Garth Rattray

Only 60.4 per cent of the electorate 'spoke' on September 3. Given the proximity of the votes (both the popular vote and the parliamentary seat count) - their message was either one of equivocalness or (as Mr. Golding sees it) a wish for political cooperation.

The narrow Jamaica Labour Party win may render them impotent; therefore, Mr. Golding's conciliatory entreatment of "constructive engagement" was well timed and masterfully executed. Unfortunately, having endured the nail-biting preliminary election results and final counts, we must remain on tenterhooks until the protestations and legal challenges are resolved.

Whatever transpires eventually, we've earned a well-deserved rest. Certainly, the timing of 'Sleep Week' (a Sanofi Aventis regional activity) could not be more appropriate; not only for regular insomniacs but also for stressed-out politicians and their retinue, the pollsters, the various electoral planning and oversight bodies, the electorate and the businesspeople that financed their chosen party. In commemorating 'Sleep Week', Sanofi Aventis has scheduled a pharmacy focus; a medical meeting; an appreciation day and an interview during the 'Dear Pastor' programme on Power 106 at 9:45 tonight.

Educating the public

The interview is an attempt at sensitising and educating the general public about insomnia because sleep deprivation often goes undiagnosed, underdiagnosed or given scant regard, it can be deleterious to our health. Contrary to popular belief, people of all ages need 7-8 hours of restful sleep each night. Insomnia is repeated poor quality or inadequate sleep (in spite of ample opportunities and available time) that results in daytime impairment. Insomnia is twice as common in women as in men.

It is characterised by difficulty in falling asleep, difficulty staying asleep, waking up too early or un-refreshing sleep (even after a full night's 'sleep'). Insomnia may be, transient (less than one week); short term (one to four weeks); intermittent (on and off) or chronic (at least three nights per week for over one month). Chronic insomnia may be primary (unrelated to anything else) or secondary (caused by existing medical conditions, chronic pain, medication, substance abuse, stress, hot flashes, depression, poor sleep environment or night work).

Insomnia can result in daytime sleepiness, fatigue, impaired cognition (reasoning/thinking/perception), memory problems, irritability, major depression, inability to focus, drug/alcohol abuse, cardiovascular problems, slower reaction time and a likelihood of accidents (sometimes fatal). Being awake for 24 hours is as impairing as drunkenness. Fatigue can also augment the effects of alcohol and medications.

Rhythm dysynchronisation

Special mention must be made of shift workers because they experience rhythm dysynchronisation - the repeated misalignment between the worker's sleep pattern and the social norm. These chronically sleep deprived people suffer health and family problems. Shift work induced insomnia has been blamed for the Exxon Valdez oil spill in Alaska, the Chernobyl nuclear reactor meltdown in Russia, the Bhopal chlorine gas leak, the radiation gas cloud in Pennsylvania and even the NASA Challenger disaster. Here in Jamaica mistakes made by government doctors, nurses and air traffic controllers suffering from 'shift work sleep disorder' may prove fatal to the many people that depend on their alertness and efficiency, those professions remain understaffed.

Insomnia is best diagnosed by obtaining a thorough history from the patient and perhaps his/her sleep partner. Patients should keep a sleep diary. Insomnia may correct itself but, if not, it is treated by removing stimulants from the system, identifying and eliminating causative medications, relaxation therapy, stress control, sleep restriction (to set hours), reconditioning (using the bedroom only for bedroom activities), by using short-term medications (hypnotics) and/or melatonin for rest and circadian rhythm realignment.