Posted in Health, music, news

Why Music Helps One Sleep

A study from the University of Sheffield has found people find music, such as Perfect from Ed Sheeran, to be the most helpful sleep aid.

Looking at 651 respondents, study authors found 62% used music to lull themselves to sleep and genres chosen included Classical (Mozart, Chopan), Pop (Ed Sheeran, Coldplay) and Brian Eno (rock, ambient techno).

The Guardian reports the following:

When streaming service Spotify analyzed its users’ Sleep playlists, it found Sheeran was the most commonly chosen artist, although this is probably down to his ubiquity rather than some hitherto unexplored somnolent quality in his music. In fact, his three most popular tracks on Spotify all hover slightly above the ideal bpm rate for sleep: Perfect comes in at 95bpm, Shape of You at 96bpm and Happier at 90bpm. Still they are notably slower than the 117-122 bpm that has characterized most popular music from the 1940s until today.

How does music affect sleep?

Although we don’t know for sure why music helps one sleep, we believe it stimulates the parasympathetic nervous system, inducing relaxation, slower breathing, slower heart rate, and digestion.

A study in 2017 performed by neuroradiologist, Dr. Jonathan Burdette, found any music that appeals to an individual will better connect a “default mode network” in the brain seen on functional MRI.

 

Brain-on-music (1)

 

 

Another study from the University of Helsinki found music to affect the receptors of dopamine, a neurotransmitter involved in mood.

Another theory is music distracts one from thinking about his/her day thereby reducing stress hormones and epinephrine that may be triggered from anxious thoughts.

 

Sleeping Pill Use “Worse than Smoking”

Arizona State University researchers last year reported the use of use of sleeping pills is “worse than smoking” for one’s health.

Sleep researcher, Shawn Youngstedt, told CNN, “They are as bad as smoking a pack of cigarettes a day. Not to mention they cause infections, falling and dementia in the elderly, and they lose their effectiveness after a few weeks.”

For years sleeping aids including antihistamines (ex. diphendyrdramine), benzodiazepines (ex. lorazepam, alprazolam), non-benzodiazepine sedative-hypnotic (ex. Ambien) have been studied and linked to side effects including:

  • Sleep walking
  • Insomnia
  • Numbness, tingling
  • Diarrhea
  • Constipation
  • Memory loss
  • Dizziness
  • and more

In 2012, a study of 10,500 people found those who used sleeping pills were 4X as likely to die in the 2.5-year study than those who didn’t use medications for sleep.

Dr. Kripke and his colleagues at Scripps also found a 35% increase risk of cancer, noting lymphoma, lung, colon and prostate cancer risk was worse than that of smoking.

Also in 2012, a study published in Thorax, found benzodiazepine use linked to the severe lung infection, pneumonia.

In 2014, a study from China Medical University in Taiwan found only four sleeping pills a year increased risk of heart attack by 20% and 60 tablets a year was linked to a 50% increase.

A separate study found an increased risk of aortic dissection with sleeping pill use.

 

Insomnia-Image_08.03.2016.jpg

 

What causes insomnia?

Insomnia is a disorder where one has difficulty falling asleep and/or staying asleep.  Many factors can cause insomnia. These include:

  • Medications (stimulants, decongestants)
  • Caffeine
  • Alcohol
  • Stress, anxiety, depression
  • Thyroid disorder
  • Chronic pain
  • Neck and back arthritis
  • Diabetes
  • Respiratory conditions (asthma, COPD)
  • Gastroesophageal reflux
  • Urinary frequency
  • Diarrhea
  • Neurological conditions
  • Sleep apnea

and of course environmental issues such as noise, temperature, and kitty cats.

Treatments for insomnia

Treating insomnia can be complex.  We begin by treating the underlying cause, such as any of those listed above.  Then we can try the following:

  • Lowering the room temperature to an average of 65 degrees F
  • Shut off artificial lights 1-2 hours before going to bed
  • Avoiding alcohol
  • Dinner  including foods rich in tryptophan (fish, nuts, tofu, turkey, eggs and seeds)
  • Warm bath
  • Cognitive and/or behavioral therapy
  • Aromatherapy including lavender
  • Black out curtains to keep out light
  • Daily exercise
  • Listen to low volume music such as classical, the blues, or jazz
  • to name a few.

