Let's all make a point to get better at sleep medicine

[birchswing]

I kind of assumed @Wilf that your account was devoted to some serious issues and also to comedy. The obsession with IQ and pseudo intellectuals has the beginnings of a character, but you never fleshed it out. Your comments about people with a lower IQ having less worth to society are either dark comedy or you're a confused individual.

I'm guessing you're going with comedy, though.

In one sentence you're angry that I post a Steve Harvey video because he's a "*****" and accuse me of insulting Steve Harvey in ways that are pseudo-intellectual. The difference between us being that I'm a poseur and you go right for the jugular? That must be what a genius would do because I'm not a genius and I didn't do it, but you did.

If I take you at face value, you did very well in college in spite of being lazy because you are inherently superior in your intelligence. You have more worth than other people to society. What benefit can you provide this forum with your intelligence that is of any more value than anything Ceke or I have posted?

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[hamstergang]

Psychiatry is one of the few physician forums where patients are common posters. I am not sure why the moderators allow it, especially since they are both also trolls.

I certainly wouldn't say both are trolls.

 

[Doctor Bagel]

I certainly wouldn't say both are trolls.

Although one was for a while. An amusing one, but very clearly a troll. The other not at all.

I'm with Wilf, though, in that sometimes it's nice to be free from questions about treatments or constant criticisms about your profession. I also agree that moderators in other forums probably wouldn't tolerate that as much as it's tolerated here.

 

[Ceke2002]

I'm with Wilf, though, in that sometimes it's nice to be free from questions about treatments or constant criticisms about your profession. I also agree that moderators in other forums probably wouldn't tolerate that as much as it's tolerated here.

Actually that's one of the reasons I haven't been posting here quite as much as before (although yes I did ask a question in this thread). I was kind of getting the feeling that maybe the non medical people on here should probably back off a bit before we completely out wear our welcome. Besides that I've been too busy keeping track of happenings in the medical community here, and deciding, with the current crisis of RMO/Internship placements in Australia, whether or not to go ahead with my pre-med undergrad application this year.

 

[Ceke2002]

I just remind them that they decided to seek out care and ask what are they willing to do to get better?
I certainly do not have the legs to create drive-by business by standing on the corner.

Of course, and I'm sure there are far better uses of your time than trying to drum up extra business by encouraging patients to stay on who aren't actually willing to do any work beyond opening their mouths and swallowing benzos. I meant from the point of view of if the patient is actually compliant, and willing to work with a treatment plan, CBT-i, and all that. Just the mention of Michael Jackson's situation made me wonder where the cut off point is with treatment -- obviously I'm assuming it would be before you killed your patient with Propofol of course.

Random change of topic, but I find Fatal Familial Insomnia to be an utterly fascinating condition -- dreadful, but fascinating.

 

[Shikima]

Damn tsetse flies.

 

[Ceke2002]

Damn tsetse flies.

Yes, annoying little things that drive you to sleep after several months of torture...kind of like me in a way.

*ahem* No, seriously, African Sleeping Sickness, I'm assuming prevalent in Africa but somewhat rare outside that owing to travel advice and education? How often would you see a case of this sort, or any of the more 'exotic' type diseases that cause interference with sleep?

 

[Shikima]

I never seen anything exotic from genetics or microbal in relation to sleep. Travelling? Get 50% DEET.

 

[smalltownpsych]

I thought I posted on this thread about the connection I have seen between level of daily activity and sleep problems. Way too many of a our patients spend a lot of time being understimulated.

On a related note, I was thinking about how the myth of stress being bad has permeated our society. This was because a new patient of mine was recently advised by a school therapist to drop their higher level math class because they were getting a B and this was causing them to become depressed and have thoughts of suicide. Obviously, when I talked to the kid, the B was not the problem and the perfectionism was being driven by anxiety from a deeper source. Anyway, the point is that the automatic response by many in our society is to stop doing productive activities as the first response to any signs of emotional difficulty.

 

[Shikima]

Everyone is a winner and it's ok not to get the correct answer. That's the model being taught to our children.

And I think the better choice of words would be, people are overstimulated and not active enough. Looking at the 2 process model, we need to be busy to induce sleep. Ever dug a ditch? - Feeling quite sleepy at the end of the day because you've expended a lot of energy (free roaming Adenosine) and plenty of inflammatory markers released (TNF-alpha, Il-1, IL-6, PG).

Too often, high amount of emotional energy are contributing to the lack of sleep - thinking and worrying is a very stimulating activity engaging the sympathetic nervous system. Thus is the crux for MJ's death.

 

[smalltownpsych]

Everyone is a winner and it's ok not to get the correct answer. That's the model being taught to our children.

And I think the better choice of words would be, people are overstimulated and not active enough. Looking at the 2 process model, we need to be busy to induce sleep. Ever dug a ditch? - Feeling quite sleepy at the end of the day because you've expended a lot of energy (free roaming Adenosine) and plenty of inflammatory markers released (TNF-alpha, Il-1, IL-6, PG).

Too often, high amount of emotional energy are contributing to the lack of sleep - thinking and worrying is a very stimulating activity engaging the sympathetic nervous system. Thus is the crux for MJ's death.

Physiological activity is definitely important. but I also think there is an important difference between productive vs. unproductive mental activity, as well.

 

[Shikima]

Stuck in a rut.

 

[sunlioness]

Do any of you fine people have any handy articles or resources about sleep aids in pregnancy? I'm not finding very much. My ten year old sleep book that Shikima recommended said that they're all absolutely contraindicated. That's not right, is it?

 

[Shikima]

Benadryl.
As pregnancy progresses, melatonin production is increased.

Treatment for insomnia? CBTI. More effective than any medication.

RLS symptoms? Increase iron or opiates. Can't use DA agonists.

 

[sunlioness]

Benadryl.
As pregnancy progresses, melatonin production is increased.

Treatment for insomnia? CBTI. More effective than any medication.

RLS symptoms? Increase iron or opiates. Can't use DA agonists.

Thank you. I found an article as soon as I posted that, of course. But I'm going to look up some CBTI stuff too.