Ask The Sleep Doctor – Narcolepsy, Insomnia, Sleeping Pills, and RLS

Dear Dr. Rosenberg,

My 24-year-old son was diagnosed with narcolepsy several years ago. Although his major complaint is sleepiness, he has a hard time staying asleep. Isn’t this unusual in a disorder that causes sleepiness?

ANSWER:

No, in fact many narcoleptics, prior to treatment, complain of frequent awakenings and very light sleep. Narcolepsy is a disease where the boundaries between sleep and wakefulness are disturbed. Therefore, just as sleep intrudes into wakefulness during the day, wakefulness intrudes into sleep during the night. There are excellent therapies available for this. Have your son discuss this with his sleep specialist.

Dear Dr. Rosenberg,

Is there any place for using sleeping pills in insomnia? My husband cannot fall asleep and has a hard time staying asleep. He has had several negative sleep studies and has not responded to behavioral therapies. He is becoming progressively more anxious and irritable.

ANSWER:

Yes, there are instances where medications should be introduced. There are amongst us some with insomnia who suffer from hyper arousal. Their fight or flight sympathetic nervous systems and hypothalamic pituitary adrenal systems are in constant overdrive, producing excessive amounts of stress hormones such as cortisol. In many, there may be a genetic hereditary basis. These patients may benefit from the judicious use of medications for sleep. Although a minority, I encounter several patients a month who respond nicely to pharmacological therapy. Close monitoring is of course necessary.

Dear Dr. Rosenberg,

I have had severe restless legs syndrome for years. I take medications but I don’t like the side effects. Recently, a friend of mine mentioned that I should have my vitamin D levels checked. What do you think?

ANSWER:

A very good idea. Several recent studies have shown that among other factors, low vitamin D levels can cause RLS. In fact, in my practice, checking vitamin D levels is part of our routine workup for RLS.

Dear Dr. Rosenberg,

Our seven-year-old son sleepwalks every week on average. This started about two months ago. Should we wake him up when we find him wandering?

ANSWER:

No, the best thing to do is gently guide him back to bed. There is no danger associated with waking him but this can cause agitation and prolong the episode. What you should do is safety-proof the home. Place gates at the top of the stairs, and alarms or bells on bedroom doors so that you are aware that your child is sleepwalking. Make sure upstairs windows cannot be opened wide enough that your child could jump out of them.


Robert S. Rosenberg, DO, FCCP, is the medical director of the Sleep Disorders Center of Prescott Valley, Arizona and sleep medicine consultant for Mountain Heart Health Services in Flagstaff, Arizona. Dr. Rosenberg is Board Certified in Sleep Medicine, Pulmonary Medicine, and Internal Medicine. His book Sleep Soundly Every Night, Feel Fantastic Every Day  is a best seller. Dr Rosenberg’s latest book is The Doctor’s Guide to Sleep Solutions for Stress & Anxiety. Visit Dr Rosenberg’s website www.AnswersForSleep.com which offers a wealth of information on sleep topics.

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