Editing Sleep disorder (section)

== Treatment ==
[[File:Room for sleep studies - NÄL hospital.jpg|thumb|Sign with text: ''Sömnförsök pågår'' (Sleep study in progress), room for sleep studies in [[NÄL]] hospital, Sweden.]]
Treatments for sleep disorders generally can be grouped into four categories:
* [[Psychotherapy|Behavioral and psychotherapeutic]] treatment
* Rehabilitation and management
* Medication
* Other [[Somatic symptom disorder|somatic treatment]]

None of these general approaches are 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 may be compatible, 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.<ref>{{cite journal | vauthors = Ramar K, Olson EJ | title = Management of common sleep disorders | journal = American Family Physician | volume = 88 | issue = 4 | pages = 231–238 | date = August 2013 | pmid = 23944726 | url = https://www.aafp.org/afp/2013/0815/p231.html }}</ref> Medications and somatic treatments may provide the most rapid symptomatic relief from certain disorders, such as narcolepsy, which is best treated with prescription drugs such as [[modafinil]].<ref name="pmid22608642">{{cite book |title=Neurobiology of Psychiatric Disorders |vauthors=Voderholzer U, Guilleminault C |year=2012 |isbn=978-0-444-52002-9 |series=Handbook of Clinical Neurology |volume=106 |pages=527–40 |chapter=Sleep disorders |doi=10.1016/B978-0-444-52002-9.00031-0 |pmid=22608642}}</ref> Others, such as chronic and primary insomnia, may be more amenable to behavioral interventions—with more durable results.

Chronic sleep disorders in childhood, which affect some 70% of children with developmental or psychological disorders, are under-reported and under-treated. Sleep-phase disruption is also common among adolescents, whose school schedules are often incompatible with their natural circadian rhythm. Effective treatment begins with careful diagnosis using sleep diaries and perhaps sleep studies. Modifications in [[sleep hygiene]] may resolve the problem, but medical treatment is often warranted.<ref>{{cite journal |vauthors=Ivanenko A, Massey C|title=Assessment and Management of Sleep Disorders in Children  |journal=Psychiatric Times |volume=23 |issue=11 |date=October 1, 2006 |url=http://www.psychiatrictimes.com/articles/assessment-and-management-sleep-disorders-children}}</ref>

Special equipment may be required for treatment of several disorders such as obstructive apnea, circadian rhythm disorders and bruxism. In severe cases, it may be necessary for individuals to accept living with the disorder, however well managed.

Some sleep disorders have been found to compromise glucose metabolism.<ref name="Keckeis">{{cite journal | vauthors = Keckeis M, Lattova Z, Maurovich-Horvat E, Beitinger PA, Birkmann S, Lauer CJ, Wetter TC, Wilde-Frenz J, Pollmächer T | display-authors = 6 | title = Impaired glucose tolerance in sleep disorders | journal = PLOS ONE | volume = 5 | issue = 3 | pages = e9444 | date = March 2010 | pmid = 20209158 | pmc = 2830474 | doi = 10.1371/journal.pone.0009444 | veditors = Finkelstein D | doi-access = free | bibcode = 2010PLoSO...5.9444K }}</ref>

=== Allergy treatment ===
Histamine plays a role in wakefulness in the brain. An allergic reaction over produces histamine, causing wakefulness and inhibiting sleep.<ref>{{cite journal | vauthors = Thakkar MM | title = Histamine in the regulation of wakefulness | journal = Sleep Medicine Reviews | volume = 15 | issue = 1 | pages = 65–74 | date = February 2011 | pmid = 20851648 | pmc = 3016451 | doi = 10.1016/j.smrv.2010.06.004 }}</ref> Sleep problems are common in people with [[allergic rhinitis]]. A study from the [[N.I.H.]] found that sleep is dramatically impaired by allergic symptoms, and that the degree of impairment is related to the severity of those symptoms.<ref>{{cite journal | vauthors = Léger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, El Hasnaoui A, Bousquet J | display-authors = 6 | title = Allergic rhinitis and its consequences on quality of sleep: An unexplored area | journal = Archives of Internal Medicine | volume = 166 | issue = 16 | pages = 1744–1748 | date = September 2006 | pmid = 16983053 | doi = 10.1001/archinte.166.16.1744 | doi-access = free }}</ref><ref>{{Cite web|url=https://sleepfoundation.org/sleep-topics/sleep-related-problems/allergic-rhinitis-and-sleep|title=Allergies and Sleep|website=sleepfoundation.org|access-date=2017-06-08}}</ref> Treatment of allergies has also been shown to help sleep apnea.<ref>{{cite journal | vauthors = Staevska MT, Mandajieva MA, Dimitrov VD | title = Rhinitis and sleep apnea | journal = Current Allergy and Asthma Reports | volume = 4 | issue = 3 | pages = 193–199 | date = May 2004 | pmid = 15056401 | doi = 10.1007/s11882-004-0026-0 | s2cid = 42447055 }}</ref>

