Sleep loss management and treatment

Management and treatment of sleep loss are rarely addressed by clini-cians, despite the large toll on society. There are no formal treatment guidelines in primary or specialty care for dealing with sleep loss (Dinges et al., 1999). The most effective treatment for sleep loss is to sleep longer or take a short nap lasting no more than 2 hours (Veasey et al., 2002), and to have a better understanding of proper sleep habits.

Catching up on sleep on the weekends—a popular remedy for sleep loss—does not return individuals to baseline functioning (Szymczak et al., 1993; Dinges et al., 1997; Klerman and Dijk, 2005; Murdey et al., 2005).

If extended work hours or shift work cannot be avoided, specific behavioral tips to stay alert are available (NSF, 2005c), as are such wake-promoting medications as caffeine, modafinil, and ympathomimetic medications (direct and indirect acting), including pemoline and methylphenidate (Mitler and O’Malley, 2005). In a randomized clinical trial caffeine and modafinil showed similar benefits for performance and alertness (Wesensten et al., 2002). Modafinil is the only FDA-approved drug for shift work sleep dis-order, although it is not approved for sleep loss. Behavioral approaches developed for insomnia also may be useful for sleep loss, but no formal studies have been undertaken expressly for sleep loss. Furthermore, there have been no large-scale clinical trials examining the safety and efficacy of modafinil, or other drugs, in children and adolescents.

Behavioral approaches developed for insomnia also may be useful for sleep loss, but no formal studies have been undertaken expressly for sleep loss. Furthermore, there have been no large-scale clinical trials examining the safety and efficacy of modafinil, or other drugs, in children and adolescents.

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