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Getting a good night's sleep is so easy for the majority but, when something goes wrong with this natural reaction to physical tiredness, the way you feel the next day can be serious. It can be simply that you feel excessively tired. You walk around in a daze, feeling as if you had no sleep at all. This can affect your performance at work because you find it more difficult to concentrate. Moods can also change for the worse with you feeling more irritable and bad tempered. Headaches become more common.

One quite understandable reaction is to reach for the ambien bottle which has a proven track record for helping people get to sleep and stay asleep for longer. But, like many conditions, insomnia is not "cured" by taking medication. The best that ambien can do is to give relief to the immediate symptoms. In the long term, cognitive behavioural therapy provides a "cure" in most cases. So the answer is just walking into your local doctor's surgery and get an appointment? Well, not necessarily.

In an increasing number of rural and urban areas in the US, there is a widening gap between the supply of primary care physicians and the demand for their services. Because pay levels are lower than in hospitals and the debts from medical school are higher, only about a quarter of newly qualified physicians go into general practice. It can now take months to get an appointment as the population ages and more boomers require treatment. The shortage of doctors is also highlighted in states like Massachusetts where new health insurance legislation is restoring cover to many who have gone years without insurance. It is an irony that universal health cover is meaningless without a significant increase in the number of doctors in general practice. This situation will only grow worse as older doctors retire over the next decade. As it applies to insomnia, not only is there is a shortage of physicians but also of therapists.

Against this background, it was interesting to see a new potential solution for the treatment of insomnia. It has long been known that as people fall asleep, the circulation of blood slows and more blood stays longer in the arms and legs. As a result, the hands and feet warm slightly. In the Center for Sleep Medicine in New York, specialists have begun to train insomniacs in the use of biofeedback techniques to replicate this physical response.

It usually takes between two and three hours of training spread over a number of weeks for the brain to learn how to control the body's heart rate, circulation and temperature rise. About 90% of those taking part in the experiment have mastered the necessary skills and have found it easier to get to sleep. Although biofeedback and relaxation skills have been used alongside or as an alternative to ambien for some time, this is one of the first major centers to run a full-scale training exercise. If this technique can be proved effective in a statistically significant number of ordinary people rather than volunteers patient and persevering enough to learn a physical skill, it could be a highly cost-effective solution to a difficult medical problem.

As it stands, physicians are forced into the expedient of prescribing ambien to treat insomnia because there are too few therapists. The heart and temperature monitors are relatively cheap. If demand rose, the price would drop further. A simple "how to" guide plus the equipment might be all that many people need to relearn the art of failing asleep.


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