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Insomnia
Sep 28th, 2011 Headlines

The involuntary manslaughter trial of Michael Jackson raises the question: how far do some people have to go to get a good night’s sleep?

The drug at the center of the Michael Jackson case is propofol, which is also known by the brand name, Diprivan. Propofol is a drug that provides sedation for short surgical procedures and diagnostic tests that may be uncomfortable for a patient.  It also causes amnesia, so that the patient isn’t aware or doesn’t remember what they’ve just had done.  It’s a milky white liquid that is injected into the bloodstream and has sometimes been jokingly referred to as “Milk of Amnesia”.

It is such a great medicine for quick procedures because it works quickly (usually within 40 seconds) and only lasts about 6 minutes. Doctors can then titrate it to last for the length of the procedure, and patients wake up quickly thereafter.

Propofol, however, shouldn’t be used as a sleep aid. The same goes with any powerful sedative or anesthetic; it can cause the patient’s breathing to slow down and even stop at high doses. It can also cause low blood pressure.  Patients undergoing sedation with propofol need to be closely monitored, for example with a machine that measures oxygen, to make sure that they are not getting too much.

Michael Jackson reportedly suffered from insomnia due to anxiety about the tour he was planning. How common a problem is insomnia for most people? About 1/3 of all adults experience weekly trouble sleeping at night, and millions of people say they have trouble functioning the next day due to lack of sleep.  Studies show they don’t miss more work due to insomnia, but their performance is impaired. They supposedly cost employers the equivalent of 8 days of lost productivity.

So, what exactly is insomnia? It is when a person has difficulty falling or staying asleep.  Primary insomnia means there is no obvious medical condition that is causing the problem. On the other hand for secondary insomnia, something else is causing the insomnia whether it’s asthma, arthritis, cancer, or medication.

There is quite the lengthy list of causes to insomnia. A few common causes include stress, depression, medications, caffeine intake, changes in schedule, eating too much before going to bed, etc.

Getting too little sleep can, unfortunately, take a significant toll on your overall health and well being. It can lead to poor job or school performance, slow reaction time which can lead to accidents, mental health problems like depression or anxiety, obesity, poor immune function, high blood pressure, heart disease, diabetes.

A recent CDC study found that teens who get less than 8 hours of sleep a night are at higher risk of things like drug and alcohol abuse, suicidal thoughts, feeling sad, being inactive.  In fact, some high schools have a later start time to encourage teens to get more sleep at night.

We all have trouble sleeping from time to time and minor insomnia can fortunately be reduced by healthy sleep habits. Good habits include going to bed at the same time every night, avoiding caffeine in the evening, exercising, and keeping a dark, quiet sleep environment.  People with more significant sleep problems may be prescribed sleep aids.   In general, these are recommended for long-term use. Therefore, patients may need to turn to relaxation techniques and  behavioral, cognitive therapy to help them train the body to prepare for and stay asleep.



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