EXPERT
Dr. Gary H. Miller, M.D.
Pulmonologist
Dr. Gary H. Miller M.D. is a top Sleep Medicine Specialist in Washington, . With a passion for the field and an unwavering commitment to their specialty, Dr. Gary H. Miller M.D. is an expert in changing the lives of their patients for the better. Through their designated cause and expertise in the field, Dr. Gary H. Miller M.D. is a prime example of a true leader in healthcare. As a leader and expert in their field, Dr. Gary H. Miller M.D. is passionate about enhancing patient quality of life. They embody the values of communication, safety, and trust when dealing directly with patients. In Washington, DC, Dr. Gary H. Miller M.D. is a true asset to their field and dedicated to the profession of medicine.
47 years
Experience
Dr. Gary H. Miller, M.D.
- Washington, DC
- New York Univ Sch of Med, New York Ny
- Accepting new patients
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Child wakes up screaming every 40 minutes
This would definitely be appropriate for your daughter to see a pediatric sleep specialist. They would take a history and they might arrange for monitoring sleep for a night in READ MORE
This would definitely be appropriate for your daughter to see a pediatric sleep specialist. They would take a history and they might arrange for monitoring sleep for a night in a laboratory environment. It's hard to know without more information if this is something abnormal or not.
How can I manage sleep apnea for my mother who is 70 years old?
Ordinarily sleep apnea is treated with devices such as a dental device or CPAP or perhaps oxygen , and medication is never used to treat sleep apnea. Associated conditions such READ MORE
Ordinarily sleep apnea is treated with devices such as a dental device or CPAP or perhaps oxygen , and medication is never used to treat sleep apnea. Associated conditions such as heart failure or nasal problems might be treated with medicine. There are no natural ways to treat sleep apnea because it is not treated with pills ; with the very large exception of weight loss and avoiding alcohol and sedatives. Sleep apnea causes sleepiness. It would be really helpful to talk to the treating doctor.
What is the best way to treat sleepwalking?
I presume that her daughter is still fairly young. This is actually normal behavior in children up to roughly teenage years. In general no treatment is needed and other than providing READ MORE
I presume that her daughter is still fairly young. This is actually normal behavior in children up to roughly teenage years. In general no treatment is needed and other than providing an environment free of injury hazards for tripping or falling in the dark the best option is usually to not intervene with medicine. Seeing a pediatric sleep specialist might be useful for peace of mind and to be sure this is simply benign sleep walking.
Can there be side effects from sleep medications?
Sleeping medication has many potential side effects. You mentioned the presence of hypertension and older men with hypertension are at considerable risk for sleep apnea. The doctor READ MORE
Sleeping medication has many potential side effects. You mentioned the presence of hypertension and older men with hypertension are at considerable risk for sleep apnea. The doctor who will see him should consider this possibility carefully along with his other problems..
Can yoga help with sleep?
It might help a bit. Rotating shifts are extremely difficult challenges for workers. Studies of nurses working as shift workers show considerable adverse health effects beyond READ MORE
It might help a bit. Rotating shifts are extremely difficult challenges for workers. Studies of nurses working as shift workers show considerable adverse health effects beyond simple fatigue or sleepiness.
What is the treatment for hypopnea syndrome?
Hypopnea syndrome is an unusual term as sleep physicians usually consider it to be part of sleep disordered breathing, which includes sleep apnea and hypopnea. If this is typical READ MORE
Hypopnea syndrome is an unusual term as sleep physicians usually consider it to be part of sleep disordered breathing, which includes sleep apnea and hypopnea. If this is typical obstructive sleep apnea/hypopnea, standard treatments include weight loss, CPAP, dental orthotic, corrective surgery, or nasal valves. Treatment is generally quite effective. There are other "flavors," and more detailed information would be useful for you.
What is cataplexy? How can it be treated?
Cataplexy is sudden, involuntary loss of motor tone usually triggered by strong emotion, including anger or laughter. It is not associated with loss of consciousness and is not READ MORE
Cataplexy is sudden, involuntary loss of motor tone usually triggered by strong emotion, including anger or laughter. It is not associated with loss of consciousness and is not associated with seizure activity. While there are uncommon causes, if it is present along with daytime sleepiness, it is considered a pathognomonic feature of narcolepsy. Cataplexy can be a serious problem for driving, operating dangerous equipment, or even walking in places where loss of motor control could potentially cause serious injury. Treatment consists of medication.
