All About Sleep Specialists and the Field of Sleep Medicine

If you’re like some of us here at Remrise, every time a misspelling takes place on the internet, you awake in a bone-chilling sweat. Nevertheless, despite leaps and bounds in spell checking technology, about 70 million Americans still suffer from sleep problems — that’s one in five people! 

Despite all the technological advancements in the world, sleep still seems to elude us.

Even though we spend about a third of our life sleeping, if we’re lucky, sleep itself remains a great enigma.   

Sleep problems like trouble falling asleep, early awakenings, waking up in the middle of the night, and not being able to fall back to sleep can affect your sleep quality, sleeping patterns, and just about every element of waking life as well. 

Sleep problems are shockingly common and can be very debilitating — and those are just the problems we’re aware of. There are also sleep problems that evade our attention like sleep apnea, which is less apparent and need to be diagnosed by a specialist.

Sleep problems can be due to habits like drinking too much coffee throughout the day, or reading your cell phone in bed. Sometimes sleep problems can be solved through basic behavioral changes like only consuming caffeine in the morning or limiting cell phone use before bed.  In other cases, they require the insights of a sleep specialist.

If you experience sleep disturbances over an extended period, it may be time to visit a sleep specialist. You can choose to visit a sleep specialist, or your primary care doctor can refer you based on your symptoms.

What is a Sleep Specialist?

A sleep specialist is a medical doctor or psychologist who has specialized training in the field of sleep medicine — a subfield of medicine dedicated to the study of sleep with a particular focus on sleep disorders.  

A sleep specialist may be a medical doctor (M.D. or D.O.) or a clinical neuropsychologist (Ph.D.). Sleep specialists are experienced in the diagnosis and treatment of those suffering from sleep disorders.  

Sleep specialists must undergo special training in the field of sleep medicine and sleep disorders. The American Board of Sleep Medicine, or ABSM, is responsible for accreditation of trained sleep specialists. In 2005, there were about 3,000 licensed sleep specialists practicing in the United States.

Types of sleep disorders

Sleep medicine relates to the diagnosis and treatment of sleep disorders.  Sleep disorders are very common — 75% of Americans have had at least one symptom of a sleep problem a few nights a week within the past year.

There are over eighty sleep disorders, but most sleep medicine deals with the five most common disorders.  These are:

Insomnia

Insomnia is a sleep disorder which is characterized by having issues falling and/or staying asleep. About a third of the population has a form of insomnia at any time.

Sleep apnea

Sleep apnea, which is estimated to affect 22 million Americans, is a disorder characterized by difficulties breathing during sleep. Sufferers of sleep apnea may stop breathing during sleep for brief periods of time.  

In obstructive sleep apnea, the most common form of the disorder, the throat’s muscles relax and block the airway during sleep, leading to breathing problems.  Sleep apnea is associated with a host of problems including high blood pressure and diabetes. Over time, untreated sleep apnea can even be fatal. Doctors estimate that 80% of sleep apnea cases remain undiagnosed.

Narcolepsy

Narcolepsy is a neurological disorder that is characterized by intermittent, uncontrollable episodes in which patients fall asleep during the day.

Restless Legs Syndrome (RLS)

RLS is an uncomfortable condition characterized by uncomfortable sensations in the legs, as well as an irresistible urge to move one’s legs.

Periodic Limb Movements

Periodic limb movements are a disorder in which the legs repetitively cramp or jerk during sleep, leading to sleep disruptions and feeling sleepy during the day.

How sleep specialists diagnosis sleep disorders

Sleep medicine involves the use of polysomnograms, which is a technique that sleep specialists adopt to examine your sleep patterns. Polysomnography typically takes place at a sleep center in an overnight sleep study.

The polysomnogram involves having approximately 25 electrodes attached to your head, chest, eyes, and legs, in order to determine whether or not you have a sleep disorder and gain insight into the nature of your sleep problems. The sleep specialist will also look at other aspects of your sleep, such as your breathing patterns while sleeping, in order to fully characterize your sleeping behavior and identify any issues.

If the sleep doctor determines that you have a sleep disorder from the polysomnogram and other initial tests, you may be required to perform further testing such as home sleep tests.  You may also be referred to specialists who can ensure that you do not have another non-sleep-related disease that is affecting your sleep quality.  

If you believe you may have a sleep disorder you should speak to your doctor to determine what treatment options are best for you.

When to see a sleep specialist?

You may wish to consult a sleep specialist to resolve your sleep issues.  The sleep specialist can work with you to learn about your symptoms and perform more advanced testing if necessary.

Sleep problems that are more complex and serious, such as is the case with sleep disorders like sleep apnea, narcolepsy, or RLS, require professional medical attention.  

Symptoms of sleep disorders include difficulty falling asleep, moving more while sleeping, breathing abnormally during sleep, and/or being sleepy during the daytime. If you experience any of these symptoms, you may consider speaking to a sleep specialist.  

