcone (Imovane) and zaleplon (Starnoc - in Canada). I believe that the 14 day limit recommendation was implemented to address the inherent problems seen with barbiturates (overdose risk, dependence and tolerane) and benzodiazepines (dependence and tolerance).
I hope this is the type of feedback that you were looking for - Cam.
poster:Cam W.
thread:51834
URL: http://www.dr-bob.org/babble/20010111/msgs/51858.html