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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Insomnia

My husband has been struggling with not being able to fall asleep for the last 3 years. he has been tested for sleep apnea and has it, however the problem isn t the sleep apnea, he can t even fall asleep, Insomnia. No medication is helping and am wondering if maybe its a more serious issue?
Wed, 19 Oct 2016
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Neurologist 's  Response
Hello! Insomnia is a condition where the patient repeatedly can not initiate or maintain sleep eventhough the adequate time and circumstances are available.
It is a very complex disorder to diagnose and treat. For exploring the condition, different evaluation has to be done. At first, 2-week sleep of the patient should be studied to a obtain a sleep pattern, medical and psychiatric questionnaire to detect comorbidities with a thorough medical history and a review of systems, the sleep history to explore the timing of insomnia, sleep's habits and presence of other sleep disorders associated with insomnia. A careful family history should be obtain to discover if there is a risk of fatal familial insomnia or heritable disorders that may alterate sleep. Also, social habits should be considerated like use of caffeine, tobacco, illecit drugs and alcohol. Some drugs that cause insomnia are beta blockers, clonidine, stimulants, some antidepressants. Some underlying disorders that induce insomnia are sleepless legs syndrome, depression, anxiety, lungs in chronic obstructive pulmonary disease etc.
For the management there are cognitive behavioural therapy and medicamentous therapy. The cognitive behavioural therapy is the chosen form of management in primary insomnia (where are no underlying causes or conditions). Sleep hygiene education (avoid use of caffeine, enviromental noise, watching tv in bed etc) and stimulus control therapy (use the bed only for sleep(no eating, no tv, no working in bed) and only when sleepy, no daytime sleeping etc) are part of the cognitive behavioural therapy which he can try.
I hope i have been of help.





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Suggest Treatment For Insomnia

Hello! Insomnia is a condition where the patient repeatedly can not initiate or maintain sleep eventhough the adequate time and circumstances are available. It is a very complex disorder to diagnose and treat. For exploring the condition, different evaluation has to be done. At first, 2-week sleep of the patient should be studied to a obtain a sleep pattern, medical and psychiatric questionnaire to detect comorbidities with a thorough medical history and a review of systems, the sleep history to explore the timing of insomnia, sleep s habits and presence of other sleep disorders associated with insomnia. A careful family history should be obtain to discover if there is a risk of fatal familial insomnia or heritable disorders that may alterate sleep. Also, social habits should be considerated like use of caffeine, tobacco, illecit drugs and alcohol. Some drugs that cause insomnia are beta blockers, clonidine, stimulants, some antidepressants. Some underlying disorders that induce insomnia are sleepless legs syndrome, depression, anxiety, lungs in chronic obstructive pulmonary disease etc. For the management there are cognitive behavioural therapy and medicamentous therapy. The cognitive behavioural therapy is the chosen form of management in primary insomnia (where are no underlying causes or conditions). Sleep hygiene education (avoid use of caffeine, enviromental noise, watching tv in bed etc) and stimulus control therapy (use the bed only for sleep(no eating, no tv, no working in bed) and only when sleepy, no daytime sleeping etc) are part of the cognitive behavioural therapy which he can try. I hope i have been of help.