Youngstedt also suggests exercise. He states its “healthier” than using sleeping aids and “research suggests those who are physically active have a lower risk of developing insomnia in the first place.”

Now it could be that those who suffer from certain medical conditions are more at risk of insomnia but more needs to be studied in terms of why these medications are linked to poor health outcomes.

 

sleep.jpg

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, news

Benzodiazepine Abuse Being Overlooked

While the country struggles to fight the opioid epidemic, we may be overlooking the high use and abuse of benzodiazepines.

Benzodiazepines “Benzos” fall under a class of medications used for anxiety, insomnia, and mood disorders.  Their brand names include Xanax, Valium, Klonipin, Ativan and the generic names all end in “am” such as diazepam, clonazepam, and alprazolam.

Benzodiazepine-Withdrawal-Symptoms-And-Treatment_Top-Five-300x298.png

Similar to opioids, benzos are considered controlled substances by the DEA and require a prescription to be dispensed.  They are highly addictive and can cause very uncomfortable withdrawals.  But unlike opioids, benzo withdrawal can be deadly.  Some may suffer seizures when they miss their dose, and in the medical field we never recommend abrupt withdrawal of a treatment involving benzodiazepines.

Symptoms of benzodiazepine withdrawal include:

  • anxiety
  • insomnia
  • restlessness
  • heart palpitations
  • headaches
  • tremors
  • nausea
  • inability to concentrate
  • hallucinations
  • psychosis
  • seizures

This class of medication has worried providers for decades.  We hesitate prescribing benzos to women of childbearing age as it can cause severe fetal defects if one takes it while pregnant.  Moreover, its interaction with alcohol, opioids, and recreational drugs could enhance one’s risk of inebriation, somnolence and respiratory depression.

The typical benzodiazepine is prescribed as “one pill every eight hours as needed prn (for) anxiety.”  However, I never wrote the prescription in this fashion as I didn’t want patients driving during the day while taking this medication.  So I would instruct them to only take at bedtime or once as needed if they were to be home and in bed.  And if anxiety was an all day issue we add therapy to the treatment plan.

According to BachHuber et al 31% of fatal overdoses that occurred in 2013 involved a benzodiazepine.

And benzodiazepine prescriptions are exponentially rising as patients have difficulty filling opioid prescriptions.  “Sleeping it off” is turned to as a means to battle pain if one cannot obtain adequate pain control.

Moreover our anxiety, impatience, and insomnia is rising as our addiction to computers, the internet and smartphones skyrocket.

This vicious cycle puts our country at risk for another epidemic of a dangerous, addictive and lethal-if-abruptly-discontinued, drug.

It’s time we address the underlying causes of pain, anxiety and addictive behaviors rather than limiting the prescribing power of medical providers.  Patients need help and if they can’t receive it through one modality they will search for other means.  Benzos provide an inexpensive way to relax, sleep and manage pain, but can be in fact more dangerous than the opioids and drugs we are trying to limit.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, news

Having Trouble Sleeping? Could Have Been from ONE Night of Drinking Years Ago

A study from the University of Missouri – Columbia suggests four drinks in one session may permanently affect one’s ability to sleep.

Exposing mice to alcohol levels equitable to human binge drinking, researchers found the expression of the gene, ENT1, was reduced.  Moreover they found a lack of adenosine surge, a chemical that promotes sleep.

Many believe alcohol makes one sleepy, thereby drinking, wine, beer, or scotch as a sleep aid.  But medical professionals warn against this as it can disrupt the sleep cycle.

With millions of Americans suffering from insomnia, work loss, and sleepy driving, this study makes us wonder if avoiding alcohol-fueled parties in our younger years could have such a profound effect on our future health.

Insomnia-Image_08.03.2016.jpg

What causes insomnia?

