Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. From the middle of the 20th century, research has provided increasing knowledge and answered many questions about sleep-wake functioning. The rapidly evolving field has become a recognized medical subspecialty in some countries. Dental sleep medicine also qualifies for board certification in some countries. Properly organized, minimum 12-month, postgraduate training programs are still being defined in the United States. In some countries, the sleep researchers and the physicians who treat patients may be the same people.
The taking of a thorough medical history while keeping in mind alternative diagnoses and the possibility of more than one ailment in the same patient is the first step. Symptoms for very different sleep disorders may be similar and it must be determined whether any psychiatric problems are primary or secondary.
The patient history includes previous attempts at treatment and coping and a careful medication review. Differentiation of transient from chronic disorders and primary from secondary ones influences the direction of evaluation and treatment plans.
The Epworth Sleepiness Scale (ESS), designed to give an indication of sleepiness and correlated with sleep apnea, or other questionnaires designed to measure excessive daytime sleepiness, are diagnostic tools that can be used repeatedly to measure results of treatment.
Pharmacology is necessary for some conditions. Medication may be useful for acute insomnia and for some of the parasomnias. It is almost always needed, along with scheduled short naps and close follow-up, in the treatment of narcolepsy and idiopathic hypersomnia.
Chronic circadian rhythm disorders, the most common of which is delayed sleep phase disorder, may be managed by specifically-timed bright light therapy, usually in the morning, darkness therapy in the hours before bedtime, and timed oral administration of the hormone melatonin. Chronotherapy has also been prescribed for circadian rhythm disorders, though results are generally short-lived. Stimulants may also be prescribed. When these therapies are unsuccessful, counseling may be indicated to help a person adapt to and live with the condition. People with these disorders who have chosen a lifestyle in conformity with their sleeping schedules have no need of treatment, though they may need the diagnosis in order to avoid having to meet for appointments or meetings during their sleep time.
Common side effects of prescription sleeping pills such as Lunesta, Sonata, Ambien, Rozerem, and Halcion may include:
It's important to be aware of possible sleeping pill side effects so you can stop the drug and call your doctor immediately to avoid a more serious health problem.
Yes. Mixing alcohol and sleeping pills can have additive sedating effects from both drugs, and the combination can cause someone to stop breathing, which could cause death. Sleeping pill labels warn against using alcohol while taking the drug.
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