• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Falls Tied to Insomnia, Not the Sleeping Pills

Posted on: Thursday, 14 April 2005, 12:00 CDT

Doctors often hesitate to prescribe sleeping pills to people in nursing homes out of concern that the medication may lead their patients to fall and injure themselves. But a new study suggests that it is insomnia, not the pills, that may be responsible for many falls.

Writing in The Journal of the American Geriatrics Society, researchers from the University of Michigan say that doctors should more seriously consider using hypnotics, a sleeping aid, for older people who have trouble sleeping.

The lead author, Dr. Alon Avidan, and his colleagues followed the health of more than 34,000 nursing home residents over a six-month period and found that those with untreated insomnia were 90 percent more likely to have fallen than the other residents. Those who had been given sleeping pills were 29 percent more likely to have fallen.

Sleep loss, the study said, can cause daytime sleepiness, mental impairment and changes in the way muscles perform. It can also slow reaction times.

These are the same problems that many doctors worry will occur if they prescribe sleeping aids, and previous studies have suggested that those drugs were contributing to falls. But the new report argues that earlier researchers did not take into account the role of insomnia itself in those falls.

But newer medicines, Avidan said, leave the system faster and do not have the same effect on mental functioning. When an older patient has insomnia, he said, a carefully chosen medication "might not be such a bad idea."

Avidan said he had received no financing from the pharmaceutical industry.

*

MORE CHILD GOLFERS, MORE INJURIES More and more children are taking up golf. But as they do, a good number of them are ending their day in the emergency room instead of the clubhouse.

A study in The Journal of Neurosurgery reports that head injuries are becoming a growing problem for younger players. The biggest dangers are errant swings and golf cart mishaps.

The lead author of the study, Dr. Scott Rahimi of the Medical College of Georgia in Augusta, home of the Masters, said he began the study after noticing that more children were coming into the emergency room with golf injuries.

The researchers reviewed the records of more than 2,500 children seen by neurosurgeons at the medical college over a six-year period and found that golf accidents were the second most common sports injury, behind bicycle accidents. Fifteen children were injured, the study said, seven by golf clubs, seven by golf carts and one by a ball. Most recovered well, but one died after a golf cart accident.

A review of other studies, the researchers said, found that golf injuries among children were also on the rise elsewhere. The injuries occur not only on golf courses but also in parks and at homes.

Although children generally cannot hit a ball very hard, it is fairly easy to cause a skull fracture, the most common injury.

*

VITAMINS' LIMITS IN CANCER FIGHT People who eat food high in antioxidant vitamins and minerals have been shown to have a lower incidence of cancer. But can there be too much of a good thing?

A study in The Journal of the National Cancer Institute found that when cancer patients took high doses of vitamin E, their risk of a new cancer actually went up. The study was led by Dr. Isabelle Bairati of Laval University in Quebec.

"Our results suggest that caution should be advised regarding the use of high-dose a-tocopherol supplements for cancer prevention," the researchers wrote, referring to the synthetic form of vitamin E.

The 540 volunteers in the study, all with head or neck cancer, took 400 international units a day. On the first day of radiation therapy, they began a three-year course of vitamin E or a placebo.

Compared with patients receiving the placebo, the researchers found, the patients given the vitamin supplements were about twice as likely 20 percent versus 10 percent to develop a new cancer.

In the period after the supplement was given, those who had received the vitamin E did a little better in avoiding cancer than those given a placebo. And after eight years, the rate of new cancers was the same in both groups.

Last month another study, published in The Journal of the American Medical Association, found that high doses of vitamin E might raise the risk of heart failure in people with diabetes or clogged arteries.

The authors of the new study suggested that people who wanted to reduce their cancer risk might be better off improving their diets than taking supplements.

*

DRINKS BEFORE NURSING? New mothers who want to breast-feed have long been advised, even by health care workers, to have a drink to help them relax and produce milk. The recommended drink varies often it is beer, sometimes it is wine but the advice has popped up in cultures around the world for centuries.

In a new study, researchers say that when they hooked women up to breast pumps and measured their output, they found that those who had drunk alcohol took longer to release their milk and produced less. The study, led by Dr. Julie Mennella of the Monell Chemical Senses Center in Philadelphia, appears in The Journal of Clinical Endocrinology & Metabolism.

"For women who are being told, 'Here, drink, you're going to make better milk,' I want them to know that there's no evidence for that," Mennella said.

The researchers cited studies showing that about a quarter of women reported having been advised by health professionals to have a drink before breast-feeding.

For this study, 17 nursing women came in for two session to have their milk pumped. In one session, they had no alcohol; in the other they had about two drinks (neither beer nor wine, as it turns out, but screwdrivers, a mix of vodka and orange juice).

During the pumping, researchers drew blood to test for levels of two hormones involved in lactation, oxytocin and prolactin. Alcohol, they found, changed the production of both hormones, reducing oxytocin levels by more than half and more than tripling the prolactin. Those changes, the researchers said, explain why the women had more trouble producing milk.

This does not mean that nursing women should avoid alcohol, Mennella said. Although there is a myth that alcohol is stored in the breast, the baby will not be exposed if a woman waits a few hours to breast-feed after having a drink, she said.

Source: International Herald Tribune

More News in this Category