Many Factors Can Keep The Aged Awake At Night

February 10, 1987|By Allan Bruckheim, M.D.

Q--I can`t seem to get enough sleep at night. I`m 74 years old, but I`m in good health. What`s wrong with me?

A--Take heart. Insomnia is the most common sleep disturbance; but since it`s a symptom, not a diagnosis, you should take some time to think about what might be causing your problem.

Age is a factor. The older you get, the more likely you are to sleep less efficiently. You wake up during the night, arise early in the morning, feel sleepy during the day. However, while you may be sleeping less at night, chances are you`re also napping during the day. Result: the overall amount of sleep you`re getting hasn`t changed.

On the other hand, your insomnia could be the result of stress. The death of a loved one, a change in job status, even travel, can all temporarily disrupt your sleep habits. This type of insomnia usually lasts no more than three weeks.

If your sleep troubles continue longer than that, a medical problem may exist. Depression is often accompanied by insomnia. Older depressed people may find themselves awake at the crack of dawn. Manic or anxiety disorders can also cause insomnia.

Drugs and alcohol may have an effect on sleep too. A nip of alcohol before bedtime, which many people claim helps them sleep, may actually result in your awakening early in the morning.

What should you do about your insomnia? Even if you think you know what the problem is, it`s best to consult your doctor. One other note: Sleeping pills are not the answer to insomnia. Though a short course of medication does work in some specific instances, sleeping pills are not an effective long-term solution.

Q--Our local clinic has advised us to keep Ipecac at home to induce vomiting in case our children swallow any dangerous substances. Is there any danger in the use of Ipecac itself?

A--Yours is a frequently asked question, so let`s run it down again. To date, syrup of Ipecac is the safest and most effective way to eliminate toxic materials from the stomach. Adverse reactions to Ipecac are quite rare, and are usually associated with its abuse, either through a massive overdose, chronic use by those afflicted with anorexia nervosa or bulimia, or use by someone with a pre-existing congenital condition.

An earlier fluid form of Ipecac was far more toxic than the form you buy today, and is no longer on the market. Check your medicine cabinet right now, and if Ipecac fluid is on the shelf, dispose of it and replace it with the newer syrup of Ipecac.

Across my desk: There is new evidence that cocaine can be detected in hair samples, and expert testimony concerning cocaine detection by the

``hair`` method has already been presented in a U.S. court.

Dr. Frederick Smith, director of the graduate program of forensic science at the University of Alabama, Birmingham, has modified a currently available urine cocaine test to one that can utilize hair samples to verify the presence of drugs in the body.

A sample of the hair is prepared by washing and pulverizing and the soluble extract of the hair sample is tested using a technique called

``radioimmunoassay.`` Minute quantities can be detected in this manner, and this technique has already been utilized to detect traces of phenobarbital and morphine in strands of hair. The current urine test, called ``Abuscreen`` and available from Roche Diagnostics Systems in Nutley, N.J., forms the basis for the modifications that Dr. Smith has devised.
