Q&A: sleep aids vs. sleeplessness; how to check blood pressure at home; light boxes for seasonal depression; & soy and breast cancer risk
ICYMI 👉
In this week’s reader-submitted Q&A, we’re tackling these questions:
What’s worse—the side effects of sleep medicines or not sleeping?
How can I accurately measure my blood pressure at home?
Do light boxes help with seasonal blues?
Is it safe to eat soy if I have breast cancer?
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Disclaimer: The views expressed here are entirely my own. They are not a substitute for advice from your personal physician.
The following subscriber questions have been lightly edited for length and clarity.
QUESTION #1: SLEEP AIDS VS. SLEEPLESSNESS
Hi Dr. McBride, My name is Cindi. I’m 70 years old and I’m not sleeping well, and I haven’t for a very long time. I quit drinking two years ago and I slept better for a little while after that, but then got back to a bad pattern of not sleeping. So my question is: what’s worse- the side effects from a sleeping aid (not Ambien but I mean other sleep aids that you can buy without a prescription) or not sleeping? I would love an answer to that question. Thank you!
Great question, Cindy. The choice between taking a sleep aid and not sleeping depends on the context and the underlying causes of the sleep problem. Let me explain. Sleep aids may be the lesser of two evils in short-term cases like jet lag, temporary stress, or recovering from surgery. The potential downsides of sleep aids are that long-term use can lead to psychological or physiological dependence, where it becomes difficult to sleep without the aids. Sleep aids also can cause side effects such as daytime drowsiness, cognitive impairment, or an increased risk of falls, particularly in older adults.
Perhaps most importantly, sleep aids might mask, rather than address, the root causes of insomnia, such as stress, anxiety, sleep apnea or a side effect from a medication.
What about the effects of not sleeping? Missing a single night of sleep can lead to irritability, reduced cognitive function, and impaired decision-making. Chronic sleep deprivation can have more severe consequences, including weakened immune function, increased risk of chronic conditions (e.g., heart disease, diabetes), and impaired mental health.
The upshot: if the choice is between no sleep and using a sleep aid in the short term, a properly used sleep aid may be what you need. But long-term reliance on sleep aids is not ideal. Addressing the root cause of sleep difficulties through lifestyle changes, cognitive behavioral therapy for insomnia (CBT-I), or other treatments is preferable.
Here is my recent post about sleep hacks and sleep aids. I hope it helps!
QUESTION #2: HOW TO CHECK BLOOD PRESSURES AT HOME
Hi Dr. McBride- I am a former patient of yours who moved across the country and still follow your advice here! So thank you. My question today is this- I have high blood pressure so I check the readings at home using my own machine. But they vary so much I have no idea what to believe. Do you have any advice on how to check it properly?
-Sonia
Dear Sonia,
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