Sleep Problems: Diagnosis and Treatments Explained

You know you're not sleeping well, but you're not sure why.

First, your doctor will give you a checkup and talk with you about what's going on. He or she'll ask you questions such as:

  • What medical conditions do you have?
  • What medications are you taking?
  • How stressed are you feeling these days?
  • How much alcohol do you drink?
  • How much caffeine are you getting?

If you've already tried things like allowing enough time for sleep and making your bedroom a good place for rest, your doctor may suggest you go to a sleep lab for more tests. This may take a night or two.

At the sleep lab, you'll be hooked up to monitors that will track your heart, brain, movements, and breathing patterns as you sleep. A sleep specialist will review the results and tell you what they mean.

Treatments

Your treatment will depend on what type of sleep problem you're having.

Insomnia

The first thing to try is changing your sleep habits. For instance:

  • Go to bed the same time each night and get up at the same time each morning.
  • Don't nap during the day.
  • Stop stressful chores or discussions long before you go to bed.
  • Relax before bedtime. Try deep breathing, prayer, gentle stretching, meditation, or journaling.
  • Keep your bedroom dark, quiet, and cool. Use earplugs or eye shades if needed.
  • Can't sleep? Go into another room and read, or do something relaxing and quiet.
  • Avoid caffeine.
  • Don't drink alcohol before bed.
  • Quit smoking.
  • Exercise regularly and maintain a healthy diet.
  • Avoid large meals before bedtime.
  • Remove electronics such as laptops, smart phones from the bed.

Circadian Rhythm Disorders

These are like jet lag in that your body clock is "off." Treatment depends on the specific type of  circadian rhythm disorder and may include adjustment of bedtimes and rise times, appropriately timed melatonin use, and bright light therapy.

Snoring

Try these tips:

  • Sleep on your side.
  • Don't drink or smoke.
  • Avoid sleeping pills and other sedatives.
  • If you're overweight, work on weight loss.
  • Get medical treatment for any allergies or nasal blockages you may have.

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Sleep Apnea

When you have sleep apnea, you briefly stop breathing several times a night. Losing extra weight may make it better. Also, avoid alcohol and sleeping pills.

Ask your doctor if you need a CPAP machine. (CPAP stands for continuous positive airway pressure.) With CPAP, you wear a mask while you sleep, and it raises the air pressure inside your throat. This keeps your airway more open, so you can sleep better. You'll need to go to a sleep lab to get a CPAP prescription and follow-up. Other PAP machines include the BiPAP for two levels of air pressure and the VPAP, which has varying levels of air pressure.

For some people, it helps to wear a dental brace that holds the lower jaw forward during sleep.

For others, an implanted device called Inspire is now available. The device, called an upper airway stimulator, delivers mild stimulation to nerves that control airway muscles, keeping them open. There are also several types of surgery available for sleep apnea.

Narcolepsy

People with narcolepsy fall asleep when they don't want to. Taking scheduled naps can help such as taking a nap before important events.

Your doctor may also prescribe a medication to help you stay awake and treat the sudden loss of muscle control when you wake up.

Restless Legs Syndrome

Cutting down on caffeine may help. So can taking a warm bath or relaxing before bed. Hot or cold packs on your legs may provide relief. Iron supplements may be beneficial if iron deficient.

Prescription medicines that might help include:

These may have side effects, so talk about the pros and cons with your doctor.

Nightmares and Night Terrors

If your child has a nightmare or night terror, comfort them. If they have those dreams often or if they're severe, tell your child's doctor.

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Pregnancy and Sleep

It's normal to not sleep well during pregnancy. Take afternoon naps, drink warm milk, or relax in a warm (not hot) bath before bedtime. Exercise during the day should help, too. Check with your doctor before starting an exercise program.

You may be more comfortable sleeping on one side, with a pillow supporting your head and abdomen, and another pillow between your knees. Sleeping on the left side is better as this increases the amount of blood and nutrients which reach the baby.

If you're pregnant, never take sleeping pills or any herbal remedies without talking with your doctor first.

Age

Changes in the sleep pattern are part of the normal aging process and are not necessarily associated with a sleep disorder. Maintaining good sleep hygiene is important

Exercise helps you sleep better at any age.

Elderly people who don't sleep well at night may find afternoon naps helpful. Don't nap too much, or it will make it harder to sleep at night.

Get outside in the sunlight during the day, particularly in the morning, too.

WebMD Medical Reference Reviewed by Naya Ambardekar, MD on July 24, 2017

Sources

SOURCES: 

American Academy of Family Physicians. 

American Academy of Child and Adolescent Psychiatry. 

Lucile Packard Children's Health Services. 

Medline Plus: "Narcolepsy." 

Agency for Healthcare Research and Quality.

American Sleep Apnea Association.

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