X-Envelope-to: CFS-L@NIHLIST.BITNET
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Newsgroups: alt.med.cfs
Date:         Sat, 9 Jan 1993 20:40:00 PDT
              <CFS-L@NIHLIST.BITNET>
From:         GLADSTONE@CSMCMVAX.BITNET
Subject:      Re: sleep

        Benzodiazepines are somewhat addicting, but not sleeping is worse.
The problem with benzos is that they tend to supress REM sleep, and so
decrease the quality of sleep.  However, there is a brand new benzo
called Quazepam (Doral).  It's big claim to fame is that it does _not_
supress REM.  ( So they say )
        Valium and most of the benzos are not appropriate for inducing sleep,
since they are tranqualizers and sedatives.  They tend to have long half
lives and active metabolites with long half lives.  It seems to me that this is
just what a sufferer of CFS does not need.  The ones that are hypnotics,
( Halcion=triazolam and Dalmane=fluroazepam ) are designed specifically
for sleep.  Dalmane should be avoided because it has an active metabolite
with a very long 1/2 life. ( 4 days! )  This will cause a healthy person to feel
like they have CFS with repeated use.   Halcion, on the other hand, is an
ultra-short duration compuond with a 2-3 hour 1/2 life.  It is not for
everybody, and has recieved a lot of bad press, but it works very well
and is totally out of your system in the morning.  No hangover or residual
impairment.  It should be used cautiously at first until one is familliar
with it's effects.
        If nothing else works, remember, not sleeping is very bad, both
physically and mentally.  Xanax is a long acting compound, and I do not
understand why anybody with CFS would want to take it, except that it is
supposed to have some antidepressant effects along with antianxiety
properties, while producing a minimum amount of sedation compared to
the other benzos.  In this respect, it is a unique member of this class of
compounds.
        Halcion side effects are rare, tabloid journalism notwithstanding,
but it does produce anteriograde amnesia.  One may have trouble remembering
events that have just occured.  This property is usefull for inducing
amnesia prior to certain medical procedures.  A very close relative,
Versed=Midazolam, is used for this purpose.  One may fall asleep
very quickly, and it sort of 'sneaks up' on one.
        If you do take Halcion, _don't_ smoke in bed or leave the
stove on, etc.  The only real symptom experienced during withdrawl
from Halcion is rebound insomnia and REM rebound.  On the other hand,
Valium and Xanax ( along with most other benzos ) have anticonvulsant
properties, so siezures can occur with abrupt discontinuation of
Xanax, especially if it has been used in high doses.  Exercise care.
I have not heard of this occuring with Halcion.
        Hope this helps.  There are some novel sleep inducers on the horizon,
and when I learn more about them I will post the info to this group.
        As far as I am concerned, all other current sleep inducing
drugs are dangerous, cause respiriatory depression, and should be avoided.
( Placydil, barbiturates, opiates, etc. )
        The benzos do not depress respiration and have a very wide
margin of safety.  If 1 tablet puts you to sleep, 100 will not kill you,
unlike other classes of drugs.  However, they do potentiate resp depression
of other drugs, and should not be mixed with alcohol, etc.
        By the way, alcohol, while it may get you to sleep faster,
definately degrades the quality of sleep.
One good way to get to sleep is to read a very bad book! or overly long
network postings.  ;-)

Gladstone>  <GLADSTONE@CSMCMVAX.BITNET>

Disclaimer:  These opinions are my own, and my employer does not allow,
let alone endorse, any opinions on the part of it's employees.
Refer to an MDiety for further information.  Better yet, ask 5 of them
and you will get 5 different opinions.  Best of all, do your own research
and make your own decisions.  :-0
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