What Your Doctor Can Do for You

Whether you have a full-blown sleep disorder or chronic sleep loss related to pain, treating the sleep problem can make a huge difference - not only by helping you feel better physically but also by empowering you emotionally, says Daniel Rooks, PhD, director of the Be Well! Tanger Center for Health Management at Beth Israel Deaconess Medical Center in Boston. 

Depending on your medical history and current health status, your doctor may prescribe medication to help you sleep. "Generally we don't like to prescribe short-term sleep agents but instead go for the longer-term solution, such as treating the pain or working with brain hormonal levels. Therefore, we often prescribe a low-dose antidepressant to people with chronic pain conditions because it improves serotonin levels, sleep, pain and depression," says Doris Cope, MD, University of Pittsburgh Medical Center. 

If you're in acute pain, your doctor may prescribe pain medication, such as an opioid or narcotic drug, for a limited time. Taking pain medication for a long time, though, isn't advised because you can develop a tolerance for the drug, and its effectiveness may wear off, says Dr. Cope. Your doctor may recommend medications that promote sleep, such as zolpidem (Ambien) or zaleplon (Sonata), which are also intended for short-term use. One new sleep medication on the horizon is eszopiclone (Estorra). The FDA currently is reviewing results of 24 clinical trials on the drug, which is intended for people with chronic or short-term insomnia. If approved, the drug could be launched in mid-2004.

Perhaps falling asleep is not a problem for you but you feel excessively tired during the day. The medication modafinil (Provigil), which promotes wakefulness, was first FDA approved to treat daytime sleepiness in people with narcolepsy. In September, 2003, a U.S. advisory panel unanimously recommended that the FDA approve Provigil to treat daytime sleepiness caused by sleep apnea. By a six-to-two vote, the panel also recommended approving the drug to treat daytime sleepiness in shift workers. 

An existing serotonin-blocking drug called mirtazapine (Remeron), which is approved by the FDA for treating depression, is being investigated as a treatment for people with sleep apnea. In a recent clinical trial, Remeron reduced the number of times that breathing slowed or stopped during sleep by about 50 percent, and it reduced the number of times that sleep was interrupted during a night by about 28 percent. 

To confirm or rule out a sleep disorder, your doctor may suggest you spend a night in a sleep lab.

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Marie Karns is a freelance writer living in Oregon and a frequent contributor to Arthritis Today.

Also of Interest:

So Tired You Don't Feel Normal? | What's Your Trouble? | Reset Your Clock | How Tired Are You? | How Much Sleep Do You Need? | What Can Your Doctor Do For You?