The Vital Sign of Sleep

By Dr. Gregg D. Jacobs
July 27, 2005

Despite the fact that sleep problems such as insomnia are common, few physicians ask their patients about insomnia and even fewer provide treatment recommendations. As a result, physicians should routinely assess sleep as a key "vital sing" in all office visits. Physicians should ask basic questions such as whether the patient has difficultly falling or staying asleep, how many hours they are sleeping, and whether they feel sleep-deprived. Physicians and patients also need to know that over-the-counter sleep aids, herbal remedies, and anti-depressant medications are not effective treatments for insomnia. They should also keep in mind that newer-generation sleeping pills such as Ambien, Sonata, and Lunesta are the best choices as a sleeping pill for short-term insomnia (with several new sleeping pills expected to be approved soon), and that cognitive-behavioral therapy (CBT) is more effective than sleeping pills for chronic insomnia without their side effects.

The number of sleep clinics that can diagnose and treat patients with sleep problems such as insomnia has increased to 2200 centers in 2005, and there are now an equal number of board certified sleep medicine specialists in the United States (there were less than 100 twenty years ago.) Unfortunately, only a small number of these sleep specialists have expertise in CBT, and there are only several hundred psychologists world-wide with expertise in CBT.

Sleep is becoming increasingly recognized as an important vital sign. As a result, more treatments for sleep disorders are becoming available, as are the number of professionals available to diagnose and treat sleep disorders.