In the News

Vision in the Desert | October 2010

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2010-10Barry Krakow, MD, PTSD Sleep Clinic founder, hopes the concept will catch on with others.

Is the Maimonides PTSD Sleep Clinic that opened in Albuquerque, NM, in March a vision of the future? Barry Krakow, MD, its founder, certainly hopes so.

The clinic exists inside Krakow's already well-established Maimonides Sleep Arts & Sciences Ltd sleep center and nightmare treatment clinic, but is unique by focusing specifically on treating sleep disorders in patients with posttraumatic stress disorder (PTSD).

The occurrence of sleep disturbances such as nightmares and insomnia is, of course, one of the diagnostic criteria for PTSD, and the PTSD Sleep Clinic offers the cognitive behavioral therapy and imagery rehearsal therapy that researchers, including Krakow, have shown can ease nightmares in PTSD patients. However, they also take a holistic view of patients and ask what other factors might be disrupting the patients' sleep, including sleep-disordered breathing, restless leg syndrome, or circadian rhythm disorders.

Incoming chronic insomnia patients routinely undergo a sleep study at Maimonides, and Krakow says approximately 70% end up having an apnea-hypopnea index (AHI) greater than 5 and another 20% have upper airway resistance syndrome. In other words, about 90% of insomnia patients present with some form of comorbid sleep-disordered breathing, a condition Krakow, along with fellow researcher Dominic Melendrez, termed "complex insomnia" in 2001. Krakow sees similar rates among incoming PTSD patients, which may explain why the standard approach to treating PTSD-related sleep disturbance was not working for them, and why many of these patients report so much frustration in working on their sleep problems with many well-intentioned PTSD therapists.

"We ask our new PTSD patients how they arrived at our clinic and it is not unusual to get the raised eyebrow or turned down lip that says, ‘Boy, you don't know what it took to get here,'" Krakow says.


Read full article at Sleep Review

Mr.Es Strange Visitors - Blog Talk Radio

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blogtalkradio_logoDr. Barry Krakow is the founder of Maimonides International Nightmare Treatment. Dr. Krakow is a board certified sleep disorders specialist who has conducted more than two decades of research in the treatment of chronic nightmares and disturbing dreams at the University of New Mexico School of Medicine (1988-1999) and the Sleep & Human Health Institute (2000-2009). His work has focused on the use of cognitive-behavioral methods for the treatment of chronic nightmares and disturbing dreams. He is a leading researcher on the treatment of chronic nightmares and his research groups have published the most information on this area. Dr. Krakow is also co-author of Conquering Bad Dreams and Nightmares (1992), Insomnia Cures (2002) Turning Nightmares Into Dreams ( 2003), and Sound Sleep, Sound Mind (2007).

Journal of Nervous and Mental Disease

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Persistent Insomnia in Chronic Hypnotic Users Presenting to a Sleep Medical Center: A Retrospective Chart Review of 137 Consecutive Patients

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 complexity unlikely to respond fully to medication.


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How to Stay Awake Naturally

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The java jolt that helps you stay awake can take up to eight hours to wear off. Caffeine can also reduce your sleep time, alter the normal stages of sleep, and decrease the quality of your sleep.

How can you stay awake naturally? Try some of these 12 jitter-free tips to take the edge off sleepiness.

1. Get Up and Move Around to Feel Awake In one well-known study, Robert Thayer, PhD, a professor at California State University, Long Beach, studied whether people were more energized by eating a candy bar or taking a brisk 10-minute walk. Though the candy bar provided a quick energy boost, participants were actually more tired and had less energy an hour later. The 10-minute walk increased energy for two hours. That’s because walking pumps oxygen through your veins, brain, and muscles. If you work at a desk, get up frequently for short walks. At meal breaks, walk to a restaurant or, if you bring your lunch, head for a nice spot to eat it. Whether you take a walk outside or just in the building where you work, it will make you feel more alert and refreshed.

2. Take a Nap to Take the Edge Off Sleepiness There are two things to remember about naps: Don’t take more than one and don’t take it too close to your bedtime. “Nap between five and 25 minutes,” says Barry Krakow, MD, author of Sound Sleep, Sound Mind: Seven Keys to Sleeping Through the Night. It’s best to nap about six or seven hours before you would normally go to bed. If you must take a late nap close to bedtime, make it a short one.


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Good news for insomnia sufferers

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Los Altos Town Crier -

A good night’s sleep can be elusive. In a world where a hectic pace is considered normal, sleep problems are common. Lack of quality sleep leads to poor health and increases the risk of diabetes, heart disease, mood disorders, obesity and even sudden death. Sleep deprivation is a serious problem, estimated to cost more than $100 billion in lost productivity, medical expenses, sick leave, and property and environmental damage.

A 2005 National Sleep Foundation study found that 30-40 percent of adult Americans suffer from at least occasional insomnia, with difficulty getting to sleep, staying asleep or experiencing nonrefreshing sleep. Some consider it to be the No. 1 health problem in stressed-out western societies.