Doxepin
In 2016 the American College of Physicians advised that insomnia be treated first by treating comorbid conditions, then with cognitive behavioral therapy and behavioral changes, and then with drugs; doxepin was among those recommended for short-term help maintaining sleep, on the basis of weak evidence. The 2017 American Academy of Sleep Medicine recommendations focused on treatment with drugs were similar. A 2015 AHRQ review of treatments for insomnia had similar findings.
Sleep deprivation
Obstructive sleep apnea is often caused by collapse of the upper airway during sleep, which reduces airflow to the lungs. It has many serious health outcomes if untreated. Positive airway pressure therapy using a CPAP (Continuous positive airway pressure), APAP or BPAP devices is considered to be the first line treatment option for sleep apnea. Mandibular displacement devices in some cases can reposition the jaw and tongue to prevent the airway from collapsing. For some patients supplemental oxygen therapy may be indicated. Nasal problems such as a deviated septum will shut down the airway and increase swelling in the mucus lining and nasal turbinates. Corrective surgery (septoplasty) in some cases may be an appropriate choice of treatment.