Is there a natural way to treat insomnia?
Yes, there is. The general technique is called cognitive behavioral therapy for insomnia. It consists of behavioral interventions to improve sleep quality. It is really important READ MORE
Yes, there is. The general technique is called cognitive behavioral therapy for insomnia. It consists of behavioral interventions to improve sleep quality. It is really important to allow adequate time for sleep as well as the most common cause of daytime tiredness in the United States is choosing to sleep less than a person needs to sleep. There are a variety of reliable online websites offering cognitive behavioral therapy as well as trained sleep psychologists in most communities. The New York Times health section contained an overview and summary about a year ago. I am sure you can find this if you search the New York Times website.
Is there a way to control sleepwalking?
Sleepwalking is best thought of as a defective awakening. It may or may not be normal in a 12-year-old. I would see a board-certified specialist in sleep medicine who is comfortable READ MORE
Sleepwalking is best thought of as a defective awakening. It may or may not be normal in a 12-year-old. I would see a board-certified specialist in sleep medicine who is comfortable treating children. It's actually okay to awaken sleepwalking people, but they may become momentarily quite agitated or confused when they fully awaken in an odd and unexpected environment. Bedrooms should be free of obvious injury dangers such as trip hazards as walking around in the dark may lead to accidents even when wide-awake. Generally, sleepwalking people have about the same injury risk as awake people stumbling around in the dark, and a standard nightlight would also be appropriate.
My mother has narcolepsy since the last 10 days all of a sudden. How can it be treated?
What you are describing is called excessive daytime sleepiness, and narcolepsy would be exceedingly uncommon as a new diagnosis in a 72-year-old female. This is not normal and READ MORE
What you are describing is called excessive daytime sleepiness, and narcolepsy would be exceedingly uncommon as a new diagnosis in a 72-year-old female. This is not normal and the likely causes could include sedating medications or sleep deprivation, which may not be voluntary (consider pain, excessive urination, noisy environment, etc.). Sleep apnea is also common as one ages and affects potentially as many as 5%-10% of adults, especially if they are overweight. First step is careful diagnosis. Consultation with a sleep specialist is needed.
What are the main causes of night terrors?
This actually has a fairly complex answer. The behavior you describe is called a parasomnia. A first question is, "Has he done this since childhood?" If so, night terrors are quite READ MORE
This actually has a fairly complex answer. The behavior you describe is called a parasomnia. A first question is, "Has he done this since childhood?" If so, night terrors are quite probable. There should not be more than one episode nightly in general and there should be no history of injury. There may be a predilection for them happening early in the night.
If this is not a long-standing problem, there is probably something more serious medically. That could include sleep apnea or PTSD or seizures or medication side effects or a harbinger of Parkinson's called REM behavior disorder. If these are "just" night terrors and they disrupt your sleep, treatment with medication is likely to be quite effective. Other entities would each have their own intervention. Seeing a sleep disorder specialist would be helpful.
If this is not a long-standing problem, there is probably something more serious medically. That could include sleep apnea or PTSD or seizures or medication side effects or a harbinger of Parkinson's called REM behavior disorder. If these are "just" night terrors and they disrupt your sleep, treatment with medication is likely to be quite effective. Other entities would each have their own intervention. Seeing a sleep disorder specialist would be helpful.
I hear vague noises in my head when I sleep. It disturbs me. What can I do?
This may be a problem called tinnitus, especially if you have some hearing loss or are over 40. That is an abnormality of hearing, not sleep. It would be wise to see a specialist READ MORE
This may be a problem called tinnitus, especially if you have some hearing loss or are over 40. That is an abnormality of hearing, not sleep. It would be wise to see a specialist in ears, called an otolaryngologist. They can test hearing and decide what should be done.
What could be the side effects of sleeping pills in the long run?
Unisom and over-the-counter sleeping aids work by using antihistamines with anticholinergic properties. They cause dryness of moist membranes. They can also cause constipation. READ MORE
Unisom and over-the-counter sleeping aids work by using antihistamines with anticholinergic properties. They cause dryness of moist membranes. They can also cause constipation. Probably more importantly depending on age, prolonged use can be associated with mental impairment or confusion and there is concern in older patients that some of this might prove irreversible. There is not much data to support using sleeping pills beyond short-term , more than a month or 2. Common causes of insomnia include depression anxiety and stress and undesirable behaviors such as drinking alcohol at bedtime or caffeine at bedtime. It would be worth discussing this in person with a physician who knows you/her.
