Q. I’ve been plagued my entire adult life by insomnia. I have no trouble nodding off but then wake up. If I really can’t get back to sleep I read a book, but I do get very tired a lot of the time.
My GP did prescribe medication, however I find I start to feel just as tired if I take these for more than a week.
Now I read that sleep problems are linked to developing dementia and I am even more motivated to find a solution to my problem.
A. Insomnia is a huge problem for many people in Britain, with more than 15 million prescriptions for sleeping tablets issued each year. But tablets are not a solution.
And in terms of dementia, it is in fact a version of these tablets that are associated with risk rather than insomnia itself. Major trials show an association between the use of ‘sleepers’ known as benzodiazepines and an increased risk of developing dementia.
Insomnia is a huge problem for many people in Britain, with more than 15 million prescriptions for sleeping tablets issued each year. But tablets are not a solution (stock image)
Doctors and patients rely on various kinds of sleeping pills but actually their help is minimal and they have significant side effects.
Exercise is a good weapon against insomnia but must be done long before bedtime as it can be too stimulating.
All insomniacs should consider trying specific sleep therapies either via a clinic or alone.
Sleep restriction therapy involves calculating how much sleep you are used to and then setting a strict waking up and bedtime based on those few hours. So if it is five hours and you need to wake at 7am, you are only allowed to go to bed at 2am. This routine becomes instilled night after night and gradually you bring bedtime earlier by 15 minute increments.
Another treatment is stimulus control therapy. This is a form of cognitive behavioural therapy focusing on the notion that bed is only for sleep and sex, with strict instructions, such as no books or computers, to follow.
For example, you are taught that if you are in bed but awake for more than 15 minutes, you get out again. Genuine insomnia solutions such as this take time and patience to implement, but can provide the answer.
Major trials show an association between the use of ‘sleepers’ known as benzodiazepines and an increased risk of developing dementia (stock image)
Q. For the past four years in the autumn I have experienced very itchy arms – worse on the lower forearms. I take daily antihistamine and sometimes I rub ice cubes along my arms for relief. Blood tests are fine.
A. A symptom that only occurs for a few months of the year must surely be responding to a change outside the body during that time.
Allergic skin conditions can be precipitated by a huge number of external factors such as plants, central heating, dietary changes, damp, clothes, toiletries or detergents, and an annual issue is likely the result of a change in one of these.
Symptoms should be managed properly with antihistamines, in consultation with your GP, and this always involves trying at least three or four different ones, including prescribed ones.
People with very significant and distressing allergies will need doses far beyond the typical once-daily level. When a skin problem is confined to one area of the body, creams should also be used to calm down the sensation: these could include cooling creams, such as two per cent menthol, and possibly even steroid creams.
I stand by my doubts over chiropractic
Sadly last week a chiropractor was arrested on suspicion of manslaughter after an 80-year-old man died from a traumatic spinal cord injury sustained during treatment.
It came after I gave my opinion on chiropractic treatment in my previous column – and received a deluge of angry emails questioning my stance on its safety.
I was criticised by the chiropractic community for short-sightedness or arrogance, not opening my eyes to types of health treatment beyond what I learned at medical school and in conventional practice.
In fact, healthcare evolves continually and doctors embrace these changes and new treatments that go far beyond what we learn during training.
We can only do so when they are proven by trials to be both effective and safe, first doing no harm.
I cannot say that about chiropractic treatment.
Hope I’ll put my 40s behind me in the same shape as Davina
Before my 40th birthday, like many people prior to such a landmark, I decided to make a concerted effort to get into the best shape of my life, with regular workouts including my current obsession, spinning, and a sensible diet. I was feeling pretty good about my achievements.
Then Davina McCall decided to post this picture of herself on social media to mark her 50th.
On the bright side, I suppose it’s something to aim for. By that I mean having such a great physique. Not her bottom.
Davina McCall decided to post this picture of herself on social media to mark her 50th
It was good to see actress Sheridan Smith looking back to her best after suffering ill health last year, said to have been triggered by the death of her father.
The 36-year-old admits she turned to ‘self-medicating’ with alcohol as a coping mechanism. She is not alone.
When people can admit anxiety is the problem and receive a diagnosis, there should be help available: cognitive behavioural therapy (CBT) is known to be the best treatment for anxiety, and it should be available on the NHS in all areas, in person or online.
I was alarmed by the backlash against disclosing sexuality to GPs. We discuss a lot of intimate issues with our patients and knowing the make-up of a patient population, whether their sexuality, race or smoking habits, means we can commission the appropriate services and resources for our practice demographic. It is certainly not so we can share the information with rogue third parties.