When your sleep is disrupted enough that it becomes a problem, you need to see a medical professional. Be prepared to answer detailed questions about your sleep history and overall health.
Getting enough sleep is an absolute imperative for good health. If simple changes to your lifestyle and environment haven’t alleviated a sleep problem, it may be time to see a health care provider to evaluate your sleep history. A good primary care physician may be able to diagnose and treat a sleep disorder, but she may also refer you to a credentialed sleep specialist.
Do You Need to See a Sleep Specialist?
Expect a sleep specialist to take a detailed medical history in addition to a sleeping history for you and your family members, says Carol Ash, DO, medical director of Sleep for Life in Hillsborough, N.J.
Our bodies are genetically programmed to respond to stimuli — sound and, particularly, light — in order to fall asleep and wake up on a regular cycle, Dr. Ash explains. Any deviation from that cycle should be explored, she says.
Sleep disorders can be either primary, a problem limited to sleeping itself, or a symptom of another physical or psychological condition. For that reason, sleep history may be quite detailed.
Be wary of a physician who suggests a pharmaceutical sleeping aid without a thorough discussion of the possible causes of your problem and a detailed sleep history, Ash advises. With some sleep disorders, like sleep apnea (a condition in which the airway closes during sleep), sleeping pills can be dangerous.
What's Your Sleep History?
There are almost 40 different questionnaires sleep specialists might administer to construct a sleeping history. However, the sleep history questions tend to fall into the following categories:
How much sleep do you get? Is it restful? The doctor will want to know how long you sleep, whether you fall asleep against your will, whether you have trouble falling or staying asleep once you’re in bed, or if you have difficulty staying alert once you wake up. Are you anxious about how well or how long you sleep?
Do you have problems breathing? Do you snore? What about symptoms of sleep apnea? In some cases of sleep apnea, disruptions in breathing can be so severe that a person is startled awake.
Do you have nightmares? Do you wake up startled or anxious because of unpleasant dreams? A sleeping partner may be able to help answer this question.
Are there disorders that affect the transition from wakefulness to sleep? Do you move restlessly during the night? Grind your teeth? Talk in your sleep?
Are you consistently sleepy? Are you tired despite a full night’s sleep? Do you become sleepy in the middle of the day? Do you ever feel paralyzed while sleeping? What about wetting the bed?
Do you sweat while sleeping? This question refers to excessive sweating that is not the effect of an overly warm environment.
After evaluating the sleep history, a specialist may recommend you undergo an overnight test that will allow clinicians to get a better sense of your sleep patterns and sleeping history. During a sleep test, technicians will monitor your bodily movements and observe several different physiologic processes: for example, brain activity, air flow, oxygen flow, and heartbeat.
The first and most important step, Ash says, is to respect your body’s need for a good night’s rest and take action if you’re falling short. “We have to start taking sleep seriously,” she says.
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