Trouble sleeping? Learn what treatments may help

If you have trouble getting to sleep, staying asleep, or getting good quality sleep, you’re not alone, although it can feel that way in the middle of yet another sleepless night. According to statistics compiled by the American Sleep Association, 50 to 70 million adults in the U.S. have a sleep disorder, and the number could be higher because many people don’t seek help from a physician for their sleep problems.

Occasional trouble sleeping is common, but if you or a family member has ongoing sleep problems, you should talk with your primary care physician. He or she may recommend that you see a sleep medicine specialist to find out what condition is causing your problem.

While there are about 80 different types of sleep disorders, the most common ones include:

• Insomnia
• Sleep apnea
• Restless leg syndrome
• Narcolepsy
  

The symptoms of common sleep disorders

Each type of sleep problem is characterized by certain symptoms. Knowing what symptoms to look for and how to describe them to your doctor can help you get an accurate diagnosis. The symptoms you should be aware of include:

• For insomnia: The main insomnia symptoms are difficulty falling asleep, waking during the night and being unable to fall back asleep, and waking too early. People with chronic insomnia experience these symptoms at least three times a week and symptoms continue for at least three months.
• For sleep apnea: There are two types of sleep apnea. Obstructive sleep apnea occurs when the airway is blocked by the soft tissue in the throat. Symptoms include loud or frequent snoring, restlessness during sleep, gasping for air during sleep, daytime sleepiness, fatigue, and trouble concentrating. Central sleep apnea is caused by a dysfunction in the brain. Basically, the brain fails to tell the body to breathe for a short period. People with this form of the disorder may gasp for air in their sleep and wake frequently during the night.
• For restless leg syndrome: People with this syndrome feel an intense urge to move their legs when resting, for example lying in bed or sitting for a long time. Some people also experience tingling in their legs.
• For narcolepsy: Narcolepsy is a neurological disorder. People with this condition are excessively sleepy and experience uncontrollable episodes of falling asleep during the day. Some people also have periods of sudden muscle weakness, hallucinations, and episodes of sleep paralysis.

Getting the right diagnosis

Before referring you to a sleep specialist, your primary care doctor will talk with you about your sleep problems and may check for underlying health problems that have similar symptoms, such as allergies and asthma that can make breathing more difficult, a seizure disorder, or depression. Your primary care doctor may also ask you to keep a sleep diary for a few weeks. This can help identify the types of symptoms you experience and their frequency and severity.

The next step in diagnosing your condition may be a sleep study, which is also known as polysomnography. The test is non-invasive and usually requires you to spend a night or two at a sleep facility. If your doctor suspects you may have narcolepsy, a daytime sleep study will also be recommended. During the test, monitors and electrodes are attached to your head, legs, and chest and record data about brain wave activity, eye movement, muscle tone, heart rhythm, and breathing. In some cases, these tests can be performed at home.

Understanding your treatment options

The type of treatment your doctor recommends will depend on the sleep problem you’re diagnosed with and its severity.

• Insomnia treatments: If your inability to sleep is caused by pain from a condition like arthritis or depression or anxiety, your doctor will treat these underlying causes first to see if your sleep improves. Additional treatments can include improving your sleep habits (no screens in bed, avoiding caffeine, regularizing bedtime and waking time); cognitive behavioral therapy; and stress management techniques such as meditation or guided breathing exercises. If these treatments don’t provide enough relief, your doctor may prescribe sleeping pills or certain antidepressants.
• Sleep apnea treatments: For both types of sleep apnea, your doctor may recommend using a continuous positive airway pressure (CPAP) device or another airway pressure device. There are also oral devices for sleep apnea that bring your jaw forward to keep your throat open. For central sleep apnea, your doctor may recommend using supplemental oxygen while sleeping or taking medications that stimulate breathing.
• Restless leg syndrome treatments: Your doctor’s first suggestion may be lifestyle changes, including avoiding alcohol and tobacco, taking part in regular exercise, massaging your legs before bed, and using a heating pad or ice pack. If you have low iron levels, a risk factor for restless leg syndrome, your doctor will recommend iron supplements. Anti-seizure medications and medications used to treat Parkinson’s disease may also be prescribed.
• Treatments for narcolepsy: Most of the symptoms of narcolepsy can be controlled with medications. Stimulant medications are prescribed to counter daytime sleepiness. There are also several medications that can be prescribed to treat REM disturbances and muscle weakness, including antidepressants and a medication called Xyrem (sodium oxybate).