title: Nasal dilator strip therapy for chronic sleep maintenance insomnia: a case series.
abstract: Sleep-disordered breathing (SDB) is a salient factor in chronic sleep maintenance insomnia. However, many insomnia patients with comorbid SDB may not be interested initially in receiving treatment with continuous positive airway pressure or oral appliance therapy. As an interim pathway, we used Breathe Right nasal dilator strip (NDS) therapy to introduce these patients to the relationship between insomnia and SDB. We hypothesized that NDS-associated improvements might motivate patients to pursue comprehensive SDB therapies. In this open label trial, three men with chronic sleep maintenance insomnia were treated with an educational session about SDB coupled with nightly NDS therapy. At 4-week follow-up, global insomnia severity, difficulty staying asleep, difficulty falling back asleep when awakened, total number of awakenings, and wake time after sleep onset systematically improved. Following NDS therapy, all three insomnia patients elected to pursue comprehensive SDB treatment at local sleep centers.
authors.affiliation: Sleep and Human Health Institute, Albuquerque, New Mexico 87109, USA. bkrakow@sleeptreatment.com
authors.forename: Barry
authors.initials: B
authors.lastname: Krakow
authors.forename: Dominic
authors.initials: D
authors.lastname: Melendrez
authors.forename: Brandy
authors.initials: B
authors.lastname: Sisley
authors.forename: Teddy D
authors.initials: TD
authors.lastname: Warner
authors.forename: Jessica
authors.initials: J
authors.lastname: Krakow
mesh_terms: D016022:Case-Control Studies; D002908:Chronic Disease; D004106:Dilatation / Q000295:instrumentation*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D009296:Nasal Cavity; D011446:Prospective Studies; D012189:Retrospective Studies; D023842:Rhinometry, Acoustic; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000628:therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000628:therapy*; D014851:Wakefulness / Q000502:physiology