Illegal, Fat or Erect—But Rested

Dolors & Sense

by Sanford Rose

KISSIMMEE Florida—(Weekly Hubris)—12/26/11—I am an unwanted guest at life’s second feast.

Burdened by a genetic inheritance that is useful for some purposes, but certainly not for restful living, I have always had an unquiet mind and consequently have waged a life-long struggle for sleep.

Age has sharpened this struggle. It is not true that old people need less sleep. But it is true that they often get less sleep, particularly of the restorative variety—that which is termed delta or slow-wave sleep.

It is this loss of deep sleep—uncompensated by nearly ubiquitous daytime napping, which is most often shallow, or Stage 1, rest—that predisposes the old to many serious and ultimately fatal illnesses.

Unfortunately, I am aging in unquiet and increasingly unprosperous times.

Let’s try that again: to those with anxious minds—amygdalal hyperactivity, more precisely—every time is troubled.

The anxious mind is itself a recessionary world.

It may be that of a person of property (which today is often held only precariously), but its possessor still is envious of the “poor man’s riches, the prisoner’s release.”

So, I quest for pharmaceutical sleep aids.

I have found just three bona-fide hypnotics that not only induce sleep but do not compromise sleep architecture. Indeed, they improve that architecture. They extend the period of delta or slow-wave restorative sleep.

They are: GHB, gabapentin and trazodone. (Some studies suggest that the ever-popular Ambien belongs on this list but, while it unquestionably improves sleep latency, the evidence of its impact on deep sleep is more equivocal than that for the other three.)

The first two drugs potentiate in different ways the great tranquilizing neurotransmitter in our brains—gamma aminobutyric acid. The third operates on the serotonin system.

GHB has the fewest known side effects. But it has one drawback. It is the “date-rape” drug and so is banned by law, except as the principal component of a super-expensive narcolepsy nostrum called Xyrem.

Gabapentin is legal and useful, but it helps pack on the pounds.

Trazodone is also readily available and efficacious but, in many, it infallibly contributes to penile tumescence.

So the unquiet, aging (male) mind either must remain troubled or, reluctantly, choose to enter one of the states described by the title of this posting.