Obstructive Sleep Apnea
Obstructive sleep apnea occurs when the airway becomes blocked repeatedly during the night. Some characteristic symptoms of obstructive sleep apnea are snoring, choking or gasping during sleep, and fatigue or daytime sleepiness. Around 20% of the adult population have obstructive sleep apnea and people who are obese or have high blood pressure are at an increased risk of developing it.
Treatments for Obstructive Sleep Apnea
- Continuous Positive Airway Pressure (CPAP)
- A CPAP machine can reduce apneas and hypopneas and improve sleepiness, however, adherence to using the machine regularly can be difficult.
- Weight loss
- Oral appliance
- Surgery on upper airway
- Hypoglossal nerve stimulation
Insomia
Chronic insomnia occurs when a person has difficulty initiating sleep or waking too early in the morning for 3 or more times a week for 3 months or more and is not explained by another health problem. Around 30% of the adult population are affected by chronic insomnia and 10% have insomnia that affects daytime function.
Treatments for Insomnia
Cognitive Behavioral Therapy (CBT)
- CBT is a tool to help people focus on their behaviors, cognitions, and perceptions (perpetuating factors).
- CBT can have equal or better effects than dugs and can have longer lasting effects.
- There are minimal side effects to CBT compare to using drugs.
CBT can be done in individual or group sessions. It can be done via face-to-face, telehealth, or online format and be brief (2 sessions) or up to 8 weeks. CBT is led by trained therapists (psychologists, physicians, or nurses).
Prescription Medications
There are several groups of medications that may be prescribed for insomnia including, but not limited to
- Hypnotic medications
- Psycho-active medications with sleepiness as a side-effect
- E.g. Trazadone, amitriptyline, doxepin, trimipramine, mirtazapine, olanzapine, quetiapine
- Anticonvulsant medications
- E.g. Gabapentin, pregabalin
- Melatonin receptor agonists
- E.g. Ramelteon
- Other
- E.g. Chloral hydrate, Sodium oxybate
Over-the-Counter Medications
There are over-the-counter medications that can also help with sleep:
- Melatonin
- Antihistamines
- E.g. Diphenhydramine, Doxylamine
- Herbal remedies
- E.g. Valerian