Talking With Your Doctor About Sleep Disorders

• Overview
• Qualifying The Healthcare Provider
• Before Making An Appointment
• Preparing For Your Appointment

Overview

Certain symptoms may indicate that you are suffering from a sleep disorder. For more information about these symptoms, visit the Sleep Disorders section. Often, insomnia and/or excessive daytime sleepiness occur as the result of another sleep disorder or because of a pre-existing medical condition.

For example, someone who unknowingly suffers from sleep apnea will usually experience excessive daytime sleepiness because of constant nighttime awakenings. Similarly, an individual with a highly stressful job may experience chronic insomnia, but might be too busy to seek help until job performance is affected.

In deciding whether or not to seek help, chronic is the word to keep in mind. Some possible conditions below may indicate that professional consultation is needed if:

• Your sleep-related problem(s) has persisted for more than six weeks;
• You are constantly unable to fall asleep or stay asleep at night or stay awake during the day;
• Your sleep problem has been the reason for a serious incident, such as a car accident, possible job loss, or a jeopardized interpersonal relationship;
• You have used sleeping pills and feel you are becoming too dependent on them;
• You are discouraged from sleeping in separate beds from your partner because of your kicking or snoring;
• You feel that you have tried everything else, yet you still have problems with your sleep.

It's important to keep in mind that sleep disorders are not rare. Millions of people have problems related to their sleep. It's also important to realize that a sleep disorder can be very serious.

When you feel that your nighttime sleep impairs your daytime function, it is a clear indication that you should see a doctor. Your primary care physician may try to determine the cause or causes of your disrupted sleep. If you have discussed your sleep-related problems and concerns with your primary care physician, it is possible that he or she can refer you to a reputable, licensed sleep specialist in your area.

If you do not have a physician that you see on a regular basis or you have decided to contact a professional sleep specialist on your own, there are some questions you should ask that will ensure you find the appropriate health care provider.

Qualifying the Healthcare Provider

1. Are you licensed and accredited? When you are searching for a sleep specialist or sleep center, it is important to ask about the licensure status of the health care provider and/or the sleep center. Keep in mind that not all licensed sleep specialists practice at a licensed sleep center and likewise, not all licensed sleep centers employ licensed sleep doctors. American Academy of Sleep Medicine (AASM) accreditation means that the facility meets high standards for being knowledgeable in the field of sleep medicine. Because becoming accredited by the AASM requires intense analysis, rigorous procedure, and a great deal of time, both for the individual professional and the sleep facility, inquiring into their status provides you some degree of confidence and protection.
2. How long have you been practicing sleep medicine? Pertaining to a sleep center, the question could be rephrased to ask, "How long has this sleep center been diagnosing and treating sleep disorder patients?" For a sleep specialist, "How many years have you been practicing sleep medicine?" After you have made a decision about a sleep specialist, these are some questions to ask before making an appointment.

Before Making an Appointment

• Do you accept my insurance plan? Before asking this question, find out from your insurance provider about the type of coverage your plan provides.
• What is the estimated cost of an initial evaluation? If your insurance covers the cost of the visit, this may be an unnecessary question. This question becomes important only if your plan covers a percentage of the visit, in which case, you will be required to pay the difference. You may also need to pay the co-payment amount required for a doctor's visit.
• How long will my appointment take? In most cases, an estimation of time for your initial visit can be made. In addition to a medical history and physical examination, the interview portion of your visit can take anywhere from half an hour to two hours. Your visit might be greatly shortened if you come to your appointment prepared. One way to possibly shorten your appointment is by bringing a completed Epworth Sleepiness Test and the Self Assessment Test.
• Do I need to bring anything? You will probably be asked to complete some forms or questionnaires at least a week before your scheduled appointment. In addition to this information, your bed partner should accompany you to your first appointment, if possible.

Preparing for Your Appointment

Before Your Appointment

Most sleep disorders centers perform many of the same procedures. Usually, the center will send you their forms and questionnaires before your appointment. We suggest that you also complete the Sleep Log in pdf format. The form requires you to have Adobe Acrobat installed on your computer. Download Adobe Acrobat

It can be very helpful to have your bed partner accompany you to your appointment. If you do not have a regular bed partner, another person who lives with you or visits frequently may be able to complete the questionnaire. If it is not possible for your partner to attend, make sure he or she completes the Bed Partner Questionnaire (in pdf format) for you to bring to your appointment. In addition, the sleep specialist may need to speak to your bed partner at another time. Download Adobe Acrobat

A critical piece of information for your doctor is a list of medications you are currently taking. Because most people cannot recall details of prescriptions or over-the-counter medications at the doctor's office, complete the Medication Log (in pdf format) and bring it to your appointment. Download Adobe Acrobat

In addition to some medical forms and sleep-related questionnaires, the sleep center or doctor may ask you to keep a notebook of events. Called a "sleep diary," this notebook will indicate psychological and social issues, as well as your thoughts and feelings, about your sleep problem. A sleep diary may be important for your appointment in that it will enable you to recall particularly bad nights of sleep and the events of the day before. More often than not these events are forgotten or left unmentioned during a sleep appointment. The sleep diary may assist you in identifying particular stresses that affect your sleep.

During Your Appointment

To assist you and your doctor when you have an appointment, there are two likely events that you can expect:

• Physical Examination - An examination is necessary so that your doctor can rule out or factor in physical causes of your sleep-related problem, such as high blood pressure, irregular heart rate, your weight, or abnormal pain. The doctor may also examine the inside of your mouth (if he or she suspects you have sleep apnea).
  
• Medical History - In addition to past and recent conditions in your medical history, the doctor may also ask about medical histories of immediate family members.
  

The interview portion of the appointment will take anywhere from half an hour to one hour. It is the sleep specialist's opportunity to find out more about what affects your sleep. This may include your attitude about certain things, your feelings about your condition, as well as other issues. It's important to be honest about subjects that affect you. Small details can be very important.