How Do You Know If You Have a Sleep Disorder?
Friends and family often ask me, "How do I know if I have a sleep disorder, and what can I do about it?" I thought that I would review some of the signs and symptoms of sleep disorders and how you should prepare yourself to visit your doctor to present your sleep problems.
Typically, a sign that you have a sleep disorder is if you have trouble going to sleep or staying asleep, problems staying awake ("I don’t have a sleep problem, I can fall asleep anywhere), unusual behaviors during sleep (e.g., sleep walking), very loud, disruptive snoring, or episodes where people see you stop breathing during sleep. If any of these issues are present, they should be discussed with your doctor and may even require a visit to a sleep specialist.
Each of these issues would require a separate blog, but I would at least like to give some insight about what your doctor may ask you so that you can be prepared. The main areas that your doctor will key in on are:
How is your sleep at night? Note if you have difficulty falling asleep and/or staying asleep, or if the problem is early morning awakening. Also, be able to assess if the problem is dependent on quality versus quantity of sleep. If you have difficulty sleeping, do you get stressed and frustrated by your inability to sleep? What do you do when you can’t sleep? The start of the sleep problems may also be useful in solidifying a specific diagnosis.
What is you weekday and weekend bedtime and rise time? An important differentiating factor in judging the significance of a sleep problem is if it is present even when you have the chance to "sleep in." Also important is how continuous the sleep is. Are there many awakenings and if so how long are they? Do you get out of bed each time and for how long?
What happens while you are asleep? Obviously, a bed partner would be most useful to answer these questions. Is loud snoring or witnessed apneas (stopping of breathing) present? Note if there are any repetitive movements that occur during sleep or when relaxing trying to get to sleep. Are dreams frightening or threatening? Do you sleep walk, talk, grind your teeth, or wake up confused?
How tired are you during the day? Your doctor will very likely give you a form to fill out called the Epworth sleepiness scale. Its purpose is to give an overall view of how sleepy you are in a variety of different situations. Check it out at this Stanford site.
What is your medical and psychiatric history? Many psychiatric and medical conditions will affect the way you sleep, so be able to name your medical problems. Your doctor will want to know if you feel depressed or anxious. Equally important are the medications that are used to treat illnesses, many of which can cause either sleepiness or arousal. Do you use any medications to help you sleep or stay awake, even over-the-counter drugs? Bring a complete list of medications, herbal supplements, and vitamins.
Do you have any habits that can affect your sleep? Caffeine, nicotine, and alcohol can alter sleep greatly, so be honest with your doctor (and yourself) if you are habitually using these substances.
I hope this list will help you be an "educated consumer" when it comes to seeing your doctor for a sleep issue. Like the Boy Scouts say: Be prepared!
Allen Blaivas, FCCP, DABSM, is a graduate of New York College of Osteopathic Medicine and is a quadruple board-certified physician practicing in pulmonary, critical care, and sleep medicine. He runs the sleep laboratory at the VA New Jersey Health Care System and loves taking care of our nation’s veterans. He’s a clinical assistant professor of medicine at Rutgers New Jersey Medical School and holds clinical privileges at Hackensack University Medical Center and New York Presbyterian-Lower Manhattan. He has clinical research interest in obstructive sleep apnea and COPD.