=== Acupuncture ===
A review of the evidence in 2012 concluded that current research is not rigorous enough to make recommendations around the use of [[acupuncture]] for [[insomnia]].<ref name="CheukEtalAcupuncture">{{cite journal | vauthors = Cheuk DK, Yeung WF, Chung KF, Wong V | title = Acupuncture for insomnia | journal = The Cochrane Database of Systematic Reviews | volume = 9 | issue = 9 | pages = CD005472 | date = September 2012 | pmid = 22972087 | doi = 10.1002/14651858.cd005472.pub3 | pmc = 11262418 }}</ref> The pooled results of two trials on acupuncture showed a moderate likelihood that there may be some improvement to sleep quality for individuals with insomnia.<ref name="CheukEtalAcupuncture" />{{rp|15}} This form of treatment for sleep disorders is generally studied in adults, rather than children. Further research would be needed to study the effects of acupuncture on sleep disorders in children.

=== Hypnosis ===
Research suggests that [[hypnosis]] may be helpful in alleviating some types and manifestations of sleep disorders in some patients.<ref name="Stradling">{{cite journal | vauthors = Stradling J, Roberts D, Wilson A, Lovelock F | title = Controlled trial of hypnotherapy for weight loss in patients with obstructive sleep apnoea | journal = International Journal of Obesity and Related Metabolic Disorders | volume = 22 | issue = 3 | pages = 278–281 | date = March 1998 | pmid = 9539198 | doi = 10.1038/sj.ijo.0800578 | doi-access = free }}</ref> "Acute and chronic insomnia often respond to relaxation and hypnotherapy approaches, along with sleep hygiene instructions."<ref name="Ng">{{cite journal | vauthors = Ng BY, Lee TS | title = Hypnotherapy for sleep disorders | journal = Annals of the Academy of Medicine, Singapore | volume = 37 | issue = 8 | pages = 683–688 | date = August 2008 | pmid = 18797562 | doi = 10.47102/annals-acadmedsg.V37N8p683 | s2cid = 18511973 | doi-access = free }}</ref> [[Hypnotherapy]] has also helped with nightmares and sleep terrors. There are several reports of successful use of hypnotherapy for parasomnias<ref name="Graci">{{cite journal | vauthors = Graci GM, Hardie JC | title = Evidenced-based hypnotherapy for the management of sleep disorders | journal = The International Journal of Clinical and Experimental Hypnosis | volume = 55 | issue = 3 | pages = 288–302 | date = July 2007 | pmid = 17558719 | doi = 10.1080/00207140701338662 | s2cid = 21598789 }}</ref><ref name="Hauri">{{cite journal | vauthors = Hauri PJ, Silber MH, Boeve BF | title = The treatment of parasomnias with hypnosis: a 5-year follow-up study | journal = Journal of Clinical Sleep Medicine | volume = 3 | issue = 4 | pages = 369–373 | date = June 2007 | pmid = 17694725 | pmc = 1978312 | doi = 10.5664/jcsm.26858 }}</ref> specifically for head and body rocking, bedwetting and sleepwalking.<ref name="Hurwitz">{{cite journal | vauthors = Hurwitz TD, Mahowald MW, Schenck CH, Schluter JL, Bundlie SR | title = A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror | journal = The Journal of Nervous and Mental Disease | volume = 179 | issue = 4 | pages = 228–233 | date = April 1991 | pmid = 2007894 | doi = 10.1097/00005053-199104000-00009 | s2cid = 10018843 }}</ref>

Hypnotherapy has been studied in the treatment of sleep disorders in both adults<ref name="Hurwitz" /> and children.<ref name="Owensa">{{cite journal | vauthors = Owens LJ, France KG, Wiggs L | title = REVIEW ARTICLE: Behavioural and cognitive-behavioural interventions for sleep disorders in infants and children: A review | journal = Sleep Medicine Reviews | volume = 3 | issue = 4 | pages = 281–302 | date = December 1999 | pmid = 12531150 | doi = 10.1053/smrv.1999.0082 }}</ref>

