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SLEEP DISORDERS TREATMENTS |
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Treatment for a sleep disorder depends
on what is causing the disorder. For example, if major depression is
the cause of insomnia, then treatment of the depression with
antidepressants should resolve the insomnia. Medications Sedative or hypnotic medications are generally recommended only for insomnia related to a temporary stress (like surgery or grief) because of the potential for addiction or overdose. Trazodone, a sedating antidepressant, is often used for chronic insomnia that does not respond to other treatments. Sleep medications may also cause problems for elderly patients because of possible interactions with their other prescription medications. Among the safer hypnotic agents are lorazepam, temazepam, and zolpidem. Chloral hydrate is often preferred for short-term treatment in elderly patients because of its mildness. Short-term treatment is recommended because this drug may be habit forming. Narcolepsy is treated with stimulants such as dextroamphetamine sulfate or methylphenidate. Nocturnal myoclonus has been successfully treated with clonazepam. Children with sleep terror disorder or sleepwalking are usually treated with benzodiazepines because this type of medication suppresses stage 3 and stage 4 NREM sleep. Psychotherapy Psychotherapy is recommended for patients with sleep disorders associated with other mental disorders. In many cases the patient's scores on the Beck or Zung inventories will suggest the appropriate direction of treatment. Sleep education "Sleep hygiene" or sleep education for sleep disorders often includes instructing the patient in methods to enhance sleep. Patients are advised to: Wait until he or she is sleepy before going to bed. Avoid using the bedroom for work, reading, or watching television. Get up at the same time every morning no matter how much or how little he or she slept. Avoid smoking and avoid drinking liquids with caffeine. Get some physical exercise early in the day every day. Limit fluid intake after dinner; in particular, avoid alcohol because it frequently causes interrupted sleep. Learn to meditate or practice relaxation techniques. Avoid tossing and turning in bed; instead, he or she should get up and listen to relaxing music or read. Lifestyle changes Patients with sleep apnea or hypopnea are encouraged to stop smoking, avoid alcohol or drugs of abuse, and lose weight in order to improve the stability of the upper airway. In some cases, patients with sleep disorders related to jet lag or shift work may need to change employment or travel patterns. Patients may need to avoid rapid changes in shifts at work. Children with nightmare disorder may benefit from limits on television or movies. Violent scenes or frightening science fiction stories appear to influence the frequency and intensity of children's nightmares. Surgery Although making a surgical opening into the windpipe (a tracheostomy) for sleep apnea or hypopnea in adults is a treatment of last resort, it is occasionally performed if the patient's disorder is life threatening and cannot be treated by other methods. In children and adolescents, surgical removal of the tonsils and adenoids is a fairly common and successful treatment for sleep apnea. Most sleep apnea patients are treated with continuous positive airway pressure (CPAP). Sometimes an oral prosthesis is used for mild sleep apnea. Alternative treatment Some alternative approaches may be effective in treating insomnia caused by anxiety or emotional stress. Meditation practice, breathing exercises, and yoga can break the vicious cycle of sleeplessness, worry about inability to sleep, and further sleeplessness for some people. Yoga can help some people to relax muscular tension in a direct fashion. The breathing exercises and meditation can keep some patients from obsessing about sleep. Homeopathic practitioners recommend that people with chronic insomnia see a professional homeopath. They do, however, prescribe specific remedies for at-home treatment of temporary insomnia: Nux vomica for alcohol or substance-related insomnia, Ignatia for insomnia caused by grief, Arsenicum for insomnia caused by fear or anxiety, and Passiflora for insomnia related to mental stress. Melatonin has also been used as an alternative treatment for sleep disorders. Melatonin is produced in the body by the pineal gland at the base of the brain. This substance is thought to be related to the body's circadian rhythms. Practitioners of Chinese medicine usually treat insomnia as a symptom of excess yang energy. Cinnabar is recommended for chronic nightmares. Either magnetic magnetite or "dragon bones" is recommended for insomnia associated with hysteria or fear. If the insomnia appears to be associated with excess yang energy arising from the liver, the practitioner will give the patient oyster shells. Acupuncture treatments can help bring about balance and facilitate sleep. Dietary changes like eliminating stimulant foods (coffee, cola, chocolate) and late-night meals or snacks can be effective in treating some sleep disorders. Nutritional supplementation with magnesium, as well as botanical medicines that calm the nervous system, can also be helpful. Among the botanical remedies that may be effective for sleep disorders are valerian (Valeriana officinalis), passionflower (Passiflora incarnata ), and skullcap (Scutellaria lateriflora). |
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| SLEEP DISORDERS RELATED ITEMS | ||
