Page Contents
You have read about a few common sleep disorders in the previous blog. Not being able to manage them well in the long run could lead you to chronic conditions and also mental conditions, especially if you are older adults. For example, Alzheimer’s disease, heart disease, diabetes, suicidality, depression, anxiety, and so forth.Â
Â
In this session, we look at the treatments that are commonly prescribed by medical professionals and health coaches.
Â
Insomnia
Cognitive behavioural therapy for insomnia (CBT-I) is the effective and common treatment option for insomnia. It helps you to diverge and replace negative thoughts that keep you awake at night. It adopts different behavioural strategies such as:
- Stimulus control therapy
- Light therapy
- Sleep restriction
- Relaxation
- Paradoxical intention.
For many people, whenever they have difficulty getting sleep, the immediate solution is to take sleeping pills. This is a bad idea. Even if it is prescribed by your doctor, sleeping pills can lead to many side effects, such as daytime drowsiness, disorientation, headache, heartburn, constipation or diarrhoea.
Â
Some over-the-counter pills that contain antihistamines can cause daytime dizziness, confusion, cognitive decline, constipation, dry mouth and urinary retention. These side effects are more concerning in older adults.
Â
Snoring
Snoring can be treated surgically or non-surgically. Non-surgical treatments include:- Lifestyle modification: avoiding alcohol before bedtime, sleeping on your side instead of back, quit smoking, and maintaining a healthy BMI.
- Practice good sleep hygiene: create comfortable ambient, avoiding electronic devices, sleeping at the same hour every night, replacing old pillows.
- Medications: taking cold and allergy medications to help nasal decongestion. Spray nasal corticosteroid spray to relief nasal congestion.
- Open nasal passages: using nasal strips and nasal dilator, taking a hot shower before bed, flushing nasal cavity with neti pot and saline.
- Oral breathing devices: wearing an oral appliance while you sleep can position your jaw and improve airflow.
- Laser-assisted uvulopalatoplasty (LAUP): surgically reduces tissue in the soft palate.
- Radiofrequency ablation: use radiofrequency to shrink excess tissue in the soft palate and tongue.
- Septoplasty: surgery on the septum in the nose.
- Adenoidectomy: surgically remove excess tissue from the back of the nose (adenoid).
- Tonsillectomy: surgically remove excess tissue from the back of the throat (tonsil).
Sleep apnoea
Treatment options for sleep apnoea are quite similar to treatments for snoring. Basically, there are conservative / lifestyle changes, mechanical therapy, dental appliances, surgery and implant.
Â
Conservative / lifestyle changes:
- Maintain healthy weight or BMI.
- Sleep on your side position (lateral position).
- Stop smoking and avoid drinking alcohol.
- Avoid taking sleeping pills.
- Treat allergies and sinus problems.
Mechanical therapy
- Continuous Positive Airway Pressure (CPAP)
- Bi-level Positive Airway Pressure (BiPAP)
- Automatic Positive Airway Pressure (APAP)
- Adaptive Servo-Ventilation (ASV)
Non-invasive dental appliances
- Oral mandibular advancement devices: helps to prevent the tongue from blocking the throat and keep the airway open during sleep.
Surgery and implant
- Nasal surgery: a surgical correction of nasal obstructions.
- Uvulopalatopharyngoplasty (UPPP): surgery to remove soft tissue on the back of the throat and palate.
- Mandibular maxillomandibular advancement surgery: a surgical correction of facial abnormalities or throat obstructions.
- Somnoplasty: uses radiofrequency energy to reduce the soft tissue in the upper airway.
- Tonsillectomy: surgically remove excess tissue from the back of the throat (tonsil).
- Hypoglossal nerve stimulator: an implanted device that stimulates hypoglossal nerve.
Restless Leg Syndrome (RLS)
For mild RLS without other underlying conditions, lifestyle changes are usually the first intervention:
- Avoid stimulants in the evening (caffeine, smoking and alcohol).
- Regular mild exercise (avoid intense exercise before bedtime).
- Practise good sleep habits and routine.
In more severe RLS, your doctor may prescribe medication, for example, dopamine agonists, opiate-based painkillers, and anti-seizure medications.
Â
If the RLS is associated with other underlying conditions, it can be more effectively cured by treating that underlying condition.
Â
Narcolepsy
- Diligent follow a routine sleep-wake cycle.
- Avoid blue light and digital devices before bedtime.
- Do not smoke, drink alcohol and caffeinated drinks in the evening.
- No intense exercise before going to bed.
- Avoid heavy meals and drinking too much fluid close to bedtime.
- Find ways to relax and calm your mind before sleep.
Medications
- Wake-promoting medications: helps you stay awake during the day
- Stimulants: helps you stay awake during the day
- Antidepressants: helps alleviate the symptoms of cataplexy, hallucinations and sleep paralysis
- Sodium oxybate: helps to improve nighttime sleep
Nocturnal leg cramps
There isn’t any medication that treats nocturnal leg cramps in particular. However, your doctors may advise some quick remedies to mitigate your cramps.- Stretch and massage
- Elevate your legs
- Stand up and walk around
- Apply heat pad or cold compress on the sore areas
- Take pain killers to manage the pain
Sleep paralysis
There is no treatment needed for sleep paralysis. However, targeting the root causes or treating the underlying conditions could improve your sleep quality:- Improve sleep hygiene and practice good bedtime routine, avoid blue light, create suitable ambient for sleep
- Take antidepressant medication if your doctor prescribes it to regulate sleep cycles
- Treat any mental conditions that may contribute to sleep paralysis
- Treat any sleep disorders that could be present, such as narcolepsy or nocturnal leg cramps
Postprandial somnolence (food coma)
Postprandial somnolence is not an illness, there is no treatment required. To manage the condition, you can experiment the following:
- Ensure your body is well-hydratedÂ
- Make sure you have a balanced diet, but not over-eating
- Exercise regularly, and also make sure you have good quality rest or sleep
- Limit or avoid alcohol consumption
- Reduce sugar, carbohydrate and sweet foods / drinks intake
Nocturia
- Avoid drinking too much fluid at night time, including alcohol and caffeine.
- If doctor prescribes diuretics medicines for your other illnesses, take them 6 hours before sleep.
- Wear compression socks at night to redistribute fluids back to the bloodstream, reducing the need to urinate.
You may also consult your doctor for:
- Medicines that work on your kidneys to reduce urine production.
- Anticholinergic medicines that treat problems on bladder muscle.
- If nocturia is caused by medications prescribed for some illnesses, consult your doctor on adjusting the timing and dosage, that may change the cycle of night time urination.
Conclusion
As you can probably see from the treatments above, medications can ease the symptoms for short-term, while doctors always prefer lifestyle changes as a long-term solution.
Â
For more medical and scientific resources, please click the links below to visit:
In the coming blog article, you will find more practical advice on how you can get good quality sleep despite the use of medications and going through therapies.