In the News

The nightmare circle broken

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The night Yael Levy turned a circle of menacing sharks into a ring of harmless dolphins, she knew she had achieved mastery over a life-long foe: her nightmares. "I was able to change my nightmare while it was happening," says the 29-year-old New York City graduate student. "I had control over my dreams." That relief was more than Levy expected when she showed up at the Sleep-Wake Disorders Center at Montefiore Medical Center two years ago. Levy says she just wanted help for her insomnia. She had no idea her nightmares were treatable, too.


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An Interview with Barry Krakow, M.D., on PTSD and Sleep - Sleep Disorders

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Initially trained as an internist and emergency room physician, Dr. Krakow's interest in treatment of sleep disturbances developed after he pursued an interest in medication side effects related to sleep problems. He has since become a sleep researcher, and runs a sleep clinic in Albuquerque, NM specialized in the treatment of sleep problems co-occurring with PTSD and other psychiatric disorders.


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Persistent insomnia in chronic hypnotic users pres... [J Nerv Ment Dis. 2010] - PubMed result

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Chronic insomnia patients may fail pharmacotherapy. We reviewed charts on 137 chronic insomnia patients new to our sleep medical center who reported persisting insomnia despite long-term usage of pharmacotherapy. We examined 4 areas: (1) patient views on encounters with prescribing physicians; (2) self-reported medication efficacy; (3) treatment-seeking goals; and (4) completion of a sleep medicine workup. Insomnia chronicity averaged 13 years; use of prescription medication for sleep averaged 3.81 years. Encounters with prescribing physicians yielded few options beyond drugs. Drug efficacy was not optimal for most of these patients. Sleeping better or drug-free were their chief goals. Subjective and objective sleep measures confirmed moderately severe residual insomnia as well as fair to poor waking impairment and quality of life. Sleep workup revealed high rates of maladaptive behavioral influences (96%), psychiatric complaints (89%), and obstructive sleep apnea (71%). In chronic insomnia patients who failed pharmacotherapy, comorbid mental and physical factors indicated a sleep disturbance comp


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An Interview with Barry Krakow, M.D., on PTSD and Sleep - Sleep Disorders

Posted in In the News

mentalhelpInitially trained as an internist and emergency room physician, Dr. Krakow's interest in treatment of sleep disturbances developed after he pursued an interest in medication side effects related to sleep problems. He has since become a sleep researcher, and runs a sleep clinic in Albuquerque, NM specialized in the treatment of sleep problems co-occurring with PTSD and other psychiatric disorders.


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Sleep Apnea May Cause Nighttime Urination - KLTV 7 News Tyler, Longview, Jacksonville |

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kltvSUNDAY, Nov. 29 (HealthDay News) -- People who wake up during the night to urinate shouldn't automatically blame a urological problem. Sleep apnea, a breathing-related sleep disorder, could be the cause.

A new study suggests that nighttime urination, or nocturia, is comparable to loud snoring as a marker for obstructive sleep apnea, a disorder in which soft tissue in the throat blocks the flow of air into the lungs, disrupting sleep.

Previous studies established a link between nocturia and sleep apnea, a potentially serious condition that affects about 25 percent of U.S. men and 10 percent of U.S. women, the researchers said. But they believe this is among the first to show that screening for nocturia could help doctors identify patients with apnea.

The study also suggests that a common treatment for sleep apnea -- positive airway pressure (PAP) therapy -- can reduce symptoms of nocturia, thereby improving sleep and preventing debilitating falls among elderly people who get out of bed at night to use the bathroom.

PAP involves wearing a pressurized air mask while sleeping.

Typically, doctors screen for apnea by assessing patients' weight (the condition is associated with overweight/obesity) and asking if they snore heavily, notice breathing problems at night or feel tired during the day (because of interrupted sleep). But because many patients, especially those who sleep alone, are unaware that they snore, apnea often goes undiagnosed.

"When you ask people about symptoms like snoring and gasping, they tend to say, 'No, I don't have them'," said study author Edward Romero, research coordinator at the Sleep and amp; Human Health Institute in Albuquerque, N.M. "But it's very easy for them to realize that they wake up at night to go to the bathroom."

One of Romero's co-authors, institute director Dr. Barry Krakow, said doctors and patients are quick to blame nocturia on diabetes, prostate enlargement and other medical conditions with which it is associated.


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