Sleep Well

The most common sleep disorder, insomnia, involves difficulty falling or staying asleep or both. For individuals with insomnia, these symptoms are distressing and cause difficulty functioning during the day.

Cognitive Behavioral Therapy for Insomnia (CBT-I), a non-pharmacological multi-component treatment that is as effective as sleeping medications in the short-term and more effective in the long-term for chronic insomnia. Several components typically comprise CBT-I:

1. Sleep Restriction, a process of increasing homeostatic sleep drive (a person’s propensity to fall asleep) and consolidating sleep by decreasing unnecessary time in bed.

2. Stimulus Control, a process of re-establishing the bed and bedroom as strong cues for sleep using specific instructions which deter the patient from being awake and worried in bed. The instructions increase the likelihood of falling asleep in bed by changing habits that influence spending time in bed awake.

3. Sleep Hygiene refers to lifestyle factors which either prevent or promote good sleep, such as caffeine intake and physical activity.

4. Cognitive Restructuring refers to identifying and challenging unhealthy thoughts about sleep and replacing them with healthy cognitions, beliefs and attitudes about sleep.

Obstructive Sleep Apnea

When the muscles in the back of the throat fail to keep the upper airway open, brief and repeated pauses in breathing occur during sleep. This condition is called obstructive sleep apnea (OSA). It causes fragmented sleep and low blood-oxygen levels, which lead to excessive daytime sleepiness (often to the extent of drowsy driving) and health problems, such as heart disease

OSA treatments

1. Positive Airway Pressure (PAP), the most common and reliably effective treatment, delivers air pressure through a mask placed over the patient’s nose during sleep. The mask delivers more air pressure than the surrounding air; enough to keep the upper airway passages open to prevent apnea and snoring. For individuals unable to tolerate CPAP, alternatives, such as adjustable airway pressure devices and expiratory positive airway pressure, have been developed and shown to have positive effects in reducing apneas and symptoms.

2. Behavior Therapy has been shown to be effective for weight loss and quitting smoking to alleviate mild symptoms of sleep apnea. Behavior therapy is also used to help people adjust to CPAP and to treat claustrophobia when it interferes with CPAP use.

3. Oral Appliances, designed to keep the patient’s throat open, are less reliably effective but more easily tolerated than CPAP for most people.

4. Surgery to remove tissue, polyps, adenoids, or tonsils; to reposition the jaw or nasal septum; or to create a new airway passage are also options.

A systematic disturbance of your sleep can significantly interfere with daily life.

When to Seek Help from a Professional

[+] If you are nodding off during the day despite enough sleep

[+] If your sleep disturbance is causing you to feel anxious or down or is significantly distressful

[+] If your sleep disturbance is interfering with your life in other ways, such as having trouble waking up on time for work or avoiding social activities, exercise, or work