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Difficulty Sleeping - Procedures, Side effects, Recovery time, Costs and alternatives

Last Updated: Dec 05, 2023

What is Difficulty Sleeping ?

Difficulty in sleeping is a condition which arises when a person loses his/her natural ability to fall asleep. This affects the person in getting the quality sleep which is required for both body and mind. Inability to fall asleep and feeling sleepy throughout the day both are associated with the sleeping problem. Some of the common sleeping problems that can be seen affecting the people around the globe are narcolepsy, sleep apnea, insomnia, circadian rhythm sleep disorder, and restless leg syndrome. Some sleeping problems can be due to an underlying health condition as well.

Insomnia is a condition wherein a person loses the ability to not only falls asleep but also to remain sleeping. In the condition of sleep apnea a person stops breathing for a few seconds in his/her sleep which leads to waking up at night. Narcolepsy is a condition wherein a patient feels sleepy the entire day leading to falling asleep without any warning. In the condition of restless leg syndrome, the patient has this urge of moving his legs. The symptoms of this condition are mostly observed at night. In circadian rhythm disorder, the body is in the state of jet lag condition. Sleep-related problems can happen to anyone but these are more common in patients suffering from the condition of anxiety and depression.

For providing relief to the patients suffering from various sleeping problems a doctor may prescribe several treatments. A doctor may advise some medication which can help the person in falling asleep. A doctor may also prescribe cognitive behavioral therapy. Besides these treatments, a doctor may recommend the patient to bring some changes to his/her lifestyle. Sometimes changes in the lifestyle bring about the required change in the sleeping habits of the patient. The doctor may choose a specific treatment based on the severity of the condition of the sleeping problem.

How is the treatment done?

Three types of treatment are available for curing the patient suffering from sleeping problems. A doctor may prescribe medicine, cognitive behavioral therapy and changes in the lifestyle.

  • Medicine: A doctor can advise a patient to take some prescription medicines to induce sleep. Based on research the most common treatment for problems associated with sleep is medicines. These medicines do not work in patients suffering from sleep apnea. For treating a short-term sleeping problem a doctor may prescribe antihistamine as they make people feel drowsy. For long-term treatment, a doctor may prescribe prescription medicines like escitalopram, ramelteon, zolpidem, and clonazepam. These medicines will be prescribed based on the medical history of the patient along with taking into account what other over the counter drugs are being taken by the patient.
  • Cognitive behavior therapy: This therapy is one of the most recommended therapies by the doctor around the globe for people suffering from the sleeping problem. This therapy can be tailored based on the symptoms and causes of the sleeping problem. This therapy can be conducted with a group of people having similar sleeping problems or it can also be conducted individually. The length of time for which this therapy is done varies as per the severity of the condition. This therapy mainly concentrates on the behavior patterns and negative thoughts which are prohibiting a person from getting a sound sleep. In therapy, a patient learns to change the negative thoughts and beliefs which are hampering the sleep. Through this therapy, a patient also learns to recognize the behavior affecting the sleep and how to change those behaviors.
  • Changes in lifestyle: A doctor may advise a patient to change their lifestyle if he/she believes that the lifestyle is hampering the sleep of the patient. A doctor may advise the patient to incorporate the following things to change their lifestyle
  • Incorporate fish and more vegetables into their diet.
  • Reducing water intake before sleeping.
  • Incorporate exercise to reduce stress and anxiety.
  • Reduce caffeine intake.
  • Reduce the use of alcohol and tobacco.
  • Take smaller meals before sleeping.
  • Stick to a schedule for sleeping.

Who is eligible for the treatment?(When is the treatment done ?)

The eligibility of a person for the treatment of sleeping problems depends upon the symptoms which are being exhibited by him/her. A person needs to fulfill the following criteria for the doctor to start the treatment if

  • A person cannot sleep after going to bed.
  • A person has a habit of waking up in the middle of the night.
  • A person has a problem going back to sleep.
  • A person does not feel refreshed after the sleep taken by him/her.
  • A person is sleeping for a very short duration of time.
  • A person is suffering from depression and anxiety.
  • A person is feeling sleepy throughout the day.

