How are sleep-wake disorders treated?

Updated: Aug 21, 2019
  • Author: Roy H Lubit, MD, PhD; Chief Editor: Ana Hategan, MD, FRCPC  more...
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Answer

Sleep apnea can be alleviated by losing weight, the use of continuous positive airway pressure (CPAP), and, sometimes, surgical treatment.

When patients who are sleepwalkers, it may be necessary to prevent them from accidentally hurting themselves at night by walking into things or out of the house.

Light-phase shift therapy is useful for sleep disturbances associated with circadian rhythm abnormalities. Patients may be exposed to bright light, from either a light box or natural sunlight, to help normalize the sleep schedule.

Cognitive behavioral therapy (CBT) are efficacious for short-term treatment of insomnia, as are hypnotic medications (see below), but few patients achieve complete remission with any single treatment.

Morin et al studied 160 adults with persistent insomnia and demonstrated that CBT, either alone or in combination with zolpidem, yielded significant improvements in sleep latency, time awake after sleep onset, and sleep efficiency during initial therapy. [8] Combined therapy produced a higher remission rate than CBT alone during the 6-month extended therapy phase and the 6-month follow-up period (56% vs 43%). Long-term outcome was optimized when medication was discontinued during maintenance CBT.

A variety of software programs are commercially available that use wrist bands or motion-detection technology embedded in smart phones to identify and record a patient’s sleep cycles and behavior. This information is then used to give feedback to the patient about the duration and quality of their sleep and to make suggestions on how they can get more consistent and refreshing sleep. Some of the devices incorporate an alarm that is programmed to avoid waking the patient from deep sleep.


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