10 Common Sleep Disorders: Treatments and Truths
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Oct 7, 2020.
Nightmares - vivid and frightening dreams associated with a feeling of anxiety or fear - are most common in children, but can happen at any age. Dreams occur during the stage of sleep known as rapid-eye movement (REM), usually in the last half of sleep.
Occasional nightmares are nothing to worry about; however, you may have a clinical diagnosis of nightmare disorder (parasomnia) if the nightmares cause ongoing trouble with daytime functioning or falling asleep, and are not due to medications or mental health conditions.
- Drug treatment for nightmares is rare; however, medicines that reduce REM sleep or nighttime awakenings may be used for severe nightmares.
- A research report also noted that watching violent media before bedtime could give rise to nightmares.
- In the study, those who viewed violent media before bed were 13 times more likely to have violent dreams that night compared to those who didn't watch such images before bed.
Got Sleep Apnea?
Do you snore? Sleep apnea is a common, but probably underdiagnosed condition, and snoring is one symptom.
- During sleep apnea, you stop breathing for short periods of time - 10 to 30 seconds - during sleep.
- Your throat or tongue may collapse and obstruct breathing. Sleep apnea can prevent the body from supplying enough oxygen to the brain.
- It can be a major health concern: sleep apnea can increase the risk of high blood pressure, stroke, heart attack, and kidney disease.
Risk factors may include obesity, large tonsils or adenoids, abnormal mouth structure, or large neck or tongue.
Your doctor may suggest you have complete a sleep study to confirm sleep apnea. Continuous positive airway pressure (CPAP) devices are used to help with sleep apnea. Some dental devices might be helpful, too. Weight loss, alcohol avoidance, and not sleeping on your back may aid with apnea, too.
Oral dental appliances are another option if you cannot tolerate CPAP, although CPAP is more reliable. The oral appliance is designed to keep your throat open. Talk to your dentist about these appliances.
We all feel like a zombie at some point in our work week. But sleepwalking - also known as somnambulism — involves getting up and walking around while in a state of sleep.
- This tends to occur more frequently in children and can run in families.
- Sleepwalking usually occurs 1 to 2 hours after falling asleep and generally lasts a few minutes.
Occasional sleepwalking in children is not usually a cause for concern, but frequent or dangerous behavior, or sleepwalking in adults, needs an evaluation. It’s always necessary to protect family members from sleepwalking-related injuries.
Has Your Body Clock Battery Run Out?
Our internal clock is run primarily by visual cues of light and darkness that are communicated within our body. Circadian rhythm sleep disorders are the result of an upset in our own internal “body clock” and can affect the timing of sleep and awakening.
Circadian rhythm sleep disorders result in difficulty falling asleep, early awakenings, poor sleep quality, and daytime drowsiness.
Treatments can vary based on the disorder, and may include lifestyle changes like avoiding caffeine, developing healthy sleep habits, light therapy, or medications like melatonin, Provigil, Nuvigil, or Hetlioz.
Learn More About Melatonin with this Drugs.com slideshow.
Narcolepsy is Not a Nap
A quick power-nap at 3 PM sounds inviting, doesn’t it?
However, narcolepsy is anything but a power nap.
- Narcolepsy involves abruptly falling into a deep sleep at an inappropriate time, for example while talking, eating or driving.
- Narcolepsy is a chronic, lifetime condition for which there is no cure.
- Symptoms usually begin between 10 and 25 years of age, and include cataplexy (a sudden loss of muscle tone), sleep paralysis, and hallucinations (while falling asleep or awakening).
- Consult with your doctor if you must drive, as the dangers are obvious.
As with some other sleep disorders, there is no cure for narcolepsy, but lifestyle changes and certain treatments, like stimulants, SSRIs, tricyclic antidepressants, or sodium oxybate (Xyrem) may be helpful.
In March 2019, once-daily Sunosi (solriamfetol) was cleared by the FDA to improve wakefulness and reduce excessive daytime sleepiness in adults with obstructive sleep apnea (OSA) or narcolepsy. Sunosi is the first selective dopamine and norepinephrine reuptake inhibitor (DNRI) approved for these indications
In August 2019, the FDA approved Wakix (pitolisant), an oral histamine-3 (H₃) receptor antagonist/inverse agonist, for the treatment of excessive daytime sleepiness (EDS) in adults with narcolepsy. Wakix is the first FDA approved treatment for narcolepsy that is not a controlled substance.
In July 2020, Xywav (calcium, magnesium, potassium, and sodium oxybates), a low-sodium oxybate product was approved for the treatment of cataplexy and excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy. Xywav provides a low-sodium option for Xyrem, and contains 92% less sodium per nightly dose.
