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Oral Antibiotics
Oral antibiotics used to treat acne include erythromycin or one of the tetracycline antibiotics (tetracycline, the better absorbed oxytetracycline, or one of the once-daily doses of doxycycline, minocycline or lymecycline). Sometimes doctors prescribe Trimethoprim (off-label use in UK). However, reducing the P. acne bacteria will not do anything to reduce the oil secretion and abnormal cell behavior that is the initial cause of blocked follicles. Additionally antibiotics are becoming less and less useful, as resistant P. acne strains are becoming more common. Acne will generally reappear quite soon after the end of treatment--days later in the case of topical applications, and weeks later in the case of oral antibiotics. Furthermore, side effects of tetracycline antibiotics can include yellowing of the teeth and an imbalance of gut flora, so doctors recommended these treatments after the determining that topical products have no effectiveness. Studies show that sub-antimicrobial doses of antibiotics such as minocycline also improve acne. Doctors believe that the anti-inflammatory property of minocycline also prevents acne. These low doses do not kill bacteria and hence cannot induce resistance.
Sleep Resources
How to Find a Sleep Center and Sleep Medicine Specialist
If a doctor refers a patient to a sleep center or sleep specialist, make sure that center or specialist is qualified to diagnose and treat any sleep problem. To find sleep centers accredited by the American Academy of Sleep Medicine, go to http://www.aasmnet.org and click on "Find a Sleep Center," or call 708-492-0930. To find sleep specialists certified by the American Board of Sleep Medicine, go to http://www.absm.org and click on "Diplomates of the ABSM."
For More Sleep Information
National Center on Sleep Disorders Research
National Heart, Lung and Blood Institute National Institutes of Health
6705 Rockledge Drive Suite 6022
Bethesda, MD 20892-7993
Telephone: 301-435-0199
Fax: 301-480-3451
Email: ncsdr@nih.gov
Website: http://www.nhlbi.nih.gov/sleep
NHLBI Health Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Telephone: 301-592-8573
TTY: 240-629-3255
Fax: 301-592-8563
Email: nhlbiinfo@nhlbi.nih.gov
Website: http://www.nhlbi.nih.gov
Garfield Star Sleeper Web site (for children, parents and teachers) http://starsleep.nhlbi.nih.gov
NIH Office of Science Education Website (for high school supplemental curriculum: Sleep, Sleep Disorders and Biological Rhythms) http://science.education.nih.gov
Resources from Other Sleep Organizations:
American Academy of Sleep Medicine (AASM)
One Westbrook Corporate Center, Suite 920
Westchester, IL 60154
Telephone: 708-492-0930
Fax: 708-492-0943
Website: http://www.aasmnet.org
American Insomnia Association (same address/phone as AASM)
Email: rmoney@aasmnet.org
Website: http://www.americaninsomniaassociation.org
American Sleep Apnea Association
1424 K Street, NW Suite 302
Washington, DC 20005
Telephone: 202-293-3650
Fax: 202-293-3656
Website: http://www.sleepapnea.org
Narcolepsy Network, Inc.
P.O. Box 294
Pleasantville, NY 10570
Telephone: 401-667-2523
Fax: 401-633-6567
Email: narnet@narcolepsynetwork.org
Website: http://www.narcolepsynetwork.org
National Sleep Foundation
1522 K Street, NW Suite 500
Washington, DC 20005
Telephone: 202-347-3471
Fax: 202-347-3472
Email: nsf@sleepfoundation.org
Website: http://www.sleepfoundation.org
Restless Legs Syndrome Foundation
819 Second Street, SW
Rochester, MN 55902--2985
Telephone: 507-287-6465
Fax: 507-287-6312
Email: rlsfoundation@rls.org
Website: http://www.rls.org
What Makes People Sleep?
Although people may put off going to sleep in order to squeeze more activities into the day, eventually the need for sleep becomes overwhelming and people must get some sleep. This daily drive for sleep appears to be due, in part, to a compound known as adenosine. This natural chemical builds up in the blood as time awake increases. While people sleep, the body breaks down the adenosine. Thus, this molecule may be what the body uses to keep track of lost sleep and to trigger sleep when needed. An accumulation of adenosine and other factors might explain why, after several nights of less than optimal amounts of sleep, people build up a sleep debt that people must make up for by sleeping longer than normal. Because of such built-in molecular feedback, people cannot adapt to getting less sleep than the body needs. Eventually, a lack of sleep catches up with everyone.
The internal "biological clock" and environmental cues govern time of day when people feel sleepy and go to sleep. The most important cues are light and darkness. The biological clock is actually a tiny bundle of cells in the brain that responds to light signals received through the eyes. When darkness falls, the biological clock triggers the production of the hormone melatonin. This hormone makes people feel drowsy as it continues to increase during the night. Because of the biological clock, people naturally feel the sleepiest between midnight and 7 AM. People may also feel a second and milder daily "low" in the mid-afternoon between 1 PM and 4 PM. At that time, melatonin production rises again and might make people feel sleepy.
The biological clock makes people the most alert during daylight hours and the drowsiest in the early morning hours. Consequently, most people do very good work during the day. In a 24/7 society, however, some people must work at night. Nearly one-quarter of all workers work shifts that are not during the daytime and more than two-thirds of these workers have problems with sleepiness and/or difficulty sleeping. Because some work schedules are at odds with powerful sleep-regulating cues like sunlight, night shift workers are often drowsy at work and have difficulty falling or staying asleep during the daylight hours.
The fatigue experienced by night shift workers can be dangerous. Major industrial accidents--such as the Three Mile Island and Chernobyl nuclear power plant accidents and the Exxon Valdez oil spill--are results of mistakes made by overly tired workers on the night shift or an extended shift.
Night shift workers also are at greater risk of being in car crashes when driving home from work. One study found that one-fifth of night shift workers had a car crash or a near miss in the preceding year because of sleepiness on the drive home from work. Night shift workers are also more likely to have physical problems, such as heart disease, digestive disturbances and infertility, as well as emotional problems. All of these problems can relate to the workers' chronic sleepiness. See "Working the Night Shift" for some helpful tips.
Other factors can also influence the need for sleep, including the production of cellular hormones called cytokines by the immune system. These compounds occur in large quantities in response to certain infectious diseases or chronic inflammation and may prompt a person to sleep more than usual. The extra sleep may help the person conserve the resources needed to fight the infection. Recent studies confirm that people who rest enough are improving the ability of the body to respond to infection.
People are creatures of habit and one of the hardest habits to break is the natural wake and sleep cycle. A number of physiological factors conspire to help people sleep and wake up at the same times each day. Consequently, people may have a hard time adjusting when traveling across time zones. The light cues outside and the clocks in a new location may suggest it is 8 AM and to should be active, but the body believes it is more like 4 AM and to should sleep. The result is jet lag--sleepiness during the day, difficulty falling or staying asleep at night, poor concentration, confusion, nausea and general malaise and irritability.
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