Tuesday, November 15, 2005

Adolescent Insomnia

The New York Times reports that the use of medication to treat insomnia in adolescents is increasing:
In 2004, more than 180,000 people under age 20 in the United States - most of them 10 or older took sleep medications, according to estimates released last month by Medco Health Solutions, a large managed-care company.
Although that represents only about one child in 500, Medco found that usage was up by 85 percent since 2000.
The numbers reported by Medco were somewhat mysterious: the company's report did not indicate why the pills were prescribed for the patients under 18, or which pills were prescribed for them.
That makes some doctors worry that the large increase may reflect a certain amount of unnecessary prescribing.

It's a fairly good article, but I disagree with one of the statements made by a sleep specialist in the article:
"The last thing we want to suggest is that it's O.K. to throw a medication at something without understanding the problem," said Dr. Judith Owens, the director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital, in Providence, R.I. "Insomnia is a symptom, not a disorder. It's like pain. You're not going to give a patient pain medication without figuring out what's causing the pain."
At least in adults, considering insomnia to be just a symptom is outdated. To quote from the new book Cognitive Behavioral Treatment of Insomnia (Perlis ML et al, 2005), "In the early 1980's...there was perhaps no rallying cry as popular as 'insomnia is a symptom, not a disorder'....After more than two decades of sleep research...Insomnia is once again considered a distinct nosological entity." The "NIH State of the Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults Statement" moves away from the concept of 'secondary insomnia'. It uses the term 'comorbid insomnia'. For example, in the case of depression associated with insomnia, it is often impossible to tell if depression is causing the insomnia, or if insomnia is causing the depression. According to the conference statement, "the limited understanding of mechanistic pathways in chronic insomnia precludes drawing firm conclusions about the nature of these associations or direction of causality."


shrinkette said...

Thanks for the great reference on insomnia.

BTW, how's it going?

CarolenK said...

There is an interesting book called Lights Out, by T. Wiley on sleep. Discusses light pollution and the ramifications of living with electric light sources--reallly bad for sleep and health in general.

Crazy Dan said...

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tốt mua thuốc said...

Mất ngủ là bệnh phổ biến hiện nay và bất cứ ai cũng có thể mắc phải và những bà bầu cũng không thoát khỏi cảnh bị bệnh mất ngủ . mất ngủ có ảnh hưởng đến thai nhi không là câu hỏi được nhiều người hỏi. Vậy nguyên nhân mất ngủ khi mang thaihay buồn ngủ là bệnh gì. Vậy có cách chữa bệnh mất ngủ hiệu quả nhất , cách trị chứng mất ngủ hiệu quả và an toàn nhất . Cùng đi tìm hiểu nhé.

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