Monday, March 12, 2007

Treatment of sleeping disorders

Sleeping disorders treatment is a complicated question, but all in all such treatments may include: 1) medical treatments; 2) behavioral or psychotherapeutic treatments; 3) alternative ways of treatment. One should bear in mind that none of these methods is universally sufficient for all patients suffering from sleeping disorders. The choice of this or that remedy depends on the patient's diagnosis, his medical and psychiatric history, and, of course, personal preferences.

There are certain drugs that are generally used in medical treatment of sleeping disorders. They are benzodiazepines, opiates, dopamine agonists, anticonvulsants, and non-benzodiazepine hypnotics. Doctor prescribe the appropriate medication for the particular sleeping disorder. But still medicines should be used in combination with behavioral treatments and sleep practices, otherwise there would be little effect.

Behavioral treatments for sleeping disorders may include relaxation training, stimulus control, cognitive therapy, sleep hygiene, and sleep restriction therapy. Generally speaking, medical treatments provide more rapid symptomatic relief from sleeping disorders. But on the other hand, behavioral and alternative treatment of insomnia may be more effective than medical ones. Some sleeping disorders, such as narcolepsy, are best treated medically, whereas others, such as chronic and primary insomnia, are best treated with behavioral therapy. As we’ve said, in order to maximize therapeutic benefits for the majority of sleeping disorders, behavioral and medical treatments are successfully combined.

Alternative therapy for sleeping disorders is a very wide subject that may include acupuncture, guided imagery, yoga, hypnosis, physical exercises, biofeedback, aromatherapy, relaxation, herbal remedies, meditation, massage, etc., i.e. everything that is to some extent or other connected with lifestyle changes, leading to better sleeping.

Saturday, February 3, 2007

Polysomnogram in diagnosis of sleeping disorders

In order to diagnose sleeping disorders the so called polysomnogram (PSG) is used. It is a multiple-component test that electronically traces and fixes particular physical activities during your sleep. When you are through with testing your polysomnogram is analyzed and depending on certain polysomnographic parameters you are diagnosed whether or not you have sleeping disorders.

As a matter of fact four main types of polysomnographic studies can be distinguished:
  1. Diagnostic daytime multiple sleep latency test is used to determine how long it takes for you to fall asleep during the day. Doctors will study your daytime sleep pattern in order to reveal your sleeping disorder.
  2. Diagnostic overnight polysomnogram monitors sleep architecture (non-REM and REM sleep, arousals, etc.) and certain body functions during sleep (breathing patterns, heart rhythms, limb movements, etc.)
  3. Two-night evaluation polysomnogram and CPAP titration is conducted on the first night of the two-night protocol to monitor and make a diagnostic evaluation of the suspected sleeping disorder. In case of sleep apnea the necessary CPAP pressure required to alleviate it is determined during the second night.
  4. Split-night polysomnogram with CPAP titration is conducted in case of patients suffering severely from sleep apnea. Here the second half of the night is used to determine the necessary CPAP pressure required to alleviate the disease.