3 Q's re: TrueHope, Sleep Aids, Dawn Simulator Risks
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Q:  3 Q's re: TrueHope, Sleep Aids, Dawn Simulator Risks

 
1. Can fish oils be taken in conjuntion with TrueHope?

2. Can TrueHope lead to toxicity issues?

3. Can St. Johns Wort be taken in conjuction with either of the above?  Are there any long/short term risks with St. Johns Wort?

4. Can Valerian Root be taken in conjuntion with all/any of the above?  Are there any long/short term risks with taking Valerian Root?

Thank You
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Can you recommend a good sleep aid for assistance with falling asleep, but one that doesn't have drowsiness the next day? 

I have racing thoughts at night and just need help falling asleep.  Once I'm asleep I'm fine.  Prescription meds I've tried incapacitate me the next day from drowsiness.

Thank you.

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Is there less risk for developing macular degenration from using a dawn simulator than a light box?

If yes, is there any risk from using a dawn simulator?

Thank you


Dear David--

I will start with your second question as it may be the most satisfying, perhaps for both of us.

I believe there is indeed a "good sleep aid for assistance with falling asleep that does not cause drowsiness the next day", and the bonus is that it is not a medication. It does not have evidence for effectiveness from "randomized trials", with a comparison versus a placebo approach, and therefore should be viewed with considerable suspicion as to whether it really works. However, if it does not work, it appears extremely unlikely that it could somehow be of any harm, as you may judge for yourself from the following story.

This is the very brief version; a more thorough explanation can be found on my website in an essay called "
Bipolar Disorder: Light and Darkness--Treatment Implications". The bottom line is this: there is a very good evidence to suggest that our brains are sensitive to light such that it can interfere with sleep (indeed, this is the very means by which the dawn simulator is supposed to work). However, not all wavelengths of light matter, in this context: only blue light. The science behind this is very good. Therefore it appears possible that one can "have one's darkness and one's light" at the same time, by using a filter at night to block blue light.

In practice this amounts to putting on a pair of safety glasses, which can fit over reading glasses, at about 8 p.m. if the goal is to fall asleep around 10 p.m.. The glasses required filter out light but allow other wavelengths of light to pass unaffected (they are a medium amber color). These cost about $40 (there are much cheaper ones, but they are much less effective at blocking blue light, which is critical for this to work). About half of the patients who have tried this at my direction report quite impressive results. I started using them about six months ago for patients and have several who are still using them regularly. However, beyond this, the approach is unstudied.

As for your first question:  The questions you are asking here all lead to rather frustrating answers. We have almost no safety data on any of these compounds (a little bit on fish oil, which has been studied and shown to contain little or no heavy metal, depending on which brand one chooses, all theoretically below levels sufficient to raise toxicity concerns). It would be yet another step to study the kinds of interactions you mention here. As for True Hope and its toxicity, that too is completely unstudied.

Finally, as you may have seen on my
webpage about light therapy, at present it is thought that even a bright light box poses no significant risk for macular degeneration (see the extended discussion of safety issues at the bottom of that page). Therefore the question of the relative risk of the dawn simulator is moot. However, it is true that if one took the most dire possible interpretation of light therapy risk, then the dawn simulator would be preferable, as it simply uses a low intensity bedside lamp, such as with a 60 W incandescent bulb. On that same webpage, you'll see more about dawn simulators.

Thank you for the interesting questions. I hope that helps.

Dr. Phelps


Published March, 2007
 
 

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