Dr. Gary H. Miller, M.D.

Early morning awakenings can be very frustrating. Anxiety and depression are particularly common causes. Drugs and alcohol can also precipitate this. There are also other acquired behavioral disorders. Having a fairly rigid bedtime and wake time with no daytime naps is helpful. Bright light and screens should be avoided late at night but sunlight in the early morning is helpful at establishing better sleep. This is really a fairly complex problem and I would direct you to a free government website www.veterantraining.va.gov/insomnia. It is available to everyone not just veterans. Most people can be cured by behavioral interventions and sleeping pills at a young age would be best avoided. If you are anxious or depressed you should consult with your physician.

I am sorry to hear of this distressing problem. The fact that he is taking sertraline and Wellbutrin and marijuana tells me there are underlying psychiatric difficulties, and his insomnia may well be related to those problems. . Anxiety, depression and various drugs are among the most common causes of insomnia. It is important to seek help and he needs to start by discussing this with the physician prescribing the sertraline and Wellbutrin. Referral to a psychiatrist or sleep specialist may be required.

There is a really complex problem for a brief answer I can surely help you to think about this. Step #1 is to look at the machine data, and to be sure that your apnea is actually adequately suppressed. You will need your sleep specialist to do that for you. If apnea is well suppressed, the next related question is... are you using the machine for enough hours

This is a very general question and there are many kinds of insomnia. Assuming that this is a straightforward chronic insomnia not associated with severe anxiety or depression or underlying medical disorder cognitive behavioral therapy for insomnia is the right treatment of choice. It takes roughly 2 months though additional follow-up may be helpful.

Insomnia can be treated and cured. First insomnia is a symptom and not a discrete entity. There are many causes. Among them are poor sleep habits, medications, drugs and alcohol, stress, sleep apnea, periodic limb movements of sleep and multiple others. The way to start with this problem is to see a sleep specialist. The American Academy of Sleep Medicine and the American Association of Sleep Disorder Centers both maintain online membership and referral information.

Yes ,insomnia in children is absolutely treatable and that almost never involves medication. Behavioral interventions are remarkably effective. You should discuss this with your pediatrician and obtain referral to a pediatric sleep disorders center through them. To give you a more detailed answer requires knowing a good deal of personal information about your daughter and is best done by her physician

Sleep problems are often a part of ADHD. Difficulty falling asleep and difficulty getting out of bed can both be seen in patients with this problem. Additionally medication used for ADHD can affect sleep. There are both behavioral and medication interventions possible.

There is not enough detail here for me to be very specific. Your daughter's age and specific compliant need to be considered. There is a specialty of pediatric sleep medicine and I would suggest consulting a pediatric sleep specialist. A Google or Bing search should help you locate nearby resources. Your pediatrician may also be able to provide a referral.

Yes, in fact there is a subspecialty certification in behavioral sleep medicine available to PhD psychologists. Their special skilsl would generally be in the treatment of insomnia.

The most common cause of excessive sleepiness is sleep deprivation. A 19-year-old should be getting 8 hours of sleep daily. Sadly most 19-year-olds gets considerably less, at least on school days. That causes a sleep debt and is repaid on days off. If you are getting 8 hours of sleep daily, on a regular schedule ,and still feel tired; an underlying sleep disorder may be present. Disorders such as narcolepsy and sleep apnea are definitely seen in young adults and consultation with a sleep specialist would be the next step.

You need to be seen by us sleep physician.There are many possible causes for excess sleepiness but the simplest one is lack of adequate sleep, and lack of regular bed and wake times. It is important to allow 8 hours for sleeping each day and not to settle into a pattern of short sleep on weekdays and an attempt to catch up on weekends. It is hard to catch up.
A polysomnogram which is a study of sleep and a daytime test to assess sleepiness may be appropriate as well as a careful history and physical examination. The American Academy of Sleep Medicine can provide you with a list of specialists in your area and is available on the web

