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Steven M. Scharf, M.D., Ph.D.

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Sleep disorders

Treatment:

INSOMNIA

The treatment is related to the cause, if the cause can be determined. If there is an obvious physical or psychological disorder causing insomnia, it should be treated. Depression is a very common cause of insomnia and can usually be treated with medication, cognitive behavioral therapy, or interpersonal therapy.

Attempts to control environmental and lifestyle factors should be made; these factors include:

Sleeping drugs should be used only when prescribed by a health care provider.

HYPERSOMNIA

Sleep apnea is treated with weight reduction and the administration of air under pressure through the nose. Occasionally, surgery or other measures may be needed.

Narcolepsy is treated by use of stimulating medications during the daytime. A new medication called modafanil seems to have fewer side effects than traditional stimulants. It is FDA-approved for narcolepsy and has recently been approved for shift work sleep disorder.

Restless leg syndrome is treated by treating the underlying disorder and with opiate or dopaminergic agonists -- these are medications that work by stimulating the receptors for dopamine and opiates in the brain.

PARASOMNIA

Night terrors are treated with hypnosis, guided imagery techniques and benzodiazepines, but safety measures may be needed to prevent people from harm during nighttime walking.

Sleep disorder clinics often are able to help people restore normal sleeping patterns through various techniques.

Expectations (prognosis):

The outcome varies with the type of disorder. Some disorders may clear up on their own.

Complications:

A complication is dependence upon sedatives or other medications prescribed for sleep disorders.

Calling your health care provider:

Call for an appointment with your health care provider if lack of sleep or too much sleep is interfering with daily living.

Also call if non-breathing spells are observed during sleep.

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