Who is not eligible for the treatment?

Before prescribing any treatment to the patients a doctor will first determine whether the concerned patient is suffering from the sleeping problem or not. In order to confirm the problem, a doctor may take into consideration the following :

  • Medical history of the patient.
  • The surrounding environment of the patient.
  • The emotional factor affecting the patient.

A doctor may advise the patient to keep a log of their sleep like noting the time when they go for sleep, when they wake up and what is the average duration of the sleep. A doctor may advise a patient to go for a sleep study to further strengthen his/her doubt. If even after going through such procedures a confirmed diagnosis of the sleeping problem cannot be made then such patients are deemed ineligible to start the treatment.

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Are there any Side Effects?

There is hardly a treatment which does not have any side effects associated with it. Medicines used for the treatment of sleeping problems also exhibit some side effects. Patients using this medicine may experience either minor side effects or a major side effect. A minor side effect may vanish after some time. In case of a major side effect, emergency medical attention is required to be taken. The side effects of these medicines include

  • increased drowsiness
  • dry mouth
  • pain in the abdomen
  • feeling nauseous
  • redness in the skin
  • state of confusion
  • decreased appetite
  • a headache

Cognitive behavior therapy has also been recently found to have some side effects. These side effects are visible in nearly 43 percent of the people going for this therapy. The side effects of cognitive behavior therapy include distress, further deterioration in the condition, stigma, strained relations with friends and family, increased crying, and feeling of shame or guilt. In case any of these side effects persists or there any other health issues arising during or after treatment, it is advised to kindly consult the health specialist immediately.

What are the post-treatment guidelines?

A patient who has undergone treatment for problems associated with the sleep is required to follow some post-treatment guidelines so that the problem does not reappear. Some of the guidelines are given below

  • A person must feel optimistic about every situation.
  • A person must decide a scheduled time for sleeping and stick to it.
  • Untimely naps must be avoided by a person.
  • A person must make the environment of their bedroom more sleep-friendly.
  • A person can include some reading in their activity before going to sleep.
  • A person may incorporate certain foods like fish to improve their sleeping habit.
  • A person must not drink coffee before going to bed at night.
  • A person should reduce the intake of water before sleeping.

How long doesit take to recover?

The extent of recovery and the time taken for complete recovery depends on patient to patient. A person suffering from a minor sleeping problem might get better in a few days while a person suffering from a serious sleeping problem might take weeks to recover from it. The patients using medicine for the treatment of sleeping problem may need a minimum of six months to recover completely. In some rare cases, the medicines are used for a longer duration than six months. Similarly, in the cognitive behavior therapy, the time of recovery of the patient depends upon the severity of the condition of the sleeping problem.

What is the price of the treatment in India?

In India, the average cost of prescription medicine used for the treatment of sleeping problems ranges from 50 rupees to 100 rupees per strip. Among the other countries like the United States and the United Kingdom, cognitive behavioral therapy is cheaper in India. The cognitive behavior therapy in India costs a person in the range of 500 to 5000 rupees based on the fees being taken by the doctor and the number of sessions required for complete recovery.

Are the results of the treatment permanent?

For a patient who has undergone any treatment for sleeping problems may exhibit similar symptoms in the future. There is a possibility that if a patient who had sleeping problems in the past may encounter any upsetting situation in the present or future may begin to feel problems in sleeping. Thus, it is very difficult to say whether the results of the treatment are permanent in nature.

What are the alternatives to the treatment?

Besides treatment with prescription medicine and cognitive behavior therapy, a patient may opt for several natural alternatives. A patient can make use of melatonin supplements for relief in their sleeping problems. A patient may also opt for yoga and several other relaxation techniques. A patient can also incorporate magnesium rich food product in their diet to aid them in sleeping like almonds, wheat bran, and legumes. A herb by the name of valerian can also be used for improving sleep. Patients suffering from sleep apnea can make use of a CPAP machine to help in curing sleeping problems.

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Written ByDr. Arun Sharma MBBS,MS - General Surgery,MCh - Neuro SurgeryNeurosurgery
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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