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Expert Q&A: Sleep Disorders

Learn more about lifestyle choices that will promote and not harm sleep, (See Treatment and Self Help) rather than taking medication for sleep. Over-the-counter medications for sleep generally contain antihistamines. These may leave you feeling drowsy and may interfere with memory and attention.

Sleep disorder specialists should be consulted in cases of significant daytime sleepiness, persistent insomnia and disturbed behavior during sleep. Referral to a sleep disorder specialist is also appropriate for evaluation of breathing-related sleep disorders.

Persistent daytime sleepiness can be debilitating or even dangerous. Daytime sleepiness can be caused by a number of issues, including self-medication with either stimulants or depressants; inadequate sleep at night; breathing-related sleep disorders, such as obstructive sleep apnea, narcolepsy or cataplexy; or psychiatric illnesses like depression. Excessive daytime sleepiness should be evaluated by a sleep disorders specialist.

Wine and other alcoholic beverages may enable someone to fall asleep more quickly, but as the alcohol is metabolized, the sleeper may experience rebound insomnia during the middle of the night. Also, if the sleeper has sleep apnea or a tendency to sleep apnea, the use of alcohol and other depressants may worsen this condition.

Pediatric sleep specialists have developed techniques that parents of infants and toddlers can use to promote better sleep and sleep habits in their children, thereby enabling tired parents themselves to have a better chance at restorative sleep. See infant sleep recommendations from the American Academy of Pediatrics.

Excessive sleep at night and/or during the day, especially in older adults, deserves medical and psychosocial evaluation to search for potentially important and treatable clinical issues, including breathing-related sleep disorders, early dementia, depression and adverse effects of prescribed and over-the-counter medications.

Early afternoon naps of about 30 minutes can be refreshing and restorative, without interfering with nighttime sleep.

Charles F. Reynolds III, M.D.

Distinguished Professor of Psychiatry Emeritus
University of Pittsburgh School of Medicine

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