I am often reminded of an Irish proverb “A good laugh and a long sleep are the best cures in the doctor’s book.” Unfortunately, in these times, they are hard to come by.
Many patients who suffer from Chronic Fatigue Syndrome or fibromyalgia have associated sleep disorders. Trouble falling asleep, staying asleep and multiple nighttime awakenings have a huge impact on the quality of life.
A recent study published in The Journal of Circulation discussed the risk of heart attacks associated with chronic insomnia. People who had trouble falling asleep had a 45 percent increased risk of a heart attack while those who had difficulty staying asleep had a thirty percent increased risk. People who woke up tired had a twenty-seven percent increased risk of a heart attack.
The study was not surprising. Regardless of the diagnosis, I am constantly discussing sleep and its importance on health and wellness. Sleeping at night and being up during the day is crucial. Testing for sleep apnea, upper airway resistance syndrome and restless legs syndrome should be ruled out if indicated. If the sleep study is positive, treatment should be instituted.
Treating low ferritin with iron for restless leg syndrome has been shown to be more efficacious than the prescription medication called Mirapex.
I use a variety of different treatment options. Many are herbal, but if a patient is not sleeping, then prescription medication is used. Valerian, Passionflower, L-theanine are some of the herbal supplements used. Often a low dose of prescription sleep medication is of great benefit. I always tell my patients, that whatever sleep aid they are using must be taken within 15 minutes of going to sleep. Using earplugs (silicone and not rubber!) can decrease noise. Turning the clock away so that if you wake up in the middle of the night you don’t focus on how much time you have left to sleep can ease the anxiety that is associated with sleeping. Putting animals (and snoring partners) in another room, if needed can improve the quality of sleep.
Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island