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I am a 57-year-old woman who has had a sleep problem for the last 30 years - since I got divorced, so I am well aware of the root cause. I usually don't have a problem falling asleep, but I wake up usually one hour later and then maybe an hour after that, and in the worse case, a couple of hours later; after this, I often can't fall back to sleep. Each time I wake, I feel I'm on auto-pilot and head straight for the fridge to eat something, usually sweet foods.
I have absolutely no control at these times. Since I am borderline diabetic, I am very worried by what I eat at these times, as well as the fact that I do not get a good night's sleep and am very tired all day. Over the years I have tried almost everything, from sleeping pills to warm milk, brandy and herbal remedies - but none of these helped. I know about sleep laboratories, but since I find it very difficult to get to sleep anywhere other than my own bed, I do not think I would benefit from this. Where can I get help? G.D., Ashkelon
Prof. Peretz Lavie, the country's most veteran sleep medicine expert at the Technion-Israel Institute of Technology medical school's sleep lab, comments:
Your story is not unique or unusual. In many cases, insomnia that first started as a direct response to a transient stressful event such as a divorce takes on a life of its own and continues to fragment sleep for many years. Moreover, many times the patient, unlike yourself, cannot even pinpoint when the insomnia started and why. The transformation of insomnia from a transitional one to a chronic condition is mostly a result of a combination of factors sometimes related to the mode of treatment or personality factors or a combination of both. Treatment is not easy and requires the patient's full cooperation. In your case, I would recommend a session in a sleep lab even if you can manage to sleep for only a few hours. This is needed to rule out any organic cause of sleep fragmentation. After that, a sleep expert can start a treatment regimen in an attempt to consolidate sleep and improve its continuity.
I am a 33-year-old man who spends most of his spare time playing basketball. Sometimes I get hit on the head with the ball and feel a bit dizzy and queasy, but I keep playing. I sometimes wonder whether this demands a medical check for concussion. If I feel okay afterwards, does it mean there was no problem? D.A., Tel Aviv.
Ned Shannon, head athletic trainer and instructor at the University of Indianapolis, comments:
It's not uncommon to get hit on the head while playing a sport. Dizziness and nausea are two signs of concussion - one of the least understood sports injuries. People assume a concussion means you're unconscious, but that isn't always the case; a concussion simply signifies injury to the brain has occurred.
A grade-one (mild) concussion never results in loss of consciousness, but it should not be ignored, as it can lead to serious consequences if you're reinjured. Possible symptoms are mild headache, ringing in the ears, blurred vision, dizziness, impairment of thought processes or memory or sensitivity to light.
Don't underestimate the injury that may have happened to you. Stop the activity and contact your physician for possible evaluation. Once your symptoms have completely gone, usually after several days, try an activity that increases your heart rate and blood pressure, such as walking or running, to see if the symptoms return.
Failure to allow the brain to heal from a mild concussion can result in serious bleeding if a second injury is sustained. When you see an athlete collapse during a game, that's often the result of a second concussion, and the first was never reported. Athletes underreport concussions because they don't want to be removed from their sport. What they don't realize is that a serious concussion could sideline them permanently.
Rx For Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx For Readers, the Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to firstname.lastname@example.org, giving your initials, age and residence.
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