John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What prescription medicines are there for insomnia?
There are numerous prescription medications options a doctor may prescribe if
a person is
suffering from short-term or chronic insomnia. Most are not recommended for
long-term use.
Medication to treat insomnia includes several classes of drugs;
Short-acting sedative-hypnotics (non-benzodiazepines) - these medications
slow activity in the brain to allow sleep.
Intermezzo was approved by the Food and Drug Administration in November 2011. It is a form of zolpidem, taken sublingually (dissolved under the tongue) and in smaller doses than Ambien.
In February 2007, the Food and Drug Administration issued a warning in regard
to sedative-hypnotic drugs and their risks, which "...include severe allergic
reactions and complex sleep-related behaviors, which may include sleep driving.
Sleep driving is defined as driving while not fully awake after ingestion of a
sedative-hypnotic product, with no memory of the event."
Melatonin receptor agonists - used to help patients who have difficulty
falling asleep and it works similarly to melatonin
ramelteon (Rozerem):
Ramelteon is a medication taken by mouth 30 minutes prior to bedtime.
Ramelteon should not be taken if the patient will not be able to sleep
for at least 7-8 hours. Insomnia usually improves in 7-10 days.
One of the advantages of ramelteon over other prescription sleep
medications is the lack of dependence on the medication.
Benzodiazepines (tranquilizers) - this class of medication is used to slow
down the central nervous system, causing drowsiness. These medications have a
high risk of dependence with chronic usage.
Tricyclic antidepressants:Tricyclic antidepressants
are medications work by increasing the amounts of certain natural substances
in the brain that are needed for mental balance.
doxepin (Silenor): in 2010, this sleep medicine was approved for the use
in people who have trouble staying asleep. Silenor may help with sleep
maintenance by blocking histamine receptors.
If your doctor recommends prescription sleep medications:
Follow all prescribing instructions given by your physician.
Tell your doctor if you are taking any other medications or supplements you
are taking as many can have adverse interactions with sleep medications.
Tell your doctor about any pre-existing medical conditions.
Note any possible negative side effects (changes in your body, and even
your emotions)
Do not use the medications nightly unless instructed to do so by a
doctor - this can lead to dependence
Avoid drinking alcohol or taking other non-prescription drugs while using
sleep medication
Never drive a car or operate machinery after taking a sleeping pill.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Restless leg syndrome (RLS or restless legs syndrome) is a common cause for painful legs that typically eases with motion, and becomes worse and more noticeable at rest. This characteristic nighttime worsening can frequently lead to insomnia. Treatment of the symptoms of restless leg syndrome is generally with medication as well as treating any underlying condition causing restless leg syndrome.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Narcolepsy, a chronic disease of the central nervous system causes have not been fully determined. Some theories include abnormalities in hypocretin neurons in the brain or an autoimmune disorder. Symptoms of narcolepsy include excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, disturbed nocturnal sleep, and automatic behavior. Diagnosis of narcolepsy is based on a clinical evaluation, specific questionnaires, sleep logs or diaries, and the results of sleep laboratory tests. Treatments of narcolepsy symptoms include medication and lifestyle changes.
Sleepwalking is a condition in which an individual walks or does other activities while asleep. Factors associated with sleepwalking include genetic, environmental, and physiological. Episodes of sleepwalking may include quiet walking to agitated running. Conditions that may have similar symptoms of sleepwalking, but are not include night terrors, confusional arousals, and nocturnal seizures. Treatment of sleepwalking generally include preventative measures. Medication may be prescribed if necessary.
Hypersomnia is a condition where a person has excessive daytime sleepiness and trouble staying awake during the day. Treatment for hypersomnia includes medication, CPAP machines, and lifestyle changes.
Caring for a loved one or patient with Alzheimer's can become a difficult and overwhelming task at times. This guide helps caregivers of individual's with Alzheimer's deal with communicating, bathing, and dressing; as well as problem solving with incontinence, sleeping, wandering; and coping with difficulties Alzheimer's patients present.
Periodic limb movement disorder (PLMD) is a sleep disorder characterized by rhythmic movements of the limbs during sleep. The movements typically involve the legs, but upper extremity movements may also occur. Movements occur periodically throughout the night and can fluctuate in severity from one night to the next. They tend to cluster in episodes that last anywhere from a few minutes to several hours. These movements are very different from the normal spasms, called hypnic myoclonia, that we often experience initially while trying to fall asleep.
When sleepiness interferes with daily routines and activities, or reduces the ability to function, it is called "problem sleepiness." A person can have problem sleepiness without realizing it. Symptoms of problem sleepiness include: consistently don't get enough sleep, or poor quality sleep, fall asleep while driving, struggle to stay awake when inactive (like watching TV or reading), have difficulty paying attention or concentrating at work, school, or home, have poor performance problems at work or school, have difficulty remembering things, have slowed responses, have difficulty controlling your emotions, and/or if you have to take naps on most days.
Sleep needs in children and teenagers depends on the age of the child. Sleep disorders in children such as sleep apnea, parasomnias, confusional arousals, night terrors, nightmares, narcolepsy, and sleepwalking can effect a child's or teen's sleep. Healthy sleep habits and good sleep hygiene can help your infant, toddler, preschooler, tween, or teenager get a good night's sleep.
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