Before a doctor can treat any sleep disorder, he/she needs to determine whether the patient is experiencing a sleep disruption, or whether it is indeed a sleep disorder.
Sleep disruptions have a discernible cause, such as work stress or financial problems, or temporary illness, whereas sleep disorders are more long-term, and do not resolve themselves over time.
Ideally, as sleep disorders (and even sleep disturbances) are so disruptive, and potentially harmful, several health professionals should be involved in diagnosing and treating the condition.
These include a dietician, a psychiatrist, a pulmonologist, a neurologist, a sleep specialist and possibly a psychologist if anxiety issues are contributing to the problem. One should always remember that sleep disruptions, if not resolved swiftly, can become sleeping disorders.
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Behavioural therapy. Cognitive behavioural therapy can address the anxiety someone experiences because of not being able to fall asleep. When experiencing sleep disturbances, anxiety over specific issues is often an underlying factor. These need to be addressed and managed before the sleep disturbance becomes a sleep disorder.
Lifestyle issues/sleep hygiene. Better sleep habits can go a long way toward treating sleep disturbances, and sometimes managing certain sleeping disorders. Things to do include avoiding daytime naps, heavy meals or exercise late at night, going to bed at the same time every night (and getting up at the same time) and ensuring one's bedroom environment is conducive to sleep. Maintaining an ideal weight is also important.
Identifying and treating underlying conditions. Ideally, in serious cases, the evaluation team should include a psychiatrist, a neurologist, a pulmonologist, a dietician and a sleep specialist. Many conditions, such as diabetes, arthritis, heart problems, depression, thyroid disease, nocturia and heartburn can affect the quality of one’s sleep.
A disrupted sleeping pattern is often one of the first symptoms of other conditions. It is also important for a doctor to check whether a sleep disorder could be related to medication that is taken to treat other conditions.
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Medication. When it comes to treating sleep disorders, there are over-the-counter medication and prescription medicines. Most doctors will try finding other solutions for sleeping problems before they resort to prescription medication, as these are often habit-forming, and could lose their efficacy over time.
Different sleeping tablets have very different effects: some are for short-term use only such as benzodiazepines. Others merely help initiate sleep, whereas others are there to maintain sleep. Others increase melatonin (a naturally occurring hormone involved in the sleeping process) levels.
There are also those that help you fall asleep, but do not stay in the body for long and do not cause a feeling of fatigue the following day, as some sleeping medications do. Then there are antidepressants that cause drowsiness and promote sleep by increasing serotonin levels.
Sedatives are often used to treat insomnia, stimulants to treat narcolepsy or sleep apnoea. Melatonin tablets (OTC) can be used in the treatment of circadian rhythm disorder and jet lag.
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Use of devices. This is only considered when treating sleep apnoea. A device called CPAP (continuous positive airway pressure) sends a constant stream of air through the nose and into the airway, keeping the airway open during sleep. This puts an end to the breathing problems experienced by sleep apnoea patients.
Surgery. Snoring and sleep apnoea can sometimes be treated by removing the sites of obstruction in the nose, throat, tongue and palate. CPAP, while being the first line treatment option, can be uncomfortable (tight mask, not being able to fall asleep with air blown into the nose) and is not always successful.
Managing sleep disorders
Diagnosing sleep disorders
Types of sleeping disorders
(References: sleepapnoea.org; sleepfoundation.org; sleepdisorders.about.com)