Your sleep specialist may ask you questions and perform diagnostic tests to identify the source of your sleep problem. Once diagnosed, most sleep disorders are easily treatable.  Sleep specialists may conduct an initial evaluation, perform more long-term testing and therapy, and provide follow-up and maintenance care throughout your treatment journey.  

Sleep specialists may also work with doctors from other specialties (for example, cardiologists or ear-nose-throat doctors) to provide the best treatment plan.

Remember, chronic sleep problems in severe cases can be associated with medical issues including heart disease, stroke, and high blood pressure, as well as a range of non-medical issues including stress, anxiety and sleep hygiene related issues. 

With an estimated 80% of sleep apnea cases going undiagnosed, it’s not a bad idea to see a sleep specialist rather than waiting for further symptoms to manifest. Typically, this sleep disorder is treated in a highly effective manner with continuous positive airway pressure, or CPAP, which is a machine that delivers a constant stream of mild air pressure to keep the airways open during sleep.

Once you’ve seen a sleep specialist

As you work towards resolving your sleep issues, remember that many sleep problems are behavioral rather than a disorder.  Therefore, one way to start getting better sleep is to adopt positive sleep hygiene habits.  

Sleep hygiene refers to a set of behaviors and sleep habits one can follow for the best sleep health. Following proper sleep hygiene ensures that you both are more awake during the day and can obtain adequate and high-quality slow-wave sleep and REM sleep during the night.  

Behaviors that promote good sleep hygiene will reinforce your body’s natural circadian rhythm.  

Good sleep hygiene results from behaviors like:

  • Getting sufficient exposure to natural light during the daytime, which can help normalize your body’s circadian rhythms 
  • Avoiding stimulants such as caffeine close to bedtime
  • Taking steps to ensure that you sleep in a pleasant, cool, dark and comfortable environment.

One way to tackle the years of habits that you have adopted, is to speak to a sleep coach. Sleep coaches are different than sleep specialists. They don’t diagnose sleep disorders, instead they help you turn around ingrained habits and optimize your sleeping environment.

Learn more about sleep coaching or book a call with a Remrise Sleep coach.

Don’t give up on your quest to obtain more, better-quality sleep. The world will thank you and you’ll feel like a billion bucks.

Glossary: 

Circadian rhythm: Your daily sleep-wake cycle, which is influenced by light (e.g. sunlight or even your cell phone) and darkness.

Insomnia: Insomnia is a sleep disorder that is characterized by having issues falling and/or staying asleep.  About a third of the population has a form of insomnia at any time.

Narcolepsy: Narcolepsy is a neurological disorder that is characterized by intermittent, uncontrollable episodes in which patients fall asleep during the day.

Periodic Limb Movement Disorder: A disorder in which the legs repetitively cramp or jerk during sleep, leading to sleep disruptions and feeling sleepy during the day.

Polysomnogram: A technique sleep specialists use in which electrodes are attached to the body.  The polysomnogram looks at your brainwaves, heart rate, eye movement, muscle tensing, leg twitching, air flow in and out of your mouth and nose, and chest wall movement.

Restless Leg Syndrome (RLS): An uncomfortable condition characterized by uncomfortable sensations in the legs, as well as an irresistible urge to move one’s legs.

Sleep apnea: A disorder characterized by difficulties breathing during sleep.  About 22 million people suffer from sleep apnea in the United States, though doctors believe that 80% of cases remain undiagnosed.

Sleep hygiene - The different practices, habits, and behaviors that one should adopt in order to both get better sleep at night and be more alert during the day.

References

  1. American Sleep Apnea Association.  Information for Clinicians. Accessible at https://www.sleepapnea.org/learn/sleep-apnea-information-clinicians/.
  2. American Sleep Association.  Sleep Doctor: Sleep Disorder Specialist.  Accessible at https://www.sleepassociation.org/health-professionals/sleep-doctor/
  3. Breus, M. Sleep Rx: When to see a sleep specialist.  WebMD. Accessible at https://www.webmd.com/sleep-disorders/features/sleep-rx-specialist#1.
  4. Harvard Medical School.  When to Seek Treatment. Accessible at http://healthysleep.med.harvard.edu/healthy/getting/treatment.
  5. Johns Hopkins Medicine.  Sleep Medicine. Accessible at https://www.hopkinsmedicine.org/sleep-medicine/index.html.
  6. Mayo Clinic.  Sleep Disorders.  Accessible at https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018.
  7. Narcolepsy.  WebMD. Accessible at https://www.webmd.com/sleep-disorders/guide/narcolepsy.
  8. National Sleep Foundation.  What is Sleep Hygiene? Accessible at https://www.sleepfoundation.org/articles/sleep-hygiene.
  9. NYU Winthrop.  What is Sleep Medicine? Accessible at https://www.nyuwinthrop.org/what-is-sleep-medicine.
  10. Periodic Limb Movement Disorder.  WebMD. Accessible at https://www.webmd.com/sleep-disorders/periodic-limb-movement-disorder#1.