Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

18 Adar 5764 - March 11, 2004 | Mordecai Plaut, director Published Weekly









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Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

More letters. I was asked about sleep disorders. This problem can be first broken down into fatigue -- meaning tired, but weak -- and sleepy which means more along the lines of losing contact with the surroundings and even falling asleep during the day.

People who are tired and fatigued can have anemia, hypothyroidism, B12 deficiency or other diseases and are best worked up by an internist. Mental fatigue can be due to stress, overwork and depression. We have spoken about this. This is best worked up by a psychiatrist.

People with daytime sleepiness may have a movement disorder when they sleep, which affects sleep quality or Pickwickian Syndrome, where overweight people may even stop breathing in the middle of the night and they wake up with a start. These people need to lose weight, but in the meantime, they sleep with machines that blow air in under pressure to keep breathing passages open. This last group is best evaluated by a sleep specialist with a sleep lab. Many people in the field do not believe there is such a thing as chronic fatigue syndrome.

Treatment for mental fatigue responds well to antidepressants. Overwork is best treated by rest. Since the elderly are poor sleepers on average, here sleep aid may be indicated. As well, the British Medical Journal also recommends the use of sleep aids for a few days after a long trip to help against jet lag. Melatonin is a natural aid for sleep especially for jet lag. It may work, but be sure the synthetic brand is used. Natural sources are from cow brains which may not be kosher, and may spread brain viruses such as mad cow disease.

In Israel we have Nocturno and Stillnox (Ambien in the USA). These medications are non-addicting and short acting. The first has a bad taste and the second may cause hallucinations in the elderly. Bonserin and Trazadone (Desyrel) are antidepressants. They work, but we have much more effective medications. Bondormin is a benzodiazepam which is the same family as valium. It is a tranquilizer as well. It may be a problem of dependence -- use sparingly. Hypodorm works well, but it is illegal to bring this drug into the USA even if it is for personal use. It causes amnesia and it has been used for criminal purposes. My thanks to Dr. Yaron Dagan, the head of the Sleep Lab at Tel HaShomer.

I would like to spend a little time on another problem that we have not spoken about. Check any Jewish periodical and it is full of weight-loss schemes. Many if not all are worthless.

We have never discussed the opposite: those who can eat anything and never gain a kilogram. This can be an acquired problem, especially in cancer and hyperthyroidism. But most of the time, these types of people have parents of the same type. Little can be done, and eating a lot to try to gain weight can be dangerous. Be happy with your lot. Write me in care of the Yated.

A message from GlaxoSmithKline, sponsor of this column. We discussed in this column antidepressants, and Seroxat is one of the best in the business. A newer antidepressant, it combines effectiveness with safety and a quick return to normal living.


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