Taiwan’s 2 million insomniacs 全台兩百萬人失眠

Mon, Jun 24, 2013 - Page 11

Approximately 90 percent of the more than 2 million people suffering from insomnia in Taiwan have never sought medical attention. However, for every thousand people 9.1 sleeping pills are consumed every day, three times the consumption rate among Americans, and most people are buying these drugs without prescriptions, raising the liklihood that they are harming their health by taking fake medicine or the wrong medicine. Yang Chih-chieh, an attending physician in the Psychiatric Department at Taipei Veterans General Hospital, says that as many as 4,000 to 5,000 patients visit the hospital’s clinic for insomnia every month, with around 200 of them coming in for the first time. Approximately a third of the patients suffer from insomnia due to physiological issues, which cannot be effectively treated by simply increasing one’s dose of sleeping drugs.

Yang says that insomnia can be defined as feeling like you have simply not gotten enough sleep when you wake up in the morning, which can be further divided into having difficulties falling asleep, waking up several times throughout the night, or having trouble falling asleep again after waking up. Dealing with insomnia within a month after it begins will show the best results, but many people wait until it becomes chronic and do not treat the fundamental causes, Yang says.

One 78-year-old man who had started having difficulties keeping his balance and falling often when walking was hospitalized before finding out that he was suffering from severe sleep apnea, which was affecting his sleep. Even after taking sleeping pills for a long period of time, his sleep had still not improved and he was waking up every day feeling dizzy and weak because he had increased the dosage, which was affecting his balance and ability to walk. After the Division of Chest Medicine arranged a breathing machine treatment for him and the Psychiatric Department adjusted his dosage, the elderly man finally got his energy back and was able to walk normally again.

According to Yang’s own analysis, elderly people typically experience insomnia because of physical problems, with half caused by sleep apnea and 20 percent by clonus or involuntary movements. Insomnia can also be brought on by side effects from medications or muscle and bone pains.

Young and middle-aged people often suffer from insomnia because of stress, anxiety or because they are not accustomed to retired life. Around a third of these young insomniacs do not need to rely upon sleeping drugs for an extended period of time. All they need to do is understand how to relax and change their bad habits in order to sleep until the sun comes up, he says. Bad habits include staying up late, smoking cigarettes, playing with your cellphone before sleeping, eating late-night snacks and drinking caffeinated beverages.

In order to better understand the fundamental problems associated with sleep disorders, the hospital opened its new Sleep Medicine Center on Monday last week, which provides comprehensive examinations that are paid for by the national medical insurance system. Starting next month the center will be collaborating with other doctors and psychologists at the hospital to better take care of patients and reduce people’s reliance on drugs.

(Liberty Times, Translated by Kyle Jeffcoat)

台灣失眠人口超過兩百萬,九成民眾都不求診,但每千人每天平均服用九點一顆安眠藥,不但是美國的三倍,還大多是自行購買,容易因偽藥、服藥錯誤而威脅健康。台北榮總成人精神科主治醫師楊智傑說,台北榮總的失眠門診每月高達四、五千人次,其中初診就有兩百人,約有三分之一是其他生理疾病造成,若未找出真正病因,吃再多安眠藥也沒用。

楊智傑表示,「失眠」的定義就是「早上起來覺得自己沒有睡飽」,可以分成入睡困難、醒來多次、一醒來就睡不著等,通常剛發生不到一個月及時處理,效果最好,但很多人拖到變成慢性失眠,都沒有解決根本原因。

一位七十八歲的老先生,五月開始因為走路不穩、頻繁跌倒而住院,才發現這位病人因嚴重呼吸中止症而影響睡眠,雖長期服用安眠藥卻毫無改善,老先生便自行加重藥量,導致每天起床就昏眩無力,影響到平衡和行走功能。在胸腔科安排呼吸器治療、精神科協助調整藥量後,老先生終於重振精神、好好走路。

楊智傑分析,老年人最常因生理問題失眠,其中有一半是呼吸中止症,二成是腿部抽筋或不自主動作,還有因服用藥物副作用、肌肉骨骼疼痛而失眠。

至於年輕人或中年人,則常因壓力、焦慮或不適應退休生活而失眠。這些年輕失眠者大約也有三分之一不需長期服藥,只要懂得放鬆技巧、改掉壞習慣就可一覺到天亮;這些壞習慣包括熬夜、抽菸(導致肺功能衰弱)、睡前玩手機、吃消夜或喝含咖啡因飲料。

為了解睡眠障礙背後的根本問題,北榮上週一揭牌成立睡眠醫學中心,提供健保給付的完善檢查,下月起開設聯合門診,讓各科醫師、心理師共同照顧,減少藥物依賴。

(自由時報記者邱宜君)