Wednesday, November 27, 2013

Guest Blog: "SLEEPING WITH THE TURKEY" by Jon Brody

This week I am featuring a guest blog by Jon Brody, Executive Director of Keiler Healthcare.


Turkey in hammock-01
This week most of us will be sitting down to a turkey feast.  Many of us have heard that the L-tryptophan in the turkey is what makes us drowsy after the huge meal.  Well, as it turns out, turkey contains no more of the amino acid tryptophan than other kinds of poultry. In fact, turkey actually has slightly less tryptophan than chicken, according to a report on Web MD.  It’s more likely the huge calorie intake, maybe the wine or maybe just wanting to tune out a noisy and nosey relative that gets us napping.  We at Prognosis 2.0 think anything that gets us a bit more sleep is a really good thing, because insomnia is directly linked to depression, heart disease and other illnesses.
It’s too bad that turkey doesn’t work, because curing insomnia in people with depression could double their chance of a full recovery, scientists are reporting. This week The New York Times and ABC News reported the findings, which are based on an insomnia treatment that uses talk therapy rather than drugs. These results are the first to emerge from a series of closely watched studies focused on sleep and depression that will be released in the coming year.
Depression is the most common mental disorder, affecting some 18 million Americans in any given year, according to government figures. And more than half of those who are depressed also suffer from insomnia.
The cycle is tough to break. You lie in bed depressed and worrying.  The anxiety keeps you awake; you become even more tired and then more depressed.
The depression-insomnia connection is indisputable and confirmed by a new study, which is the first of four on sleep and depression. The other three studies are nearing completion, and all are financed by the National Institute of Mental Health. In these studies researchers are evaluating a type of talk therapy for insomnia that is cheap, relatively brief and usually effective, but not currently a part of standard treatment.  This treatment might actually find a way to reduce the amount of Prozac and other medications that are currently used to reduce depression.  If we combine both, then maybe we can dramatically improve sleep and reduce depression.
As reported in The New York Times, a team at Ryerson University in Toronto found that 87 percent of patients who resolved their insomnia in four, biweekly talk therapy sessions also saw their depression symptoms dissolve after eight weeks of treatment, either with an antidepressant drug or a placebo pill — almost twice the rate of those who could not shake their insomnia. Those numbers are in line with a previous pilot study of insomnia treatment at Stanford.
Full-blown insomnia is more serious than the sleep problems most people occasionally have. To qualify for a diagnosis, people must have endured at least a month of chronic sleep loss that has caused problems at work, at home or in important relationships. Several studies now suggest that developing insomnia doubles a person’s risk of later becoming depressed — the sleep problem preceding the mood disorder, rather than the other way around.
The therapy is called cognitive behavior therapy for insomnia, or CBT-I for short. The therapist teaches people to establish a regular wake-up time and stick to it; get out of bed during waking periods; avoid eating, reading, watching TV or similar activities in bed; and eliminate daytime napping.
As reported in The New York Times, the four larger trials are to be published in 2014.  In these studies, the participants keep sleep journals to track the effect of the CBT-I therapy, logging what time they go to bed every night, what time they started trying to fall asleep, how long it took, how many awakenings they had and what time they woke up.  I have been in a similar study, as I averaged 2-3 hours of sleep a night for 13 years.  Even Thanksgiving Turkey couldn’t get me to rest for more than a few hours.
So get some rest, enjoy the holiday and come back to work refreshed.  If you are feeling a bit depressed maybe a little CBT along with the turkey is just what the doctor ordered.

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