Types of Sleep Disorder Treatments

Options Include Medical Devices, Medications, and Therapy

Treatments of sleep disorders include medications, surgery, therapy, and medical devices like these CPAP machines for sleep apnea
Treatments of sleep disorders include medications, surgery, therapy, and medical devices like these CPAP machines for sleep apnea. Brandon Peters, MD

There are a wide variety of sleep disorders of many potential causes, and as such there are many potential treatments specific to each disorder. In general, these fall into two broad categories: non-pharmacological and pharmacological treatments. Discover the use of medical devices, surgery, and medications like sleeping pills for the treatment of sleep disorders.

Medical Devices, Therapy, and Surgical Treatments of Sleep Disorders

Non-pharmacological treatments include all of the various options that do not involve the use of prescription or non-prescription drugs.

The use of surgery, behavioral therapy, medical equipment and devices, or other options may be employed.

  • Surgery

Surgery may be used to correct defects in the upper airway that contribute to obstructive sleep apnea. Such surgical options may include: tonsillectomy, adenoidectomy, jaw surgery, or uvulopharyngoplasty (UPPP).

  • Therapy

Although sleep is a natural body process, there is an element of behavior to it. As such, therapies meant to influence the behaviors associated with sleep can be effective. These may include: cognitive behavioral therapy (CBT), cognitive therapy, relaxation techniques, and stimulus control. Behavioral therapy may be useful in treating insomnia, parasomnias, bedwetting, and other sleep problems.

  • Behavioral Changes

In addition, other behavior changes may be employed without the need for formal therapy. For example, basic guidelines to improve sleep habits - which is sometimes called sleep hygiene - can be very effective.

For those who suffer from excessive daytime sleepiness, as may occur in narcolepsy, scheduled daily naps may be helpful. In those who have insomnia, suffering through restless or fitful sleep, sleep restriction can be useful. This involves limiting the amount of time spent sleeping so that the desire to sleep is stronger and the restlessness is reduced.

In restless legs syndrome, stretching exercises may help relieve the symptoms.

  • Medical Devices

There are a number of different durable medical equipment options, which refers to any device that is used repeatedly for treatment of a medical condition. One of the most distinctive of these options may be continuous positive airway pressure (CPAP) for the treatment of sleep apnea. Another related treatment is bilevel -- or BiPAP -- which provides two alternating pressures, one with inhalation and one with exhalation. In addition, dentists may provide mandibular advancement devices or an oral appliance for sleep apnea treatment. In individuals suffering from seasonal affective disorder (SAD) or circadian rhythm disorders, light box therapy may be used.

  • Other Non-Medication Treatments

Finally, there are a few other random non-pharmacological treatment options for sleep disorders. These might include nasal strips for snoring (of questionable benefit), positional therapy for sleep apnea that occurs only when an individual sleeps on his or her back, and playing didgeridoo to strengthen the upper airway as an alternative to CPAP.

Medication Treatments of Sleep Disorders

There are many potential medication treatments for the various sleep disorders. These would include any prescription or non-prescription drugs. The most common options are the various sleeping pills. In general, these treatments may involve short- versus long-acting agents. They may be used to prevent the onset of symptoms or to treat the symptoms once they develop.

Depending on the nature of the disorder, one might be prescribed sedatives (in the case of insomnia) or stimulants (in the case of narcolepsy or sleep apnea). Other medications targeting the specific underlying cause of the disorder may also be used. Most of these agents require a prescription. Over-the-counter medications may also be recommended, such as melatonin in the treatment of circadian rhythm disorders and jet lag. There are also medications used to treat restless legs syndrome and sleep behaviors called parasomnias.

If you feel you need treatment for your sleep disorder, start by speaking with a board-certified sleep specialist and discover what therapy will best help you to sleep better.

Sources:

Bradley, T.D. et al. "Continuous positive airway pressure for central sleep apnea and heart failure." N Engl J Med. 2005 353:2025.

Buscemi, N. et al. "The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of RCTs." J Gen Intern Med. 2007 22:1335.

Buscemi, N. et al. "The efficacy and safety of exogenous melatonin for primary sleep disorders: a meta-analysis." J Gen Intern Med. 2005 20:1151.

Edinger, J.D. et al. "Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial." JAMA. 2001 285:1856.

Golden, R.N. et al. "The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence." Am J Psychiatry. 2005 162:656.

Hoekema, A. et al. "Efficacy and co-morbidity of oral applicances in the treatment of obstructive sleep apnea-hypopnea: a systematic review." Crit Rev Oral Biol Med. 2004 15:137.

Hudgel, D.W. et al. "Pharmacologic treatment of sleep-disordered breathing." Am J Respir Crit Care Med. 1998 158:691.

Mendelson, W.B. "Hypnotic medications: mechanisms of action and pharmacologic effects." Principles and Practice of Sleep Medicine. 4th ed. Saunders, 2005.

"National Institutes of Health State-of-the-Science Conference Statement on Manifestations and Management of Chronic Insomnia in Adults." Sleep. 2005 28:1049.

Phillips, B. et al. "Management of obstructive sleep apnea-hypopnea syndrome: overview." Principles and Practice of Sleep Medicine. 4th ed. Saunders, 2005.

Sack, R.L. et al. "Circadian rhythm sleep disorders: part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm." Sleep. 2007 30:1484.

Sack, R. et al. "Entrainment of free-running circadian rhythms by melatonin in blind people." N Engl J Med. 2000 343:1070.

Stepanski, E.J. et al. "Use of sleep hygiene in the treatment of insomnia." Sleep Med Rev. 2003 7:215.

"The International Classification of Sleep Disorders: Diagnostic and Coding Manual." 2nd ed. American Academy of Sleep Medicine, 2005.

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