So we’re moving right along. We’re building on our yoga classes which themselves are building. Thanks to everyone that has attended. If you haven’t please see our day’s and times and rates. You should be pleasantly surprised. As well if you’re suffering body aches make an appointment for massage as we offer Deep Tissue, Swedish and the highly sought after Thai Massage. Based on Slide Scale so everyone can get v.i.p treatment. Also new to the Healing Arts center is New Hope Acupuncture. Slide Scale acupuncture by Miles Rowe. Please make an appointment with Miles and cure what ails ya! We’re excited for all that has developed and so much more to come! Stay posted about our Grand Opening Pot Luck coming soon.
As difficult as it is to get pregnant once you pass your forties, it is so great to hear success stories of those women who have been so lucky to get pregnant on their own or with very little assistance later in life. Below is a story of a first time mom who married for her first time at age 40 and, after six months of trying to get pregnant and not being able to, sought the help of acupuncture and chinese herbs. Here is her story. . .
A number of studies have shown that zolpidem (Ambien), the most commonly prescribed sleep-inducing medication on the market, can produce uncontrollable nocturnal eating behavior among users. Sleep related eating disorder (SRED) is characterized by partial arousals from sleep to ingest food, usually within the first three hours after sleep onset, occurring one to six times per night.1 Patients describe an “automatic” inclination to eat and an inability to return to sleep unless they eat. The foods are often high in calories and ingested in massive quantities.2
The occurrence of zolpidem-induced nocturnal eating is probably more common than currently reported. In a New York Times article3 entitled “Study links Ambien use to unconscious food forays,” Stephanie Saul interviewed Judie Evans, a 59-year-old woman who lived alone and suffered from zolpidem-induced SRED. At the time of her diagnosis, Ms. Evans was recuperating from spinal surgery, wore a full body cast, and always required help to get out of bed. Shortly after her physician prescribed zolpidem for her sleeping difficulties, she noticed that food started to disappear from her home. She initially accused the two nursing aides who were caring for her, but it was not until her son stayed with her for several days that she realized what was really occurring. “During the day, I couldn’t even make it to the bathroom by myself,” Ms. Evans said. However, on the first night he stayed over, her son found her, body cast and all, frying eggs and bacon in the kitchen. The next night, he caught her eating a sandwich and promptly sent her back to bed, but later found her back in the kitchen with the oven turned to 500 degrees, causing the pots stored in the oven to melt.3
Another woman who suffered from SRED was Helen Cary, a labor and delivery nurse in Dickson, Tennessee. Ms. Cary started taking zolpidem to help her sleep through the day so that she could work 12-hour night shifts at the hospital. Although she said that zolpidem helped her survive “five years of night shift,” she felt “very ambivalent” about the medication because while on zolpidem her behavior became very strange. “One day,” she said, “I got up-my husband describes this in great detail-I got a package of hamburger buns and I just tore it open like a grizzly bear and just stood there and ate the whole package. He said a couple things to me until he realized I was asleep.” Ms. Cary no longer takes zolpidem, and has switched to working days.3
Zolpidem is a benzodiazepine agonist that binds to the benzo 1 receptors found in the cortex and cerebellum and creates a hypnotic effect. However, unlike the anxiolytic drugs alprazolam (Xanax) and clonazepam (Klonopin), zolpidem does not bind to the benzo 2 receptors in the striatum, hippocampus, and spinal cord, and is less likely to cause ataxia, dependence, paradoxical disinhibition, withdrawal symptoms and, most importantly, respiratory depression.4 Consequently, many doctors prescribe zolpidem to treat insomnia.
A number of sleep experiments have confirmed the relationship between zolpidem and nocturnal eating. Dr. Michael Silber was one of the first to describe SRED with amnesia in zolpidem users. In a 2002 article,5 he described three cases where nocturnal eating began as a result of starting zolpidem and two cases where pre-existing nocturnal eating increased in frequency.
Melissa Feltmann, a spokesperson for Sanofi-Aventis, the French company that makes zolpidem, defends the safety of the drug. She states that “Sanofi-Aventis has received reports of people eating while sleepwalking and those reports, like all reports of adverse events, have been provided to the U.S. Food and Drug Administration.” Ms. Feltmann says that the package insert for zolpidem warns that the drug may cause a sleep-related eating disorder, but she cautions that every case of SRED in patients taking zolpidem might not necessarily be caused by the drug itself.3
A definitive etiology has not been elucidated, but a number of hypotheses are currently being explored. Dr. Carlos Schenck, a sleep disorders expert at the University of Minneapolis, believes that under the influence of zolpidem, sleeping and eating become confused by the brain.3 Morgenthaler5 and Mahowald6 further elucidate Schenck’s hypothesis. They found that the concurrence of a sleep disorder that increases arousals during slow-wave sleep (e.g. restless leg syndrome; periodic limb movement disorder; obstructive sleep apnea; and withdrawal from nicotine, alcohol, opiates and cocaine) can often lead to SRED in the setting of zolpidem use.
Until researchers discover the exact mechanism by which zolpidem causes SRED, treatment options include targeting the underlying sleep disorder (pramipexole for restless leg syndrome, CPAP for sleep apnea), discontinuing zolpidem, and replacing zolpidem with another benzodiazepine agonist such as eszopiclone (Lunesta) or pyrazolopyrimidine (Sonata).5 Najjar et al. found that despite being in the same medication class as zolpidem, eszopiclone and pyrazolopyrimidine were associated with resolution of SRED.7
Until further studies elucidate the exact mechanisms by which zolpidem induces SRED, physicians should exercise caution when prescribing it, especially in obese or diabetic patients.
John Cruz is a fourth year medical student at NYU Medical Center.
Peer reviewed by Andrea Kondracke MD
References
1) Winkelman JW. Clinical and polysomnographic features of sleep-related eating disorder. J Clin Psychiatry. 1998;59:14-19.
2) Schenck CH, Hurwitz TD, Bundlie SR, Mahowald MW. Sleep-related eating disorders: polysomnographic correlates of a heterogeneous syndrome distinct from daytime eating disorders. Sleep. 1991;14(5):419-431.
3) Saul S. Study links Ambien use to unconscious food forays. NY Times. March 24, 2006. http://www.nytimes.com. Accessed on October 21, 2009.
4) Albers LJ, Hahn RK, Reist C. Handbook of Psychiatric Drugs 2008. Hightown, Lancaster, UK: Current Clinical Strategies:72.
7) Najjar M. Zolpidem and amnestic sleep related eating disorder. J Clin Sleep Med. 2007;3(6):637-638.
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Hello all, this is a first for me, and I come to you with a humble heart.
This spring season, The Wallace Family Apiary lost 20 colonies, and we are down to just 10 colonies. We currently do not use any chemicals in our hives, consequently the colonies that survived did so because of their genetic makeup. The honey bee colonies that have high degree of hygienic traits in their genes are the ones that are survival colonies. These survival colonies are going to be the queens we use to raise/rear our future colonies. We have a goal of having 50-60 strong and healthy colonies this year, and that means splits and divisions. That also means buying established colonies from trusted bee and queen producers, for increase in genetic diversity and for more colonies to be divided for growth and expansion,…and that can be expensive. We believe in being good stewards with the bees that we have been given the responsibility for. You probably know that bees have been hit hard in the past few years, and we need local beekeepers more than ever. You can help us in our goal and in saving the bees, by donating any amount that you wish. If everyone gives a little than we can reach our goal of 50-60 healthy colonies, and we can provide more bees to our neighbors and our local agriculture community. If you want to help and donate, just click on the Donate button, and follow the instructions. Thank you for your support and thank you for helping us.
