The Doctor Responds and More.

Happy Tuesday!  Have you ever woken up and just been glad you did?  All it took for today to be a day like that for me was to open the shade on the Arcadia door and let that Arizona sun pour in.  Wherever you are, I’m sending a bit of this feeling your way.

Dr. Marks, the author of the book that was reviewed Friday, sent me a response immediately.  I laughingly wondered if it truly were sent the second my post hit the screens.  While Dr. Marks sent it as a comment, I’m going to actually copy it here:

Submitted on 2011/02/11 at 5:50 pm

Hi, thanks for your review. Also, thanks for giving me the benefit of the doubt. As it turns out, I didn’t get your question, but I’d be happy to address that now.

Even for people with medical disorders that interfere with sleep, maintaining good sleep hygiene as discussed in chapter 6 is important.

I like your comment about common sense information. I tend to err on the side of assuming people know the things I know because it’s become so routine for me. Then when I see a new patient who is doing lots of stuff to sabotage their sleep, I’m reminded that these tips may be intuitive, but that doesn’t always translate to common practice.

So attending to sleep hygiene – all aspects of it as best you can, specifically helps the chronic kidney sufferer.

Next, if a person progresses to have other medical complications such as chronic fatigue, pain or depression, the sufferer should consider sleeping medication. Chapter 5 discusses the different medication options and this information can help you make an informed choice when you talk to your doctor.

As you know, people on dialysis can develop insomnia due to sleep apnea. I only discuss sleep apnea briefly in the book. The book is really designed to be a self-help tool. Since sleep apnea requires professional help, I did not elaborate much except to give information on the symptoms, the sleep study that diagnoses it and treatment options.

Lastly, although I’m a proponent of not taking medications when you don’t need to (even though I’m a medical doctor), I believe those with chronic medical conditions are just the population of people who need sleeping medication long term.

That said – medications don’t always work all the time. Many of them loose their effectiveness. So anything you can do behaviorally to help your sleep is advantageous. All this to say, I also think the section on sleep restriction would be helpful to the person with chronic kidney disease who has broken sleep all through the night DESPITE being on sleeping medication.

One more thing, people with kidney disease can end up with day-night reversal where they are up all night and sleeping during the day. This can really get in the way of doctors appointments, dialysis if applicable, and other life commitments. This is where light therapy that I discuss in Chapter 8 may be extremely helpful. Bright light has a powerful effect on the body clock and helping people sleep at the right times.

More recent research that postdates the book supports the use of light boxes also for non-seasonal depression. This is exciting to me because it’s possible the light therapy can not only help regulate one’s sleep but lift the depression that kidney disease sufferers can develop.

Okay, I think that’s it. Thanks for the question!

And thanks to Dr. Marks for her quick response once she did receive the question.

On another issue, I received another comment from Miko Aguillera at  When I explored the site, I found it informative about quite a few different types of kidney problems, just as the name suggests.  However, there is a large advertisement on the home page for a kidney healing product.  I am not endorsing the product, nor do I know anything about it.  It might be interesting to take a look at the page if you keep that in mind.

How nice that today’s post seemed to write itself.

Until Friday,

Keep living your life!

Published in: on February 15, 2011 at 8:41 am  Leave a Comment  

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