Insomnia is a disorder where one has difficulty falling asleep and/or staying asleep.  Many factors can cause insomnia. These include:

  • Medications (stimulants, decongestants)
  • Caffeine
  • Alcohol
  • Stress, anxiety, depression
  • Thyroid disorder
  • Chronic pain
  • Neck and back arthritis
  • Diabetes
  • Respiratory conditions (asthma, COPD)
  • Gastroesophageal reflux
  • Urinary frequency
  • Diarrhea
  • Neurological conditions
  • Sleep apnea

and of course environmental issues such as noise, temperature, and kitty cats.

Treatments for insomnia

Treating insomnia can be complex.  We begin by treating the underlying cause, such as any of those listed above.  Then we can try the following:

  • Lowering the room temperature to an average of 65 degrees F
  • Shut off artificial lights 1-2 hours before going to bed
  • Avoiding alcohol
  • Dinner  including foods rich in tryptophan (fish, nuts, tofu, turkey, eggs and seeds)
  • Warm bath
  • Cognitive and/or behavioral therapy
  • Aromatherapy including lavender
  • Black out curtains to keep out light
  • Daily exercise

to name a few.

Sleeping pills are “worse than smoking”

Arizona State University researchers. last year, reported the chronic use of sleeping pills is worse than smoking for one’s health.

Sleep researcher, Shawn Youngstedt, told CNN, “They are as bad as smoking a pack of cigarettes a day. Not to mention they cause infections, falling and dementia in the elderly, and they lose their effectiveness after a few weeks.”

For years sleeping aids including antihistamines (ex. diphendyrdramine), benzodiazepines (ex. lorazepam, alprazolam), non-benzodiazepine sedative-hypnotic (ex. Ambien) have been studied and linked to side effects including:

  • Sleep walking
  • Insomnia
  • Numbness, tingling
  • Diarrhea
  • Constipation
  • Memory loss
  • Dizziness

and more.

In 2012, a study of 10,500 people found those who used sleeping pills were 4X as likely to die in the 2.5-year study than those who didn’t use medications for sleep.

Dr. Kripke and his colleagues at Scripps also found a 35% increase risk of cancer, noting lymphoma, lung, colon and prostate cancer risk was worse than that of smoking.

Also in 2012, a study published in Thorax, found benzodiazepine use linked to the severe lung infection, pneumonia.

In 2014, a study from China Medical University in Taiwan found only four sleeping pills a year increased risk of heart attack by 20% and 60 tablets a year was linked to a 50% increase.

A separate study found an increased risk of aortic dissection with sleeping pill use.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

Posted in Employment, Health, news

Ambien Side Effects: Erratic Behavior but NOT Racism

Roseanne Barr in, an apology for a tweet in which she alluded to ex-Obama aide, Valerie Jarret, as “muslim brotherhood & planet of the apes had a baby=vj” cited Ambien as the cause.

ABC News cancelled her hit show Roseanne on Tuesday.

In an apology, the actress tweeted, “I apologize to Valerie Jarrett and to all Americans. I am truly sorry for making a bad joke about her politics and her looks. I should have known better. Forgive me-my joke was in bad taste.”

She later tweeted, “I did something unforgiveable so do not defend me. It was 2 in the morning and I was ambien tweeting — it was memorial day too — i went 2 far & do not want it defended — it was egregious Indefensible. I made a mistake I wish I hadn’t but…don’t defend it please.”  CNN reports she also tweeted the following, “Not giving excuses for what I did(tweeted) but I’ve done weird stuff while on ambien — cracked eggs on the wall at 2am, etc.”

rs-181862-94818213

The makers of Ambien, Sanofi, tweeted the following response, “While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication.”

Millions of people use Ambien (zolipdem tartrate), a sedative hypnotic, in a 5 mg or 10 mg tablet form, that is used for fast-acting sleep initiation and is famous for not inducing a drowsy feeling the next morning.

Unfortunately multiple users have cited odd side effects such as driving to work in the middle of the night, or cooking breakfast.

According to rxlist.com, side effects of Ambien may include:

  • Daytime drowsiness
  • Dizziness
  • Weakness
  • Lightheadedness
  • “Drugged” feeling
  • Tiredness
  • Loss of coordination
  • Stuffy nose
  • Nasal irritation
  • Dry mouth
  • Sore throat
  • Nausea
  • Constipation
  • Diarrhea
  • Stomach upset
  • Headache
  • Muscle pain
  • Confusion
  • Insomnia
  • Euphoria
  • Ataxia (balance problems)
  • Visual changes
  • memory loss
  • mental/mood/behavior changes (such as new or worsening depression, abnormal thoughts, thoughts of suicide, hallucinations, confusion, agitation, aggressive behavior, or anxiety).

