Nightmares occur during REM sleep and the child or adult wakes and can remember not only at that time but the next day, most of the details of the dream which caused the awakening.

Sleep paralysis, or hallucination to sight and sound may occur in children and adults and it is often most marked when they are just drifting off to sleep.

They are of no significance but may cause anxiety.

Narcolepsy is a specific disorder with episodes of severe lethargy during the day so that the person must sleep.

This sleep can last for minutes or hours and may recur throughout the day.

Probably the worst treatment for insomnia is to get into the habit of taking sleeping tablets.

These are satisfactory for the short term, taken for a few nights or even a week or two, but if their use is prolonged beyond this then dependence and tolerance may develop.

Most people with sleep problems just need simple reassurance and help in modifying their habits so as to gain the benefits of a good night’s sleep.

For others with marked disturbance it may be necessary to refer them to special clinics which are being developed in many major hospitals.

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Injections of a hormone prepared from the urine of pregnant women, chorionic gonadotrophin or HCG, has been popular in some weight reducing clinics. But controlled studies have shown that it is the diet, the daily visits to the clinic and the encouragement the patients receive that causes the weight loss — and not the injection.

Motivation is all-important in losing weight. Overweight people who have had a heart attack usually lose weight rapidly and maintain their ideal weight. The aim should be to provide that motivation before the heart attack.

I think it is important for the person trying to lose weight to have the help and encouragement of someone else. If this is to be the doctor, then he or she needs to see the patient regularly to check weight loss, encourage, praise, cajole or abuse the patient.

Some patients react better to one of these methods than to others. Some need all measures at different times. Group therapy can be useful and this is why self-help organisations such as Weight Watchers have success.

Many people will seek less orthodox means and have acupuncture or hypnosis to help them control their eating. Others have had their jaws wired together so they cannot eat solid food. Some people even resort to surgery to lose weight. There is an operation called an apronectomy where the surgeon can remove the apron of fat from the abdomen. It certainly is a quick, if expensive, way to shed 10 kg.

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