expert type icon 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.
42 years Experience
Dr. Gary H. Miller, M.D.
  • Washington, DC
  • New York Univ Sch of Med, New York Ny
  • Accepting new patients

Why does my daughter talk so much in sleep?

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, READ MORE
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.

Are anti depressants recommended for people with sleep issues?

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 READ MORE
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.

Why am I not able to get over jet lag?

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 READ MORE
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

Are sleep medications lifelong?

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 READ MORE
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.

What kinds of tests are conducted to diagnose sleep disorders?

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 READ MORE
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.

Cpap pressure

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 READ MORE
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.

How can I treat my husband's snoring habit?

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 READ MORE
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).

always tired

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 READ MORE
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.

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.

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.