Insomnia: To Sleep or Not to Sleep?
Insomnia - trouble getting to sleep or staying asleep - is a top medical complaint. In fact, an estimated 50 to 70 million U.S. adults have a sleep disorder, so you are not alone.
- Your initial thought might be to use a sleeping pill, but there are many other options to help you get a good night's rest.
- First, look at your sleep routine and make adjustments, like avoidance of caffeine, late-night electronics (even TV), or exercising at bedtime. However, exercising early in the day can help promote a restful sleep.
- Short-term use of drugs such as the benzodiazepine hypnotics or OTC diphenhydramine can shorten the time to fall asleep, but you may become dependent and develop rebound insomnia if you try to stop.
- Therefore, it's always best to review any sleep medication with your doctor and develop a safe and long-term plan for a good night's sleep.
In January 2020, the FDA approved Dayvigo (lemborexant), the latest orexin receptor antagonist used for the treatment of adults with insomnia characterized by difficulties with sleep onset and/or sleep maintenance (falling asleep and/or staying asleep). Belsomra (suvorexant) from Merck was the first approved orexin receptor antagonist in August 2014. Both products are controlled substances (schedule IV) with some potential for abuse.
Snoring Can Be a Symptom
Snoring - whether it be from your spouse, a seat mate on a plane, or maybe even yourself - can wreck your sleep.
- That annoying sound occurs when the air you breath in flows down your relaxed throat muscles and causes a vibration.
- If your snoring keeps a partner up at night, wakes you up with a gasp, or causes daytime drowsiness, it’s time to see your doctor.
- Lifestyle changes, such as weight loss, avoiding nighttime cocktails, and sleeping on your side can help limit snoring.
- Respiratory allergies and dangerous sleep apnea can be associated with snoring, too.
- As sleep apnea can be a serious condition, check with your doctor if you snore or always feel drowsy in the day.
Restless Legs? Restless Night.
If you feel like you must always get up to relieve an uncomfortable feeling in your legs, you may have restless legs syndrome (RLS).
- The nighttime sensations may feel like pulling, gnawing, or burning, with an urge to get out of bed.
- An imbalance in the chemical messenger dopamine which controls muscle movement may be to blame.
- See your doctor: iron deficiency or peripheral neuropathy can also be the cause.
Common treatments for RLS are the dopamine agonists:
Common, short-term side effects of these medications include nausea, lightheadedness and fatigue.
Bedwetting (enuresis) can definitely disrupt a restful sleep for both child and parent.
- Bedwetting is a normal and common condition in young children and usually clears up by age seven.
- However, if bedwetting continues or restarts, or is accompanied by burning sensations when urinating, emotional problems, or an increase in appetite or thirst, an evaluation at your pediatrician is in order.
Motivational therapies and positive reinforcement, behavioral therapies like an enuresis alarm, bladder training exercises, and medicines like desmopressin (DDAVP, Stimate) may be helpful. Motivational and drug treatments can often be combined for an added effect, too.
Are Teeth Grinding and Snoring Related?
Teeth grinding, also known as bruxism, is the relentless clutching of teeth and jaws at night, and sometimes during the day.
- Bruxism can cause jaw disorders like temporomandibular joint disorder (TMJ), headaches, face pain, and of course, damaged teeth.
- People who grind their teeth may have other sleep-related disorders such as sleep apnea or snoring.
Talk to your dentist or doctor about the best approach: dental night guards, dental correction, and stress management may work wonders.
Long-term drug treatment is not usually used for teeth grinding, but short-term muscle relaxants like oral cyclobenzaprine (Flexeril) or even onabotulinumtoxinA (Botox) injections may be helpful for jaw or ear pain which may occur due to the nighttime teeth grinding.
Finished: 10 Common Sleep Disorders: Treatments and Truths
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- Sleep apnea. National Heart, Lung, and Blood Institute. NIH. Accessed Oct. 7, 2020 at https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/livingwith
- National Sleep Foundation. Sleep Disorders. Accessed Oct. 7, 2020 at https://sleepfoundation.org/sleep-disorders-problems
- US Centers for Disease Control and Prevention (CDC). About Sleep. Accessed Oct. 7, 2020 at https://www.cdc.gov/sleep/about_sleep/index.html
- Sateia M, Buysse D, Krystal A, et al. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine. Vol 13., No. 2, 2017: 307-342. Accessed Oct. 7, 2020 at aasmnet.org/Resources/pdf/PharmacologicTreatmentofInsomnia.pdf