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How should we best measure sleepiness?

How should we best measure sleepiness? There is no definite way of measuring sleepiness. In part, the problem is that there is no good definition of sleepiness. Secondly, we often confuse the trait of sleepiness with the state of sleepiness. It is like the story of the elephant and the blind men, with each expert…

Black box warning on sleeping pills

The FDA has a new black box warning on sleeping pills (zolpidem or AmbienR, eszopiclone or LunestaR, and zaleplon or SonataR). These can cause unusual behavior in sleep (parasomnias). Patients report walking in their sleep or eating in their sleep. This happens often enough. Rarely, patients may fall, are burned, or almost drown. They may…

Trazodone for sleep reduces worsening of memory

Trazodone for sleep reduces worsening of memory in patients with and without cognitive impairment. Trazodone has long been my preferred medicine for patients with chronic insomnia. I also use it frequently for sleep apnea patients who are not tolerating Continuous Positive Airway Pressure (CPAP) treatment. CPAP causes arousals and awakenings and disturbs sleep, and APAP…

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