Dr Neil Stanley Independent Sleep Expert
BACK James J. Walsh, ‘Insomnia as a Dread’, Medical Review of Reviews, xxxiii (1917), 130–1. I can find no criticism of other physicians in this passage INSOMNIA AS A DREAD Author's Abstract James J. Walsh, of New York, in the December number of the International Clinics calls attention to the fact that insomnia, that is essential or so-called idiopathic insomnia, for which no direct cause can be found in the physical condition of the patient should be looked upon as a dread and treated as such. Patients actually keep themselves awake fearful lest they are not going to sleep and solicitous as to the serious consequences of their wakefulness. This is true whether their 'nocturnal vigilance,' as one medical lover of long words called it, is of he kind that manifests itself at the beginning of the night or toward the end. Dr Walsh warns of course that it will often be found that wakefulness at the beginning of the night is due to the drinking of tea or of coffee or some times in young folks and especially children of drinks containing caffeine, some of which are dispensed very commonly in drug stores. Loss of sleep in the later part of the night or in the early morning rather is due to  hunger oftener than to anything else. Patients should be relieved of their anxiety just as far as possible. The dread name insomnia, which as so many newspaper suggestions and innuendos insist carries with it the danger of resultant insanity or nervous breakdown, should not be used, but the patient's condition should be simply called wakefulness. No one has ever been hurt  by wakefulness alone provided he or she has been in bed for eight hours. It seems to make no difference whether people sleep or not, because there are a large number of cases on  record now where people either have been awake or have been fully persuaded that they were awake and not a few of them were reasonably intelligent people, university professors and the like, nearly every night for weeks or even months at a time and yet have survived without in jury to health. Old physicians will often tell of their own experience with wakefulness and their solicitude with regard to its effect upon their health and yet they are alive to tell the story at past eighty years of age. People inclined to be wakeful should read quietly, have something to read near them if they do not sleep and should be sure that they have good airy rooms and be persuaded that no harm will come to them and that nature will take whatever sleep she needs. The dread of insanity after insomnia is unfounded. People on the way to the asylum are sometimes wakeful, but their wakefulness is the effect and not the cause of their insanity. There are always other signs of the insanity, and wakefulness or insomnia is never the first. Sleep is largely a habit and people who have been accustomed to go to bed at midnight or later and then try to go at ten o'clock will unless they have been out a great deal during the day commonly not sleep until their usual hour. If they become solicitous then they readily keep themselves awake, worrying about their sleep.  Insomniaphobia is just such a dread as akrophobia the dread of heights or agoraphobia the dread of open spaces or claustraphobia the dread of narrow places, or the dread of the dark, all of which are quite unreasoning: fears that disturb people very much. To give drugs for them is always a mistake. Certain physical measures, a hot foot bath taken for ten minutes, a glass of warm milk with some nutmeg, scattered rather plentifully over its surface, a hot water bottle to the feet, mas sage of the muscles of the head which keep people from feeling certain muscle tightnesses which they are often prone to call headache, all these with even a cool pack in the summer time may be employed, but drugs for wakefulness never do good and always do harm. BACK
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