University of Memphis psychology professor Kenneth Lichstein
doesn't get upset when people fall asleep while he is explaining
his work; rather, The U of M researcher prefers it.
Dr. Lichstein, an international expert on sleep disorders,
has spent much of his 24 years at the University conducting
various research projects aimed at helping people overcome
major insomnia problems. In international circles, Lichstein's
name is synonymous with "sleep" - he has published
80 journal articles and book chapters on the subject.
"Insomnia is a major problem that affects about 10 percent
of the population, and in older adults, it may affect about
25 percent of the population," Lichstein says. "It
may result in disturbed mood and anxiety, and a perceived
compromised quality of life."
Lichstein's latest project - "Treating Hypnotic Dependence
in Older Adults" - focuses on treating adults age 50
years or older who have sleep disorders and are dependent
on prescription sleep medications. His project introduces
older insomnia sufferers to drug-free treatments designed
to help them get a better night's sleep.
"Older adults with insomnia often turn to sleep medication,
risking addiction, interactions with other drugs, increased
sleep apnea and other side effects," says Lichstein.
"This is a major problem I wanted to address."
Lichstein has so far tested 44 older adults for the study,
which continues for two more years. Volunteers were recruited
through newspaper, TV and radio advertisements.
One of the test subjects, Gail Landers, did not have to be
convinced how major a problem insomnia can become. The 59-year-old
depended heavily on prescription medications to get a restful
night of sleep, often resulting in a "wrung-out"
feeling the following morning.
"Before participating in the study, I had a severe insomnia
problem," Landers says. "It usually resulted in
feelings of fatigue and crankiness the next day. I would feel
terrible throughout the day. I definitely needed help."
Lichstein says that older adults most often are bothered
with "secondary insomnia" - a disorder caused by
a medical or psychiatric problem. The other type of insomnia,
termed primary, deals more with psychological causes and usually
affects young to middle-aged adults.
Subjects in Lichstein's study undergo two treatment methods.
The first involves a relaxation method in which subjects practice
slow, deep breathing, passive body focusing and relaxing imagery.
The goal is for a more relaxed mind and body, which is more
conducive to sleep.
The second method involves stimulus control. "We teach
subjects not to go to bed by habit; only to go to bed when
they feel a strong sleep urge," Lichstein says. "Then,
if they are in bed and awake for more than 15 to 20 minutes
either at bedtime or in the middle of the night, we encourage
them to get out of bed, exit the bedroom and not return until
they feel a strong sleep urge. This method is designed to
restrict the bedroom to sleep so that the individual becomes
trained to automatically associate the bedroom with sleep."
Lichstein says the results of the study are too preliminary
to discuss, but says three smaller scale sleep medication
withdrawal studies have been consistent.
"When individuals slowly withdraw from chronic use of
sleep medications, they may experience some temporary worsening
of sleep," he says. "But by the time they are withdrawn
from the medication, their sleep is no different from when
they were chronic sleep-medication users.
"Long-term use of sleep medications reduces the effectiveness
of the drug to zero," he adds.
Lichstein's study is being funded by a $1.6 million grant
from the National Institute on Aging, a division of the National
Institutes of Health.
For Landers, the study has meant relying less on prescription
medications and a better quality of life. "While I don't
think I'm totally free of the problem, since I still occasionally
have a bad night, I really believe this treatment is effective,"
she says. "I would recommend it to anybody."
Individuals interested in participating in the study should
call (901) 678-4168. Volunteers must be at least 50 years
old, dependent on prescription sleep medication and have a
current complaint of poor sleep.