For the past couple of years, I have found it difficult to go to sleep. It takes maybe two hours, and then I awaken early. I am healthy, but feel fatigued and need an afternoon nap to help with the tiredness. Should I take sleeping pills?
|It sounds as though you have chronic insomnia. The problem is a common one, affecting between 10 and 15 percent of people. It is much more common as we age, and affects women more than men. Sometimes it complicates chronic medical or psychiatric disorders.|
Primary insomnia—which we suspect you have—may respond well to reprogramming your sleep habits. We presume you do not have breathing problems or restless leg syndrome. Many people with insomnia have a state of increased arousal, and brain-wave activity confirms this increased alert state.
Though some medications may work, long-term studies greater than six months have generally not been conducted. And we would recommend behavioral changes first.
I have heard that melatonin is good for sleep disorders. Is it safe to take, and is it effective?
|Melatonin is produced by a part of the brain known as the pineal gland. It appears that its function is to keep the body’s internal events synchronized with the changes between light and dark (night and day) in the environment. Melatonin was initially used to treat jet lag, a problem related to changing time zones during transmeridian travel. More than 60 million people experience transmeridian travel annually. Millions of people work at night or on permanently rotating shift schedules, which changes their sleep patterns. This work pattern was shown to alter the melatonin production by the body.|
Melatonin has become a popular treatment for sleep problems. Recently researchers analyzed the data from a number of randomized trials of melatonin and sleep disorders; this work was published in a recent British Medical Journal. The design of these studies was such that any chance findings or placebo effects would be identified. The results of nine trials were studied. While it was found that melatonin has some effect on helping individuals fall asleep more readily and also increased the percentage of time the subjects slept while in bed, on statistical analysis, both these effects were not proven to be clinically significant over the placebo.
Although melatonin was not proved to be significantly effective, it was shown not to be harmful. If you travel across time zones, spend more time outdoors and avoid sleep loss prior to travel, and your adjustment to jet lag will be easier.
I am 35 years old, and have had a history of lumps in my breast. The doctors have told me that I have “benign breast disease.” My concern is that I have an aunt who had breast cancer. Should I be worried?
|As much as we would like to completely reassure you, we can only do so conditionally. Benign breast disease can be divided into three groups that are significant when it comes to associations with breast cancer.|
The first group is of abnormal pathology, but in which no increased cellular division or overgrowth seems to be taking place (pathologists call it nonproliferative). The second group shows evidence of increased cellular division, but the cells are normal and typical. The third group is called atypical hyperplasia, in which increased cellular division occurs with abnormal cells in the picture.
There is an increased risk of cancer that is slight in the first group and significant in the last group. The risk is usually quoted as “relative risk,” which is a comparative number to the general population. So, for example, if the risk of the general population is made to be 1, then the first group has a risk of 1.27, or 27 percent more risk, while the third group (atypical hyperplasia) has a relative risk of 4.24, or four and a quarter times the risk of the general population.
Send your questions to: Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland, 20904. Or you may send your questions via e-mail to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend that you consult with your personal physician on all matters of your health.