Sleep disorders

Treatment

Most sleep disorders are treated with psychotherapy and cognitive behavioural therapy. In addition, pharmacological treatments can be used to help some people.

Dyssomnias

Insomnia
Transient insomnia often does not require treatment beyond identifying and managing the underlying cause. If a person has chronic insomnia, medication is often required to improve the person's quality of life, and reduce the risk of further morbidity, and benzodiazepines such as nitrazepam, or the non-benzodiazepine zaleplon, can be used for short periods to help induce sleep. Where an underlying disorder may be the cause of the insomnia, it must be identified and treated. For example, if the chronic insomnia is due to alcohol abuse, treatment should be targeted at helping to prevent the individual from drinking. For most people, psychotherapy is recommended to help resolve the psychological problems or stress that may be causing the insomnia.

Hypersomnia
Non-pharmacological treatments for sleep apnoea include adapting sleeping habits, lifestyle changes, such as losing weight and stopping smoking, using a continuous positive airflow pressure (CPAP) machine which provides a steady supply of air, and using dental devices to hold the tongue in place to keep the airway as open as possible. Treatments for narcolepsy include regular scheduling of naps during the day, and using stimulants such as methylphenidate and modafinil, which help the person to stay awake. Cataplexy can be specifically treated with tricyclic antidepressants (TCAs), eg clomipramine.

Circadian rhythm sleep disorders
Treatment of jetlag includes maximising sunlight exposure at the phase of the new local day. Shift work sleep disorder can be eased in some people by using bright artificial light to move their circadian clock to a nocturnal orientation, depending on their shifts. Delayed sleep phase disorder (DSPS) is treated by addressing why the person needs to go to bed later then the desired time, and increasing morning light exposure. Conversely, advanced sleep phase disorder (ASPS ) can be treated by increasing evening light exposure.

Parasomnias

Sleepwalking and sleep terrors are usually treated by identifying and minimising possible contributing factors. This may involve some form of psychotherapy, particularly if the sleep disorder is linked to post-traumatic stress disorder.