Q: I have restless legs syndrome and do not like taking medications. Is there anything I can do that does not include oral medications?

A: Yes. Although not as successful as medication, non-pharmacological treatments are available. These include improving sleep hygiene with a regular sleep-wake time, avoiding caffeine, alcohol, and nicotine and, lastly, performing moderate daily exercise. Some patients report that acupuncture and massage are helpful. These modalities have not yet been scientifically studied.

 

Q: My wife can drink coffee right up until bedtime and have no trouble falling asleep. If I consume anything with caffeine after four p.m., I have a hard time falling and staying asleep. Why can she drink coffee that late and I can't?

A: Recent studies have shown that those who are sensitive to caffeine may have an inherited predisposition to its sleep-preventing properties. In some people, caffeine consumption disrupts the secretion of the sleep-promoting hormone melatonin, while in others it has little to no effect.

 

Q: Is it true that sleepwalking is hereditary? My dad was a sleepwalker and now my son is sleepwalking.

A: Yes, many studies show genetics are involved in sleepwalking. We think that heredity may predispose one to sleepwalking, but there are other factors such as lack of sleep or a sleep disorder like sleep apnea that may precipitate them.

 

Q: I have read about a disorder where people eat in the middle of the night. They say it's like sleepwalking. I do most of my eating after bedtime, but I am awake. Is that the same thing?

A: No, what you are describing is called nocturnal eating syndrome or night eating syndrome (NES). In this disorder people consume over 25% of their daily calories after 6pm. However, unlike sleep related eating disorder (SRED) to which you refer, they are wide-awake and conscious of what they are doing. The two are not synonymous. In your case you are describing NES. There are several behavioral and pharmacological treatments for this condition. In fact several of the antidepressants that increase serotonin levels such as sertraline (Zoloft) and Citalopram (Celexa) have been found to be particularly effective.

 

Q: I have been having trouble falling and staying asleep for about four months. It does not happen every night, but about three to four times a week. Would this be considered insomnia?

A: Yes, it’s consistent with chronic insomnia. Chronic insomnia is difficulty falling asleep or staying asleep, as well as early morning awakenings at least three times per week and for greater than three months.