News from the Johns Hopkins Department of Psychiatry and Behavioral Sciences
For some, there’s been a tinge of “mother’s little helper” about hypnotics—sleeping pills—a suggestion that their use somehow implies weakness or that taking them more than briefly is harmful. But, says psychiatrist David Neubauer, that’s one of many myths that surfaces in sleep medicine, his specialty of 22 years.
As a clinician with Hopkins’ just-beginning Behavioral Sleep Medicine Program, Neubauer, who writes widely about hypnotic medications, hopes to dispel such ideas. The program addresses the overlap between sleep disorders and other illness, especially that with a psychiatric element. And though, as the name implies, behavioral therapy is the focus, it’s not everything. “For many patients, you blend behavioral and pharmacological treatment,” Neubauer explains. “You’d never prescribe a hypnotic medicine without attending to someone’s sleep behaviors—their bedtime routines, for example.”
About the myth: “It’s true that the average person only needs sleep medicines a short time,” he says. “But there’s no question that plenty of patients with chronic insomnia can benefit from longer use, especially if they do well at night and function well in the daytime.” The FDA concurs, he says, having expunged the “short term” wording from prescribing guidelines.
Neubauer and colleagues also counter the myth that in depression, simply treating the mood disorder makes sleep problems disappear. “Addressing insomnia directly can restore proper sleep,” he says.
As for the sleep medicine program—newly housed on the Bayview campus—it aims to “crack the puzzle of how psychiatry and sleep are interrelated,” says Director Una McCann, M.D. Its clinical arm offers therapy for sleep and circadian rhythm disorders while a research focus seeks to clarify how pain, traumatic brain injury, burns and cardiac disease, among others, relate to sleep. “A lot of people want to collaborate,” says McCann.
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