Treatments for
Trouble Sleeping
Having trouble sleeping?
2 out of 5 Americans don’t sleep enough.
If you’re one who lacks sleep or has this difficullty, your health might
be at risk, according to Matt Millen, WebMD Health News.
The lack of sleep, or insomnia, can put you at risk for
cardiovascular disease and high blood pressure, says Alon Avidan, MD, MPH, director
of the UCLA Sleep Disorders Center. He
links such poor sleep habits to kidney disease, diabetes, depression and
obesity. Cancer and Alzheimer’s disease
may also be linked to bad sleep. If life
is harder and you have trouble falling sleep, it is more likely you could
easily catch the common cold.
But, alas, there have been advances in sleep medicine that
have been approved last year, and research technology to new medication may
help and give you better options for rest.
“With insomnia treatment, it’s a lot of trial and error.”
According to sleep specialist Preethi Rajan, MD, of the North Shore – LIJ
Health System, Great Neck, New York.
Time and effort are required to find a treatment that will work for the
long term.
Apps and Online
Programs
CBT Counseling (CBT-I) addresses the habits that make it
difficult for you to sleep and are based on your unique needs. “We tell patients that cognitive behavioral
therapy (CBT) is the best way to treat chronic insomnia,” says Ketan Deoras,
MD, of the Cleveland Clinic’s Sleep Disorders Center.
But due to a shortage of therapists, few people have access
to this kind of treatment, according to Deoras.
That’s where smartphones and computers come into play: with the help of apps and online
therapy. With these apps and the
internet, the user has access to such programs like Cleveland Clinic’s GO! To
Sleep, CBT-I Coach, SHUTi, and many others.
They are free or have a low cost and you save time traveling to
appointments.
Some studies have shown that these apps have helped users
sleep more quickly and better, although they didn’t necessarily sleep
longer. “Programs like these have been
around for a few years, but only recently has research started to show that
they are effective,” Avidan says. They
may work even if the work is short term.
It provides your daily habits and synthesizes data to
provide recommendation. The user can
share the results with their doctor so they can work together. Apps that monitor sleep, like Fitbit,
although not received any scientific scrutiny, may help users sleep better,
according to Rajan. “I think they’re
incredibly promising, because they raise awareness of sleep issues, and they
might help reach people who do not otherwise come in for an evaluation.” Rajan
says. “I often see patients who tell me,
‘my device says my sleep quality is not great, but I don’t know what that
means.’ “ Avidan says that sleep apps
may make it more useful in the future to diagnose sleep problems and track how
we sleep. But Deoras warns not to get to
focused on what the apps tell you. “Some
insomnia patients are really hyper-focused on their sleep, and sometimes that
can actually make the insomnia a little worse,” Deoras says. “That focus ramps up their anxiety.”
A New Device for Sleep
Apnea
The Inspire system has an implantable device for people with
obstructive sleep apnea and don’t too good with CPAP, a typical treatment for
sleep apnea. This device was approved by
the FDA last year. “There’s a lot of
buzz about this in the sleep community,” says Rajan. Sleep apnea disrupts the flow of breathing
while the person is sleeping, making it hard to sleep. This can lead to serious health conditions
like heart disease and high blood pressure.
The new device is a surgically implanted in the person’s
chest and neck and monitors breathing, stimulating the nerve that controls the
movement of the tongue to keep airways open while the person is sleeping. According to Rajan, it works best with
moderate sleep apnea and has not been tested on obese people with a BMI greater
than 32. This would be equivalent
to a 5-foot-6 woman who weighs 200
pounds (BMI: 32.3). The company’s website suggests that it is not
meant for people who are too overweight.
These tests show that people with higher BMI’s don’t do well, according
to Quan Ni, Ph.D, Inspire’s Vice President of research. “That excludes a lot of patients,” Deoras
says, as about 18 million Americans with sleep apnea are overweight.
A 2014 research study of this device say there a few
participants who had few problems and a small number found the electrical
pulses uncomfortable, had tongue soreness and dry mouth. And only 2 people needed a follow-up
procedure to reposition the device. The
major drawback is that the device costs $20,000 plus surgery to implant and
insurance companies determine how much the cost is covered and how much the
person pays.
The centers who use the device by Inspire, estimates that
50-60 in the US and the technology is so new that sleep specialists and
surgeons have a steep learning curve, according to Avidan. “This is an emergent technology, and the
surgeon has to be fairly experienced in this operation,” says Avidan. “There are a lot of people who know how to do
it.”
New Type of Medication
for Insomnia
Insomnia drugs usually target the area of the brain that
controls sleepiness. In other words,
they stimulate the area of the brain that induces sleep. Belsomra, which was approved last year,
blocks the area of the brain that keeps you awake. According to Consumer Reports magazine has
found reports that those who took Blesomra fell asleep 6 minutes faster than
those taking the sugar pill. And
contrastly, people taking zolpidem took 20 minutes to sleep faster than those
who took some form of fake treatment like placebos. Deoras says that these medicines are
“something else to try if patients have gone through the typical insomnia
medications and aren’t getting good results.”
But Rajan says, “It’s so new, that I usually give it to patients only after
they have been on everything else and have not been helped. There’s no way to predict which patients will
respond to which medication.”
Belsomra side effects – hallucinations and feelings of
paralysis while falling asleep and waking – but Deoras says that patients have
not reported such issues and doesn’t think the side effects are any worse than
other insomnia drugs. One reason for
hesitating to prescribe the drug is cost -- $275/month with a savings
coupon. “Patients I’ve prescribed it to
have come back saying their insurance won’t cover it and the expense/ insurance
coverage is definitely difficult to deal with, and I don’t see it as
dramatically better than other meds out there. . . I know the majority of sleep
providers in our center aren’t prescribing it currently.”
In conclusion, there are more moderate treatments if you
happen to suffer from insomnia or have difficulty falling asleep. New apps, a device implanted in the sufferer
for sleep apnea, and newer medications may all help those who suffer with these
problems.
Reference
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