The medication is a gamma-aminobutyric acid (GABA) A agonist, inciting a neurotransmitter cascade that can inhibit activity between neurons, nerve cells.  Lower levels of GABA are linked to sleep disorders, so inciting the GABA receptor as Ambien (zolpidem tartrate) does, can induce sleep.  But once we’re affecting nerve signals other side effects may ensue since the GABA inhibitory neurotransmitter affects the central nervous system.

So odd behavior could be a side effect. However, as with alcohol-induced behavior, exacerbations of feelings or tendencies may occur.  Forming new opinions, which may be racist, would not be a side effect of this medication.

Medical providers warn users to hide car keys, lock of refrigerators and put child locks on stoves and ovens as “sleep walking” behavior could put them and their families at risk.  This also includes posting on social media… so keep phones away from the bed and computers off.

_______________________________________

Radio personality Mark DiCiero shares his personal experience here.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio, KDWN and Board Certified Family Physician

 

 

 

Posted in Health, news

Sleeping Pill Use is “As Bad as Smoking”

Arizona State University researchers say taking sleeping pills is worse than smoking for one’s health.

Sleep researcher, Shawn Youngstedt, told CNN, “They are as bad as smoking a pack of cigarettes a day. Not to mention they cause infections, falling and dementia in the elderly, and they lose their effectiveness after a few weeks.”

For years sleeping aids including antihistamines (ex. diphendyrdramine), benzodiazepines (ex. lorazepam, alprazolam), non-benzodiazepine sedative-hypnotic (ex. Ambien) have been studied and linked to side effects including:

Sleep walking

Insomnia

Numbness, tingling

Diarrhea

Constipation

Memory loss

Dizziness

and more.

In 2012, a study of 10,500 people found those who used sleeping pills were 4X as likely to die in the 2.5-year study than those who didn’t use medications for sleep.

Dr. Kripke and his colleagues at Scripps also found a 35% increase risk of cancer, noting lymphoma, lung, colon and prostate cancer risk was worse than that of smoking.

Also in 2012, a study published in Thorax, found benzodiazepine use linked to the severe lung infection, pneumonia.

In 2014, a study from China Medical University in Taiwan found only four sleeping pills a year increased risk of heart attack by 20% and 60 tablets a year was linked to a 50% increase.

A separate study found an increased risk of aortic dissection with sleeping pill use.

Insomnia-Image_08.03.2016.jpg

What causes insomnia?

Insomnia is a disorder where one has difficulty falling asleep and/or staying asleep.  Many factors can cause insomnia. These include:

Medications (stimulants, decongestants)

Caffeine

Alcohol

Stress, anxiety, depression

Thyroid disorder

Chronic pain

Neck and back arthritis

Diabetes

Respiratory conditions (asthma, COPD)

Gastroesophageal reflux

Urinary frequency

Diarrhea

Neurological conditions

Sleep apnea

and of course environmental issues such as noise, temperature, and kitty cats.

Treatments for insomnia

Treating insomnia can be complex.  We begin by treating the underlying cause, such as any of those listed above.  Then we can try the following:

Lowering the room temperature to an average of 65 degrees F

Shut off artificial lights 1-2 hours before going to bed

Avoiding alcohol

Dinner  including foods rich in tryptophan (fish, nuts, tofu, turkey, eggs and seeds)

Warm bath

Cognitive and/or behavioral therapy

Aromatherapy including lavender

Black out curtains to keep out light

Daily exercise

to name a few.

Youngstedt also suggests exercise. He states its “healthier” than using sleeping aids and “research suggests those who are physically active have a lower risk of developing insomnia in the first place.”

Now it could be that those who suffer from certain medical conditions are more at risk of insomnia but more needs to be studied in terms of why these medications are linked to poor health outcomes.

 

                                                                                                       LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician