One of the most well-known sleep disorders, sleep apnea is a fairly common condition. Marked by interruptions in breathing during sleep, sleep apnea causes the person suffering from this condition to wake up, or partially wake, several times during the night. Because of the frequency of these interruptions in breathing, a person with sleep apnea will have trouble getting a restful night’s sleep, causing them to feel the effects of sleep deprivation during their waking hours.

Two types of sleep apnea have been diagnosed: obstructive sleep apnea (OSA) and central sleep apnea. OSA is caused by the soft palate becoming so relaxed that it actually blocks off the breathing passageway, while central sleep apnea is caused by the brain relaxing to the point that it does not remind the body to breathe. While both types can cause interruptions to breathing on their own, most people with sleep apnea actually have mixed apnea, which is a combination of both forms.

Sleep apnea is sometimes difficult to diagnose, simply because it only strikes while the person is asleep and won’t notice that it is happening. Because most people with sleep apnea awake only partially – not fully – so they do not actually notice that they have had their sleep cycle interrupted. Thus, if someone wants to determine if they have sleep apnea, they will have to look for the symptoms.

The most common symptom of sleep apnea is excessive sleepiness upon waking. Because the sleep cycle is being interrupted, the person is not refreshed during the night and will wake up feeling lethargic, fatigued, or even feel like they need to go back to bed for another round of sleep. Also, people with sleep apnea almost always snore; often very loudly. However, a person does not necessarily have to show these symptoms to have sleep apnea. In fact, a bed partner may be the only person to notice the interruptions in breathing during the night.

Additionally, people with sleep apnea are often overweight to obese, so treatment usually involves helping people to lose weight. Treatment can also include eliminating alcohol or other substances that help people relax, quitting smoking, using special pillows or other appliances that help keep the airways open, or even special apparatus that uses air pressure to keep the airways open. This last form of treatment, continuous pressure airway pressure (CPAP), uses a breathing mask to pressurize the airways and inflate them, almost like a balloon. Though this form of treatment is more than a little disconcerting at first, they quickly get used to the mask and find that they feel much more alert in the morning.

Approximately 60 million people in the United States suffer from insomnia, and nearly half of American adults report experiencing at least one symptom of insomnia at least a few nights a week in the past year, yet the vast majority remains undiagnosed and untreated. Myths and misperceptions about insomnia and its treatment still persist that keep many sufferers from getting the sleep they need.

When people do not get enough sleep, a "sleep debt" can accumulate, which can be difficult to catch up to if it becomes too big. The consequences of not getting enough sleep can include daytime fatigue, impaired mood, depression, decreased ability to concentrate and make decisions, and increased risk of additional illness and injury. In fact, insufficient sleep has been associated with a variety of health problems, including obesity, diabetes, hypertension and heart disease.

Adding to the problem, many people are reluctant to take sleep medications. According to a recent survey, about two in ten respondents said they assumed their sleep problems would go away naturally, or that they would ignore the problem and do nothing about it.

But ignoring the problem will not always make it go away, and despite the fact that there are many new treatment options available for people living with insomnia, many misperceptions about insomnia treatment remain. This apparent confusion may cause some people to continue to needlessly suffer through sleepless nights.

All prescription medications are associated with benefits and risks. Many commonly prescribed sleep aids are classified as controlled substances by the U.S. Drug Enforcement Administration (DEA), meaning, in part, that they carry some risk for abuse or dependence.

"Non-narcotic medications may be controlled substances that still have some potential for addiction," said Suzy Cohen, RPh, a pharmacist in Ocala, Florida. "Most insomnia medications work by acting widely throughout the central nervous system and, in some cases, can be associated with residual effects including next-day grogginess and memory impairment. Consumers who have concerns about these residual effects or the potential for abuse and dependence should talk with their doctor to find a treatment option that is best for their needs."

With one exception, all currently available prescription sleep treatments fall under the controlled substances umbrella. That exception is a medication called Rozerem™ (ramelteon), which works differently from other prescription sleep medications. It targets the brain's own sleep-wake cycle and has not been associated with a risk of abuse or dependence or next-day hangover effects in clinical studies. Rozerem is indicated for adults who have trouble falling asleep. The most common side effects seen with Rozerem that were different from placebo (sugar pill) were sleepiness, dizziness and fatigue.

People with insomnia may find it helpful to practice healthy sleep hygiene behaviors, such as avoiding naps, which can disturb the sleep-wake cycle; avoiding stimulants such as caffeine and nicotine close to bedtime; establishing a regular relaxing bedtime routine; avoiding large meals close to bedtime; and exercising regularly.

No treatment is right for everyone, and there are many treatment options available for insomnia, so it is important for people to speak to their doctor to find a solution that works best for them.

Note to Editors: Important Prescribing Information: Rozerem™ (ramelteon) is indicated for the treatment of insomnia characterized by difficulty with sleep onset. Rozerem can be prescribed for long-term use. Rozerem should not be used in patients with hypersensitivity to any components of the formulation, severe hepatic impairment, or in combination with fluvoxamine. Failure of insomnia to remit after a reasonable period of time should be medically evaluated, as this may be the result of an unrecognized underlying medical disorder. Hypnotics should be administered with caution to patients exhibiting signs and symptoms of depression. Rozerem has not been studied in patients with severe sleep apnea, severe COPD, or in children or adolescents. The effects in these populations are unknown. Exercise caution if consuming alcohol in combination with Rozerem. Rozerem has been associated with decreased testosterone levels and increased prolactin levels. Health professionals should be mindful of any unexplained symptoms possibly associated with such changes in these hormone levels. Rozerem should not be taken with or immediately after a high-fat meal. Rozerem should be taken within 30 minutes before going to bed and activities confined to preparing for bed. The most common adverse events seen with Rozerem that had at least a 2% incidence difference from placebo were somnolence, dizziness, and fatigue. For complete prescribing information, please visit www.rozerem.com.

Sleep apnea is very difficult for a person to self-diagnose but, once the problem is found, there are treatments available. But for people who are overweight and have large necks, smoke, use sedatives or muscle relaxers, or just drink too much alcohol, lifestyle changes would be the best place to start either keeping sleep apnea away or treating it before it becomes a major health concern. After all, not breathing is a problem whenever it happens. So by treating sleep apnea now, sufferers can keep performing the one act they need to perform every day and every night. Sleeping Tips