If you’re struggling with your sleep, or with lack of sleep, the good news is that you don’t have to go it alone. There are professionals to help and you’ve got options. Here’s how to get started.
When Do You Ask for Help?
Typically, sleep care includes help from your primary care physician, a sleep therapist, a medical sleep specialist, a mental health professional, or some combination of these providers.
If you’ve already tried improving your sleep hygiene and sleep environment on your own, had sleep problems for more than a few weeks, and find that your daytime mood or functioning is being affected, then it’s probably time to seek professional help. Contact your primary care physician. To get an idea of the severity of your problem he or she will likely ask about your sleep habits and give you surveys to complete, like the Insomnia Severity Index, Epworth Sleepiness Scale, or PROMIS Sleep Disturbance questionnaire.
Next, your doctor may prescribe sleep medication or refer you to a sleep therapist for an initial assessment. This will include a discussion about your sleep, general health, and daily life. After learning about your background, your sleep therapist will help you decide next steps, which may include one or more of the following:
- A holistic look at your sleep situation and efforts to address the various factors negatively impacting it. Your sleep therapist will work with you on improving sleep hygiene and developing a healthy sleep routine through cognitive behavioral therapy for insomnia (CBT-i). While conventional recommendations for insomnia tend to focus on medications, CBT-i is actually the most highly recommended insomnia treatment available. The American College of Physicians says CBT-i is safer than medications for insomnia and the American Psychological Association says CBT-i works better than medications for insomnia. For those people with insomnia triggered by anxiety (such as over a new job), depression (perhaps after losing a job), post-traumatic stress disorder (PTSD), or another mental health concern, an additional benefit of working with a sleep therapist is that he or she can often also address the root causes of sleep problems, as well.
- Referral to another specialist to address other root causes of sleep difficulties may be necessary. For instance, if your insomnia is related to a medical condition such as difficulty breathing, sleep apnea, or restless leg syndrome, an analysis at a sleep center might be in order (see Sleep Study below).
- At any point in this process you may be referred (back) to your sleep therapist to continue working on a healthy sleep routine. This can be important before, during, or after other sleep-influencing factors are addressed. For instance, patients with a medical condition such as apnea may have developed bad sleep habits in an attempt to overcome their symptoms. A specialist may work with the patient regarding the apnea but then refer back to a sleep therapist to get bedtime routines back on track.
What’s a Sleep Study?
We mentioned above that a sleep therapist may refer you for a sleep study. Another name for a sleep study is a “polysomnogram” or PSG. This type of test is typically done at a sleep center. The goal is to objectively measure a potential medical condition and its impact on your sleep. To receive a polysomnogram, you spend a night sleeping (or not sleeping, depending on your condition) connected to about 25 electrodes that help a technician to monitor your brain waves, heart rate, eye movement, muscle activity, and breathing. The results help decide if you need medical care for a condition like sleep apnea or snoring.
Wait, How Do I Get Started Again?
Schedule an appointment with your primary care provider or a sleep therapist. Prepare for your appointment by thinking about your sleep routine but also about things like caffeine, alcohol, exercise, eating, and screen habits. Plan to discuss any medical conditions you have or medications you take (including over-the-counter products and supplements). When did your sleep problems or daytime sleepiness issues begin? What’s going on in your life? What’s your work schedule like? These are all things your provider will want to know about.