Explore Sleep Medicine by Topic
Key Takeaways
- Sleep medicine covers four broad categories of disorder: sleep-disordered breathing, insomnia and circadian rhythm disorders, hypersomnia, and movement disorders or parasomnias, each with a distinct evaluation and treatment pathway.
- A sleep study, whether done at home or in a sleep lab, is the objective foundation for diagnosing most sleep-disordered breathing disorders, but not every sleep problem requires one; insomnia and many circadian disorders are diagnosed primarily through history and, when needed, a sleep diary or actigraphy.
- Effective treatment exists across every category, from CPAP and hypoglossal nerve stimulation for sleep apnea, to CBT-I for insomnia, to light and melatonin timing for circadian disorders.
- Sleep health connects closely to weight and to lung and heart health; many patients benefit from care that treats sleep alongside those related conditions rather than in isolation.
Patient Questions
How do I know which type of sleep problem I have?
The pattern of your symptoms is usually the first clue. Loud snoring, witnessed breathing pauses, or gasping during sleep point toward sleep-disordered breathing. Difficulty falling or staying asleep despite adequate opportunity points toward insomnia. Excessive daytime sleepiness despite a full night in bed points toward hypersomnia. Unusual movements, behaviors, or nightmares during sleep point toward a movement disorder or parasomnia. A physician evaluation is the reliable way to sort between these when symptoms overlap.
Do I need a sleep study to be diagnosed?
It depends on the suspected disorder. Sleep-disordered breathing conditions like obstructive sleep apnea are typically confirmed with a home sleep apnea test or an in-lab polysomnogram. Insomnia and most circadian rhythm disorders are usually diagnosed from history and a sleep diary, sometimes supported by actigraphy, without an overnight study. Hypersomnia disorders like narcolepsy often require a polysomnogram followed by a Multiple Sleep Latency Test.
Can sleep disorders overlap?
Yes, and this is common rather than unusual. Sleep apnea can worsen insomnia and daytime sleepiness. Restless legs syndrome and periodic limb movement disorder can fragment sleep in ways that look like insomnia. Untreated sleep apnea and poor sleep hygiene can compound each other. Evaluation looks at the full picture rather than assuming only one disorder is present.
How does weight affect sleep, and how does sleep affect weight?
The relationship runs in both directions. Excess weight is a common contributor to obstructive sleep apnea, and untreated sleep apnea can make weight management more difficult by disrupting hunger-regulating hormones and reducing energy for activity. Many patients see improvement in both areas when sleep apnea and weight are addressed together.
How does sleep affect heart and lung health?
Untreated sleep-disordered breathing is associated with high blood pressure, atrial fibrillation, and greater cardiovascular strain over time, and it can worsen oxygen levels in patients who already have lung disease. Treating sleep apnea is often considered part of a broader plan for cardiovascular and pulmonary health, not a separate, unrelated concern.
When should I see a sleep specialist rather than my primary care physician?
A primary care physician is a reasonable starting point for many sleep concerns and can order initial testing for suspected sleep apnea. A sleep specialist becomes particularly useful for confirming a diagnosis, choosing among the full range of treatment options, managing a case that has not responded to a first treatment, or evaluating less common disorders like narcolepsy, idiopathic hypersomnia, or complex parasomnias.