Saturday, February 24, 2018 5:53

Treatment of Sleep Disorder

Posted by on Monday, October 12, 2009, 13:29
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Probably the biggest problem in the treatment of sleep disorder is that there has been far too much of it especially too much use of sleep medicines, which usually make matters worse. The first step is to have realistic expectations.

Many of us far too preoccupied with the notion that we must have a perfect night’s sleep every night and be ready to perform at peak levels the next morning. This ideal is just not in the cards for everyone every night and is very far from being achieved by most people, most nights.

The modern world almost makes sleep an endangered species. We have too much light, sound, variety, things to do, fun to have, problems to worry about. We expect our brains to work overtime on full alert and then turn  off the snap of the light switch.

It doesn’t work that way. A revved-up motor needs a cooling down. Add to this the reduced sleep efficiency that comes with aging, the use of substances, changing time zones, and wake up calls and it is no great surprise that so many people want help with their sleep.

Do the simple things first. Perhaps most important, get into the habit of easing into sleep, not charging at it in battle formation. Have as regular a bedtime as possible, on that suits your body rhythms rather than constantly fights them. Do things before sleep that slow you down, soothe, and calm you.

There are a few other simple things to do that are just part of good sleep hygiene. Don’t nap excessively during that day unless that is part of your natural rhythm. Don’t use substances. Pick a room temperature that works best for you. Keep out light and noise.

Many people become behaviorally conditioned by years of insomnia to associate bedtime and their bedroom with tossing, turning, and worrying about falling asleep. Stimulus control therapy attempts to break this negative connection and restore te status quo by re-associating bed with restful sleep.

The instructions include going to bed only when you are sleepy, using your bed only for sex and sleep, and getting out of bed and going into another room if you are unable to sleep within twenty minutes, returning only when you are sleepy. Some people find this the perfect time to do the paperwork they have piled up if you are lucky, having to face it will put you right to sleep.

Poor sleepers sometimes lengthen their time in bed in order to increase the opportunity for sleep. This is terrible strategy that result in tossing fretfully and having disrupted sleep. Sleep restriction therapy counteracts this by more closely matching your time in bed with your sleep time. The first step is to stay in bed for only the amount of time you think you are sleeping each night, plus fifteen minutes.

For example, if you have been sleeping five hours at night and normally get up at six, you are allowed to get to bed no earlier that 12:45 A.M. Once you are able to successfully remain asleep for around 90 percent of the allotted time, you increase the in bed time by going to bed fifteen minutes earlier. This process is successively repeated until the desired sleep time is achieved, which usually takes from three to four weeks.

Another treatment of sleep problems are sleeping pills. They may help for a few days to a few weeks, they don’t work for long term. Their best use is for for short periods in people who need an immediate relief from insomnia because it is a symptom of mental disorder or medical illness.

The sedative/hypnotics, tricycling antidepressants, and antihistamines all have their advantages and mostly disadvantages. Most of the sedative/hypnotics, the most widely prescribed sleeping pills, come from the same chemical class, the benzodiazepines.

Some are specifically marketed as sleeping aids and most of the others are sometimes used in this way. Although in te short term, these medicines can induce sleep with minimal hangover effects, they are ineffective for long term use and can produce physical or psychological addiction.

People develop tolerance to the sleep effects and must continually raise the doses to keep having an effect. Abruptly stopping the medicine results in rebound insomnia that may be worse than the original problem. Amnesia is common, making these impractical for use by people who might have to function unexpectedly in the middle of the night. Finally, the elderly have to especially careful because these medicines can cause confusion, delirium, or falls.

Several of antidepressants have been used to help induce sleep problems, taking advantages of their sedating side effects. Although they have the advantage of not causing addiction, some people experience significant next day effects, finding that they feel foggy. Many cold and allergy medications containing antihistamines cause significant drowsiness as a side effect and are used by many to sleep.

Hypersomnia is even more difficult to cure . Behavioral treatments have not been particularly successful in shortening sleep time or reducing daytime drowsiness. Usually the treatment focuses on counteracting daytime fatigue with stimulant medications, such as Ritalin, Cylert etc.

Circadian Rhythm Sleep Disorder can be treated with maneuvers to reset body’s internal clock so that is more closely matches the demands of environment.

Because accidents during Sleepwalking Disorder can be life threatening, safety measures are essential. Sleep on the ground floor, lock doors and windows, and remove potentially dangerous objects from the bedroom. Sleepwalking and sleep terror occur during deep NREM sleep. If you avoid sleep deprivation, this reduces the time spent in the deeper stages of sleep and seduces the risk of sleepwalking. Fortunately, most children who have those problems outgrow them.

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