sleep disorders center

What Kind of Doctor Do You See for Sleep Problems?

Sleep disorders can negatively impact a person's quality and quantity of sleep, which can result in added stress and reduced function. There are various types of doctors that can diagnose your sleep problems, which include primary doctors, pulmonologists, neurologists, ear, nose, and throat doctors, (ENTs); psychiatrists, and even dentists.
Sleep disorders can negatively impact a person's quality and quantity of sleep, which can result in added stress and reduced function. There are various types of doctors that can diagnose your sleep problems, which include primary doctors, pulmonologists, neurologists, ear, nose, and throat doctors, (ENTs); psychiatrists, and even dentists.

Sleep disorders are characterized by problems with the quality, timing, and quantity of sleep, which can cause stress and reduced functioning. 

Many different types of doctors treat sleep problems. Board certified sleep medicine specialists may have a variety of primary specialties: 

  • Primary care/internal medicine
    • Some general practitioners may handle sleep-related issues for patients
  • Pulmonology 
    • Pulmonologists specialize in the respiratory (breathing) system and often treat obstructive sleep apnea (OSA) because it’s a condition in which patients stop breathing while sleeping due to a blockage in the airway 
  • Neurology
  • Otolaryngology (commonly referred to as ear, nose, and throat doctors, or ENTs)
    • Obstructive sleep apnea and snoring are often caused by a blockage in the throat, and may be treated by ENTs
  • Psychiatry
  • Dentistry
    • Dentists can often help with obstructive sleep apnea and teeth grinding while sleeping (bruxism)

These doctors can diagnose sleep disorders with a patient history and physical exam, along with tests and procedures such as: 

  • Daily sleep log
  • Record of activity and movement with a monitor or motion detector, generally worn on the wrist throughout the day and night (actigraphy)
  • Sleep study (polysomnography)
  • Home devices that monitor breathing, oxygen saturation, position, and heart rate
  • Home sleep apnea testing 
  • Melatonin sampling 
  • Core body temperature measurements 
  • Hormone tests
  • Electrocardiogram (“ECG”) 
  • Computerized tomography (CT) scan 
  • Magnetic resonance imaging (MRI) of the brain 
  • Pulmonary function tests

What Are Symptoms of Sleep Disorders?

The International Classification of Sleep Disorders (ICSD) includes seven major categories of sleep disorders and symptoms depend on the particular sleep disorder.

  • Insomnia: problems falling asleep or staying asleep 
  • Sleep-related breathing disorders: abnormal breathing during sleep, such as sleep apnea
  • Central disorders of hypersomnolence: daytime sleepiness not due to another sleep disorder, such as narcolepsy
  • Circadian rhythm sleep-wake disorders: chronic or recurrent sleep disturbance due to changes in the patient’s circadian system or misalignment between the environment and an individual's sleep-wake cycle such as shift work disorder and jet lag disorder 
  • Parasomnias: undesirable physical events (movements or behaviors) or experiences (emotions, perceptions, dreams) that occur during sleep such as sleepwalking, sleep terrors, sleep-related eating disorder, sleep paralysis, and nightmare disorder
  • Sleep-related movement disorders: movements that disturb sleep, though patients may or may not be aware of these movements, such as restless legs syndrome, sleep-related cramps, and sleep-related bruxism (teeth grinding)
  • Other sleep disorders: do not fit into any of the other categories, such as disorders related to environmental disturbances

Symptoms of sleep disorders vary depending on the particular disorder and may include:

  • Difficulty falling asleep or staying asleep
  • Variable sleep
  • Daytime fatigue or sleepiness
  • Inability to concentrate
  • Irritability
  • Depression
  • Anxiety
  • Decreased motivation or energy
  • Persistent worry about sleep
  • Increased errors or accidents
  • Headache
  • Loud snoring
  • Awakening with choking, gasping, or smothering
  • Awakening unrested, groggy
  • Restless sleep
  • Dry mouth or sore throat
  • Frequently waking to urinate
  • Problems with memory and decision-making
  • Excessive daytime sleepiness (EDS)
  • Sudden muscle weakness (cataplexy)
  • Frequent short naps during the day
  • Transitioning from being awake to being asleep (hypnagogic hallucinations)
  • Sleep paralysis
  • Night-time compulsive behaviors such as eating and nocturnal smoking 
  • Obesity
  • Sleepwalking 
  • Night terrors
  • Sleep talking
  • Acting in a way that is strange and confused on waking up
  • Acting out vivid dreams in your sleep: may be violent and can cause injury to the patient
  • Nightmares
  • Bedwetting (enuresis)
  • Groaning
  • Hearing a loud imaginary noise just before falling asleep or awakening
  • Binge eating and drinking in the night with minimal or no memory of the binge
  • Overwhelming urge to move the legs
  • Itchy, crawling, burning, creepy, throbbing sensation in the legs
  • Trouble sitting still for long periods of time
  • Short attention span 

What Is the Treatment for Sleep Disorders?

Treatment for sleep disorders depends on the specific disorder and may include: 

  • Healthy lifestyle and behavior changes
    • Steps to improve sleep habits and practice good seep hygiene 
    • Stress reduction techniques
    • Exercise
    • Not smoking 
    • Reducing or avoiding caffeine and alcohol consumption
    • Massaging legs or soak in a hot bath
    • Weight loss
    • Avoiding alcohol and other sedatives 
    • Adjusting sleep position (to stay off the back) 
    • Relaxation exercises 
  • Cognitive behavioral therapy for insomnia (CBT-I)
  • Sleep restriction or sleep compression  
  • Sleep education 
  • Education to avoid triggers 
  • Stimulus control 
  • Continuous positive airway pressure (CPAP) 
  • Dental devices 
  • Medications (the choice of medication depends on the particular disorder)
  • Stopping medications that may be causing the problem 
    • Do not stop taking a prescribed medication without first talking to your doctor
  • Light therapy
  • Light restriction (dark therapy)
  • Sleep deprivation/phase advance
  • Chronotherapy
  • Creation of safe environment
  • Surgery for some disorders due to physical problems

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References
https://www.psychiatry.org/patients-families/sleep-disorders/what-are-sleep-disorders

https://www.uptodate.com/contents/classification-of-sleep-disorders?search=sleep%20disorders&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

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https://www.sleepdr.com/the-sleep-blog/which-doctor-should-i-talk-to-about-my-sleep-problems/