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20 Av 5765 - August 25, 2005 | Mordecai Plaut, director Published Weekly
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Home and Family

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

Director, Emergency Services, Bikur Cholim Hospital

I get asked questions about sleep very often. The most common question -- asked once again by a correspondent in Ramot -- is can sleep be banked -- i.e. can you make a deficit and then make it all up by sleeping a lot? The answer, I am sad to say, is no. People who stay up all night need more than one day to return to normal. Lack of sleep lowers the body's resistance. And in the 7 Dec. 04 issue of the Annals of Internal Medicine there is an article that lack of sleep can lead to obesity.

Nevertheless, there is a clear demarcation of when one needs to sleep and when one is sleeping for enjoyment. You should be able to tell the difference. If you cannot get up on time or cannot stay awake during the day, you are probably not sleeping enough. Never get behind the wheel of a car if you haven't slept enough. You endanger many people's lives.

Counting sheep does not help induce sleep, but relaxation does. Warm milk helps little, if at all. The British Medical Journal discussed jet lag at length, one and a half years ago. Your best bet is to try to get onto local times as soon as possible. Avoid daytime napping. Realize that the older you are, the more time you will need. Going West is harder.

Caffeine is a drug and is addictive. Safety depends on how much you are used to it. Seasoned coffee drinkers can drink massive amounts. I avoid all caffeine. I just do not like addictions. Do not forget that caffeine will make you go to the bathroom. It is a diuretic and it will speed up your heart. Those with atrial fibrillation should avoid caffeine. Caffeine is not a good idea to use to keep yourself awake when you are sleep deprived.

How can doctors keep track of all the side effects of medications? While a computer can help, most physicians keep track by using only a group of medications with which they are familiar and comfortable. By doing this and recalling side effects of classes of medications instead of individual ones, you can pretty much stay on the safe side.

I was again asked about Glaxo's sponsorship of this column. I avoid all interactions with drug companies during my regular work. I do not accept pens or other trinkets, nor do I talk to the representatives. Glaxo for this column is the only time I have compromised on these principles, and the reason is twofold: First, without their support, the column could not continue. If a private sponsor would come forth, no problem -- but this hasn't happened. Second, Glaxo's products are rarely used in emergency medicine, so I feel it will have less effect on my own practice. The only ones relevant to emergency medicine are Ventolin, which is the standard anyway, and their antibiotics, which I do use when indicated. Otherwise, Sertide, Valtrex, the dermatology products, the vaccines, Zyban, Seroxat, Requip and Avodart have no use in emergency medicine. Write me in care of the Yated.

A message from GlaxoSmithKline, sponsor of this column. Zyban does help in one addiction: smoking. The studies are quite impressive. Smoking is a disgusting and life-threatening habit, so use Zyban and quit for good.

 

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