Your question shows that you are experiencing a great deal of distress about sleeping. Paradoxically that itself can disrupt sleep. The phenomenon is called psychophysiologic insomnia. Additionally anxiety and depression in general cause sleep disruption, especially middle of the night awakenings. Stimulating medicines such as your asthma medicine might also contribute. You should however not stop the asthma medicine. There is a well-developed set of interventions that are behavioral , to help you relearn to sleep well. Medication might also be appropriate but is not considered the first treatment in most patients. The general term for these behavioral interventions is cognitive behavioral therapy for insomnia. if you google the term CBT for insomnia, you will find a much more detailed discussion of these techniques. It very much needs a professional to help you through the task. You should contact a local physician who is a certified sleep specialist to evaluate your problems. Afterward a clinical psychologist skilled in CBT for insomnia will likely be involved. Roughly 3/4 of patients can be treated without need for sustained medication.

This is a complex question with many sub questions. You have what appears to be sleep onset insomnia. That is often related to stress or anxiety or environmental factors or medications or what are generically called sleep hygiene problems. That should be explored with your physician. If you are particularly tired being immobile,hard to arrouse and remembering nothing is probably normal. Not remembering dreams can be normal. Drugs and alcohol can accentuate this behavior. Awakenings need to be longer than 2 minutes to have any chance of remembering them. Fatigue has many meanings and ought to be explored with your physician. Awakening with bruises raises the question of whether you are walking or flailing in sleep or whether there is some non-sleep related problem related to clotting disorders. I would strongly recommend seeing an internal medicine physician and perhaps additionally obtaining a sleep physician consultation.

Actually there is no need to do that. Medicine can suppress sleepwalking
behavior but sleepwalking is a normal developmental variant in children and
usually requires no treatment. Sleepwalking can best be thought of as an
incomplete awakening. It is a phenomenon sometimes seen in young
developing brains. Stress and environments which disrupt sleep can provoke
additional sleepwalking. You should be sure that there is a safe
environment free of trip hazards since walking around in a pitch black room
holds the potential for falling or bumping into things. Sleepwalking
children generally do not injure themselves but are at risk of tripping or
bumping into objects in the dark, just as they would be if they were awake.
Also be sure that it is not possible to simply walk out of the house or
apartment. It would be worth seeing a sleep specialist for an expert review
of the individual circumstances of your child. There are medical conditions
that can provoke sleepwalking and it is best to obtain a consultation. Your
pediatrician or family physician can help arrange this.

Yes, absolutely. Depression is among the most common causes of insomnia and treating depression can often greatly help insomnia. Now the other part of this question is of course, is it appropriate to treat people without depression with antidepressants? That would be an off-label use. It has not been studied or approved by the FDA. It is however not uncommon. That decision should be discussed carefully with the treating physician. The American Academy of Sleep Medicine recommends behavioral therapy as the first intervention for insomnia without associated depression or other psychiatric causes. The technique is called cognitive behavioral therapy for insomnia.

Psychiatrists treat sleep disorders in people with psychiatric illnesses. That would be an appropriate professional if anxiety or depression or other psychiatric illness was suspected. Otherwise, the correct specialty is pediatric sleep disorders which is a distinct and recognized medical specialty. The American Academy of Sleep Medicine website should be able to direct you to local resources.

This has a complex answer..let me send you the guidelines


https://sleepeducation.org/sleep-disorders/child-insomnia/#:~:text=Child%20insomnia%20is%20best%20treated,child%20should%20go%20to%20bed
.

Benign sleep talking is classified as a parasomnia and is a cousin of sleepwalking. It occurs associated with a defective awakening with only part of the brain waking up. It is a normal variant in children. You should talk to your pediatrician at the next routine visit about this.
Occasionally but not often seizures or sleep apnea can produce mumbling and vocalizations during sleep. Listening to a careful description of what you see is likely enough to exclude these things.

There are many effective treatments for snoring but acupuncture is not numbered among them. I would strongly encourage you to see a physician who is familiar with this problem. That might include a sleep specialist or an otolaryngologist. Snoring can cause significant social stress and there is effective treatment available.

There are many effective treatments for snoring but pressure points are not numbered among them. I would strongly encourage you to see a physician was for the midyear with this problem. That might include a sleep specialist or an otolaryngologist. Snoring can cause significant social stress and there is effective treatment available.