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Sleep-wake pathologies

Health is a state of complete physical, mental, and social well-being and does not only consist in an absence of illness or disability. [Definition of the WHO, 1946]

Sunday 15 July 2007

All the versions of this article: [English] [français]

The sleep medicine consultation comes down to four sorts of problems that concern 10 millions of French people (according to the press conference of the Minister of Health of January 22nd, 2007 ).

  • . 1/...Want to sleep without managing to : insomnia and sleeping pills;
  • . 2/... Be able to sleep without dozing off: excessive daytime sleepiness;
  • . 3/...Know how to sleep : how to adapt better to compulsory rhythms;
  • . 4/...Have to sleep : what one needs to know to act according to the regulation mechanisms .

  • « Want to sleep »: insomnia and sleeping pills.
    Seeing a doctor only occurs at the stage when traditional recipes and the first attempts at self-medication have been held in check.
    It leads to a first prescription, « on demand », a bit thoughtless (read on a forum : « the doctors throw it into your mouth, but since I’ve stopped, I still don’t sleep » ), but since there exists no ideal sleeping pill (Cf. "Risks of the new sleeping pills"), the subject who "wants to sleep" inexorably enters the vicious circle of tolerance/dependency.
    The treatment of insomnia requires a strong personal commitment of the sick person who will have to, gradually, "learn to think differently".


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  • "Be able to sleep" :Excessive daytime sleepiness
    During the medical consultation, it is necessary to be able to detect it at the time of the first request for « tonics ». Sometimes, it concerns people who think they simply need a lot of sleep and organize naps in their professional and private lives.
    The "nap" sometimes masks a "Sleep apnoea syndrome" in the «snorer»..
    The systematic exploration of those subjects’ sleep would allows the detection of still underdiagnosed pathologies.

  • "Know how to sleep" : The set of useful knowledge to be able to adapt to the constraints of active life.
    How can one manage "baby’s sleep", nursery, school rhythms, "shift work", "sport challenges", "jet lag"" and (even) the sleepless nights ...?

    Learn to know the "somnications" that contribute to the control of the rhythms of sleep and vigilance.

  • "Have to sleep": Obey the mechanisms of sleep regulation : the Clock and the Hourglass
    The understanding of these mechanisms is essential to be consistent with the behavioral methods used in the caretaking of insomnia or fatigue.
    They rely on elements of genetics, chronobiology and neuroscience ...

The "PAS" 2007 (Program of Actions about Sleep)

This program follows the report on the state of sleep in France, that was handed in in the end of December, 2006.
(Read the health department’s press release of Dec 14th, 2006)

"The National Health Service will send documentation on the importance of sleep and the rules for sleeping well, to the whole of the insured, before the end of March.
A big campaign of communication will be launched in June, with the printing of documentation made by the INPES [1], at the disposal of people in drugstores and at health professionals’ offices. Radio announcements will incite the French to stop banalising their sleep disorders and talk about them with their family doctor.
Together with the interministerial delegation for road safety, a media campaign on sleepiness while driving will start at the same time. Actions at school and during driving licence training period will also be taken.
These actions of prevention and consciousness-raising will continue during the first six months of 2008 with a new campaign of the INPES"
To be continued ... (electoral promises ?)


Clic on "play" to see an exerpt (2 mn.) of the January press conference 29th, 2007. PARIS, France:
Introduction to the actions’ program by Minister Xavier Bertrand.

Note of the website’s author : Sleepiness must not be mixed up with tiredness.
In France, sleepiness is mostly related to a chronic or acute sleep deprivation, in a society where it is necessary to adapt to the constraints of life rhythm.
"Man is the only animal taking on his sleep time to reproduce himself" said François Cavana (French humorist, born in 1923).
But, moreover, the modern world leaves little time over for rest (TV, Internet, night leasures and time for transports).

Yet, even if it is possible to learn to sleep less, it is impossible to diminish one’s need of sleep.

If the "energetic balance" is negative, the subject is led to doze and to suffer a reduction of his/her daytime performance.
But be careful, this does not concern the insomniac subjects who do suffer from an absence of sleepiness.

"Smg" offers you, here, an interactive screening questionnaire for sleep disorders : "clic the items for which you feel concerned" ... ... "your answers are compatible with the following problem(s)... you should mention those questions at your doctor’s office".


[1the National Institute for Health Prevention and Education