None of these general approaches is sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. Often, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can effectively be combined to maximize therapeutic benefits. Management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.
Ask your doctor for a referral to an ear, nose, and throat (ENT) specialist, who can evaluate whether you're a candidate for Continuous Positive Airway Pressure (CPAP), a specially designed nasal mask that prevents your nasal passages from collapsing and delivers air directly into your airway. If tongue position during sleep is causing your UARS, the doctor may recommend a dental device that pushes the jaw and tongue forward and prevents the tongue from blocking the opening to the throat.
If sleeping with a mask on doesn't work for you, other options are surgery; oral appliances; and newer, minimally invasive outpatient surgical treatments. These include the Pillar procedure, which involves using permanent stitches to firm up the soft palate; coblation, which uses radiofrequency to shrink nasal tissues; and even use of a carbon dioxide laser to shrink the tonsils.
According to one meta-analysis, the two most prevalent sleep disorders among children are confusional arousals and sleep walking.[57] An estimated 17.3% of kids between 3 and 13 years old experience confusional arousals.[57] About 17% of children sleep walk, with the disorder being more common among boys than girls.[57] The peak ages of sleep walking are from 8 to 12 years old.[57] A different systematic review offers a high range of prevalence rates of sleep bruxism for children. Between 15.29 and 38.6% of preschoolers grind their teeth at least one night a week. All but one of the included studies reports decreasing bruxist prevalence as age increased as well as a higher prevalence among boys than girls.[58]

Apnea means "no airflow." Obstructive sleep apnea was thought to be a disorder primarily of overweight, older men. But abnormal breathing during sleep can affect people of any age, any weight, and either sex. Researchers now know that in many cases of sleep apnea, the obstruction in the airways is only partial. Most people with sleep apnea have a smaller-than-normal inner throat and other subtle bone and soft-tissue differences.
Fatigue during the first trimester of pregnancy is likely caused by changing levels of hormones, such as progesterone. Toward the end of pregnancy, some women find it difficult to sleep because of the uncomfortable size of their abdomen. Some women are too excited, anxious, or worried about becoming mothers to sleep well. Other women who are pregnant complain that vivid dreams prevent them from getting restful sleep. Sleep apnea, especially if it's severe and causes your blood oxygen level to drop during sleep, is a risk to the fetus.
If sleeping with a mask on doesn't work for you, other options are surgery; oral appliances; and newer, minimally invasive outpatient surgical treatments. These include the Pillar procedure, which involves using permanent stitches to firm up the soft palate; coblation, which uses radiofrequency to shrink nasal tissues; and even use of a carbon dioxide laser to shrink the tonsils.
Sleep dentistry (bruxism, snoring and sleep apnea), while not recognized as one of the nine dental specialties, qualifies for board-certification by the American Board of Dental Sleep Medicine (ABDSM). The resulting Diplomate status is recognized by the American Academy of Sleep Medicine (AASM), and these dentists are organized in the Academy of Dental Sleep Medicine (USA).[53] The qualified dentists collaborate with sleep physicians at accredited sleep centers and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.[54]
Sleep dentistry (bruxism, snoring and sleep apnea), while not recognized as one of the nine dental specialties, qualifies for board-certification by the American Board of Dental Sleep Medicine (ABDSM). The resulting Diplomate status is recognized by the American Academy of Sleep Medicine (AASM), and these dentists are organized in the Academy of Dental Sleep Medicine (USA).[53] The qualified dentists collaborate with sleep physicians at accredited sleep centers and can provide oral appliance therapy and upper airway surgery to treat or manage sleep-related breathing disorders.[54]
What to do: See your dentist for an exam. Bite problems are often a cause of bruxism, and it's a good idea to check for damage to your teeth. It's likely she'll suggest lifestyle changes, such as cutting out alcohol before bed. If you chew gum, stop -- the habitual chewing action can make it more likely you'll grind your teeth at night. Wearing a dental guard or splint at night is usually the next step for bruxism. Your dentist will fit you with a device that prevents your jaw from clenching. Other treatments include Botox injections to the jaw muscle, and a biofeedback device called Grindcare.
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