Is an extreme urge to nap in the afternoon a problem?
The nap is not a problem. The extreme sleepiness might be a problem. You're not supposed to be really sleepy during the day. The most common cause for this is not getting enough READ MORE
The nap is not a problem. The extreme sleepiness might be a problem. You're not supposed to be really sleepy during the day. The most common cause for this is not getting enough sleep! Try sleeping an hour longer every day for at least 10 days and see if the need to nap abates. If it does, that is your answer. If it doesn't there may or may not be a sleep problem, but it would be worth seeing a sleep physician.
Can snoring be associated with a health problem?
Snoring can be a symptom of sleep apnea, especially if pauses are present.
Sleep apnea is a potentially serious illness. It would be worthwhile to have him tested for disordered READ MORE
Snoring can be a symptom of sleep apnea, especially if pauses are present.
Sleep apnea is a potentially serious illness. It would be worthwhile to have him tested for disordered breathing during sleep.
Sleep apnea is a potentially serious illness. It would be worthwhile to have him tested for disordered breathing during sleep.
What are the possible side effects of sleep medicines?
Every sleeping medication has side effects. Additionally some can be associated with addiction or with daytime impairment. The best first option is to see a sleep specialist who READ MORE
Every sleeping medication has side effects. Additionally some can be associated with addiction or with daytime impairment. The best first option is to see a sleep specialist who is familiar with the many causes of insomnia. Insomnia can be related to stress or anxiety or depression or medication or alcohol use or illicit drug use or sometimes it is an acquired behavior. There are many behavioral ways to deal with insomnia that do not involve use of sleeping medication. They would be a really good place to start if you want to approach the problem "without side effects"
What medicines are normally recommended to treat sleep apnea?
Sleep apnea is generally treated with devices such as CPAP or mandibular repositioning splints or sometimes with surgery or dental work. For all but the most minor apnea there READ MORE
Sleep apnea is generally treated with devices such as CPAP or mandibular repositioning splints or sometimes with surgery or dental work. For all but the most minor apnea there is no medication. Sometimes if stuffy nose or allergies contribute, medication to unclog the nose is helpful but this is not a particularly common circumstance.
How much deep sleep is enough?
Sleep trackers use the technology called actigraphy and are fairly unreliable at recognizing and classifying sleep. They measure motion. Doctors don't use motion to define sleep READ MORE
Sleep trackers use the technology called actigraphy and are fairly unreliable at recognizing and classifying sleep. They measure motion. Doctors don't use motion to define sleep staging. Tramadol is a sedating medication. If you're wide-awake in the day, even on that medicine, and experiencing no accidental naps, your sleep is probably adequate. The medical definition of "enough sleep" is the amount required for person to be optimally awake. That means no naps and no accidental falling asleep during the day. On average that is 7-8 hours nightly. It should not exceed 9 hours. You cannot find an Actigraph with sufficient accuracy at staging sleep to have reliable sleep stage numbers. The correct approach would be to obtain a polysomnogram which monitors brain waves and serves as the gold standard definition for sleep staging. That requires a physician and a sleep laboratory. If you have complaints of impairment in the day; that would be a worth while a evaluation.
Can lack of sleep cause confusion in a person?
It is hard to know without more information but someone complaining of sleeplessness has a high possibility of taking sleeping medication, and every single one of those, including READ MORE
It is hard to know without more information but someone complaining of sleeplessness has a high possibility of taking sleeping medication, and every single one of those, including the over-the-counter ones using antihistamines such as Benadryl and scopolamine can be associated with increased confusion especially in older patients. If there is medication, try stopping it.
If there is no medication involved a careful neurologic evaluation is appropriate as sleeplessness and confusion can be early signs of serious neurologic illness.
If there is no medication involved a careful neurologic evaluation is appropriate as sleeplessness and confusion can be early signs of serious neurologic illness.
Could my daughter's forgetfulness be due to lack of sleep?
Yes it is entirely possible for poor sleep and daytime tiredness to cause impaired memory and judgment. Trouble sleeping can be a sign of anxiety or stress or depression. It would READ MORE
Yes it is entirely possible for poor sleep and daytime tiredness to cause impaired memory and judgment. Trouble sleeping can be a sign of anxiety or stress or depression. It would definitely be appropriate to have her physician evaluate the problem.
