Dr. Gary H. Miller, M.D.

Sleep apnea is never normal in children and can cause serious injury.The problem should be brought to the attention of your pediatrician who will help you with this problem

This actually has a complex answer and is surely related to the emotional trauma of your parent's death. Possibilities include counseling, cognitive behavioral therapy or even medication. I would start by seeing your family physician. Referral to a psychologist or psychiatrist may be appropriate as well.

Yes, it is, and it should be treated. It can induce significant learning and behavioral problems and also cause remodeling of the throat and tongue in unfavorable ways. He should be seen
by an ENT doctor and possibly a sleep specialist.

Step 1 take away the phone at 9 p.m. Step 2 turn off everything electronic at the same time. Step 3 nothing with caffeine after early afternoon. You did not specify his age. Unfortunately, teenagers are hard wired to go to bed late and get up late. Forcing sleep time to shift to earlier by preventing sleeping excessively late in the morning on weekends will also be helpful.

It's actually quite common. In children, tonsillectomy and adenoidectomy are the preferred interventions.

I would see a sleep specialist and initiate behavioral treatment of insomnia. Sedative medications are inappropriate. Consideration of anxiety or depression would be appropriate.The American's Academy of Sleep Medicine maintains a list of accredited sleep centers.

If you seem to be getting adequate sleep and you are still sleepy the possibility of a medical cause is likely. That might include medications, or sleep apnea or other sleep disorders. Be mindful of the fact that if you are getting enough sleep some days, it may take a week of adequate sleep to restore ideal wakefulness. Consultation with a sleep specialist would be appropriate.

Actually sleeping medications are best used for only a short time and your concerned about not becoming dependent is completely appropriate. It would be reasonable to ask why you're finding it hard to go to sleep. This could be related to life stress or depression or anxiety or physical discomfort or any number of other things. I hope your doctor took the time to ask about this. If not you should raise the question again.

People are naturally sleepier in the afternoon. Your symptom is most commonly related to not getting enough sleep. For most adults that is 7-8 hours. Many of his don't get much even though we should. Try leaving more time for sleep for at least a week to 10 days and see if you feel better. If not it's time to talk to your doctor

It's likely normal but you should ask her doctor to look at her nose and throat and see if there is anything out of the ordinary. That should only take a few moments at the time of a routine visit.

The answer is sometimes. Cure rates vary greatly depending on the severity of apnea and the anatomy of the patient but overall numbers in the 30%-40% range for the most typical surgeries would be usual. In a very favorable patient with a regimen of sequential surgeries for nonresponders, cure rates can be as high as 90%. That may require as many as 3 separate surgeries or alternatively use of a stimulator for the tongue.

This does not have a really simple answer. The medication is a benzodiazepine. This is a small dose of a drug which is considered a sedative hypnotic. It is surely possible for it not to work. Common causes of insomnia include pain, depression, anxiety and poor sleep habits. In the United States all benzodiazepines are controlled substances. I would address this question in detail with the treating physician. There are particular behavioral interventions which are possible with many patients, which are called cognitive behavioral therapy. It might be appropriate. The details of the sleep difficulty matter. Is this difficulty falling asleep, or difficulty staying asleep, or difficulty with early awakenings, or all of the above? If there are awakenings can she go back to sleep again? When did this start? Is there evidence of depression? Is there snoring? What medications are currently being used for anything? Is alcohol being consumed? Is caffeine being consumed? What time is bed and what time is up and out of bed in the morning? Is there travel or shiftwork? If the treating doctor's response is to quickly write another sedative prescription without taking a detailed review of the problem, I would ask for a referral to a sleep specialist.

Talking in sleep can be normal in children. Usually, this diminishes as they get older. It's possible there is some other problem, such as sleep apnea. If there is snoring at night, or large tonsils, or overweight status a formal medical evaluation would be appropriate.Talking in sleep is a phenomenon called a parasomnia. It represents a partial, incomplete awakening.

Depression is among the most common causes of insomnia. Even depression that is largely inactive can still manifest as insomnia in some patients. Managing depression, often with medication, is both frequent and
generally beneficial. I would encourage you to also ask your psychiatrist or treating physician about adding cognitive behavioral therapy for insomnia to the depression medication.

It takes about one day for each hour of time zone change for people to adapt. The direction of your trip east or west also controls adapting. Going east is generally harder Try to have a constant bed and wake time and also to get exposed to sunlight shortly after awakening. Light is key to resetting your internal clock. You need to avoid late in the evening and that includes bright screens

In general, sleep medicines are intended for short-term use and we really discourage patients from using them long-term except in unusual circumstances such as terrible pain or severe depression. You should consider behavioral interventions and a formal look at why you are having difficulty sleeping. A sleep specialist would be a good person to consult.

The standard test is called a polysomnogram and it measures brain waves and electrocardiogram and breathing and muscle tone and oxygen levels and eye motion. It is the definitive way to measure sleep and is done overnight in a sleep lab. If the only question to be answered is, do you have sleep apnea, a more limited home version exists which might be suitable.

There are actually 2 reasons to use automatic CPAP machines. The first may be that no one ever did a formal titration as insurance often prevents that, and instead the machine will find its own settings. The second is that pressure may vary for some people considerably during the night with more pressure needed when sleeping supine ( on back) or when dreaming when apnea is often more intense. In that setting it can be more comfortable to be on a variable pressure machine.

This is actually a quite complex problem. If you hear pauses in snoring on a regular basis or alternatively if your husband is sleepy in the day he ought to be seen by a physician to look for sleep apnea. If this is just snoring with no other warning symptoms he could try an over-the-counter boil and bite orthotic that pulls the tongue forward or a nasal valve called Therevent. Neither of those require a prescription. If there is no response, formal medical evaluation would be appropriate. Finally general measures for snoring include avoiding alcohol, treating nasal stuffiness and avoiding sleeping supine (sleeping on back).

The first thing to do here is to be sure you're getting enough sleep. For some people that's a full 8 hours. Assuming there is enough sleep, the next thing to do is to look at the data recording from the BiPAP machine. Virtually all modern machines are able to track whether apnea is suppressed. If apnea is not suppressed a formal laboratory study would probably be appropriate. If it is suppressed and there is no shortage of sleep time, about 10% of sleep apnea patients will remain sleepy. There are FDA approved medicines for this.