=== Music therapy ===
{{Further|Music and sleep}}
Although more research should be done to increase the reliability of this method of treatment, research suggests that [[music therapy]] can improve sleep quality in [[Insomnia|acute]] and chronic sleep disorders. In one particular study, participants (18 years or older) who had experienced acute or chronic sleep disorders were put in a randomly controlled trial, and their sleep efficiency, in the form of overall time asleep, was observed. In order to assess sleep quality, researchers used subjective measures (i.e. [[questionnaire]]s) and objective measures (i.e. [[polysomnography]]). The results of the study suggest that music therapy did improve sleep quality in subjects with acute or chronic sleep disorders, though only when tested subjectively. Although these results are not fully conclusive and more research should be conducted, it still provides evidence that music therapy can be an effective treatment for sleep disorders.<ref>{{cite journal | vauthors = Wang CF, Sun YL, Zang HX | title = Music therapy improves sleep quality in acute and chronic sleep disorders: a meta-analysis of 10 randomized studies | journal = International Journal of Nursing Studies | volume = 51 | issue = 1 | pages = 51–62 | date = January 2014 | pmid = 23582682 | doi = 10.1016/j.ijnurstu.2013.03.008 }}</ref>

In another study specifically looking to help people with insomnia, similar results were seen. The participants that listened to music experienced better sleep quality than those who did not listen to music.<ref>{{cite journal | vauthors = Jespersen KV, Pando-Naude V, Koenig J, Jennum P, Vuust P | title = Listening to music for insomnia in adults | journal = The Cochrane Database of Systematic Reviews | volume = 2022 | issue = 8 | pages = CD010459 | date = August 2022 | pmid = 36000763 | pmc = 9400393 | doi = 10.1002/14651858.CD010459.pub3 }}</ref> Listening to slower pace music before bed can help decrease the heart rate, making it easier to transition into sleep. Studies have indicated that music helps induce a state of relaxation that shifts an individual's [[Circadian rhythm|internal clock]] towards the sleep cycle. This is said to have an effect on children and adults with various cases of sleep disorders.<ref>{{Cite web|url=https://www.webmd.com/sleep-disorders/features/can-music-help-me-sleep|title=Can Music Help Me Sleep?|website=WebMD|language=en|access-date=2019-09-29}}</ref><ref>{{Cite web|url=https://medium.com/taking-note/can-music-make-you-a-productivity-powerhouse-9161721fced6|title=Can Music Make You a Productivity Powerhouse?|last=Evernote|date=2018-07-26|website=Medium|language=en|access-date=2019-09-29}}</ref> Music is most effective before bed once the brain has been conditioned to it, helping to achieve sleep much faster.<ref>{{Cite web|url=https://www.psychologytoday.com/blog/sleep-newzzz/201812/the-many-health-and-sleep-benefits-music|title=The Many Health and Sleep Benefits Of Music|website=Psychology Today|language=en-US|access-date=2019-09-30}}</ref>

=== Melatonin ===
Research suggests that [[melatonin (medication)|melatonin]] is useful in helping people fall asleep faster (decreased [[sleep onset latency|sleep latency]]), stay asleep longer, and experience improved sleep quality. To test this, a study was conducted that compared subjects who had taken melatonin to subjects with primary sleep disorders who had taken a placebo. Researchers assessed sleep onset latency, total minutes slept, and overall sleep quality in the melatonin and placebo groups to note the differences. In the end, researchers found that melatonin decreased sleep onset latency and increased total sleep time<ref>{{cite journal | vauthors = Ferracioli-Oda E, Qawasmi A, Bloch MH | title = Meta-analysis: melatonin for the treatment of primary sleep disorders | journal = PLOS ONE | volume = 8 | issue = 5 | pages = e63773 | date = 2013-06-06 | pmid = 23691095 | pmc = 3656905 | doi = 10.1371/journal.pone.0063773 | doi-access = free | bibcode = 2013PLoSO...863773F }}</ref><ref>{{cite web|url=http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?ID=12013029090|title=Meta-analysis: melatonin for the treatment of primary sleep disorders|website=www.crd.york.ac.uk|access-date=2016-03-08}}</ref> but had an insignificant and inconclusive impact on the quality of sleep compared to the placebo group.