Sleep Disorders

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Questions to Ask Your Doctor about Sleep Disorders
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Treatment

Treatment for sleep disorders depends on the cause and may include improvements in sleep hygiene (e.g., going to bed at the same time each day) and lifestyle modifications (e.g., avoiding caffeine, exercising daily, weight loss), medications, and other treatments.

Insomnia
If sleep studies do not indicate a pathological (related to disease) cause, improving "sleep hygiene" is the best way to treat insomnia. This means consuming less caffeine, avoiding exercise late in the evening, and engaging in a regular relaxation routine before bedtime. For some people, watching TV at night is actually too stimulating and may keep them from falling asleep.

In most cases, sedatives should only be used on a short-term basis; however, some people require long-term drug therapy. Antidepressants (e.g., trazadone [Desyrel®]) may be effective in these patients.

Sleep Apnea
For patients who are overweight, a weight loss program can be helpful in treating obstructive sleep apnea. Avoiding sleeping on the back also can help relieve the condition.

Devices also are available that a person can wear during sleep. A CPAP (continuous positive airway pressure) machine can be used to apply pressure to the upper airway, preventing obstruction and keeping the airway open. Patients wear a small mask connected to the machine that provides pressure while they are sleeping.

Patients with treatable conditions, such as enlarged tonsils or a large deviated septum, may benefit from surgery. Patients with sleep apnea should never take sleeping pills because they can prevent the person from waking up enough to start breathing again.

Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD)
These disorders may be treated using medication.

Narcolepsy
There is no cure for narcolepsy, but symptoms can be managed with medication. Drugs used to treat symptoms of narcolepsy include stimulants (e.g., methylphenidate [Ritalin®], modafinil [Provigil®]), tricyclic antidepressants (e.g., imipramine, chlorimimipramine), selective serotonin reuptake inhibitors (SSRIs; e.g., fluoxetine [Prozac®], and central nervous system depressants (e.g., sodium oxybate [Xyrem®]).

Many of these drugs are addictive and can have serious side effects. It is important for people with narcolepsy to get a good night's sleep.

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