Sleep Problems and When to See Someone
Most bad sleep is temporary. Stress, heat, a new baby, too much coffee - it passes. But some of it is a medical problem with a name and a treatment, and people put up with it for years because they assume it is just how they are.
When is poor sleep worth investigating?
Roughly, when it has lasted more than a month and it is affecting your days. The signs that point at something treatable rather than a bad patch:
- Loud snoring with pauses in breathing, usually reported by whoever sleeps next to you
- Waking up unrefreshed however long you were in bed
- Falling asleep during the day - at a desk, in front of the television, at the wheel
- Lying awake for hours several nights a week, for months
- Kicking, jerking or acting out dreams in your sleep
The daytime sleepiness one matters most. If you are nodding off while driving, treat that as urgent rather than annoying.
What actually happens in a sleep study?
Less than people fear. You either sleep a night in a sleep unit or wear a monitor at home, and it records your breathing, oxygen levels, heart rate, movement and brain activity while you sleep. Nothing hurts and nothing goes inside you.
The recording is then read by a specialist, who can tell whether your breathing is stopping, how often, and what it is doing to your oxygen levels.
Which specialist do you need?
It depends on the problem, which is why people get bounced around:
- Snoring, pauses in breathing, daytime sleepiness - a pulmonologist, the lung specialist who handles sleep apnoea
- The recording itself - a neurophysiologist, who reads the brain and nerve activity
- Long-running insomnia - a psychologist, because the treatment with the best evidence is a talking therapy rather than a tablet
- Blocked nose or throat - an ear, nose and throat specialist
Our guide to neurology and neurophysiology explains what those recordings measure and how the cover works.
Are sleeping tablets the answer?
Rarely, and not for long. They work for a short stretch - after a bereavement, say - but the body adapts, and for long-term insomnia the evidence favours changing what you do rather than what you take. That is a conversation for a doctor rather than a pharmacy counter.
Where should you start?
Keep a rough note for a fortnight of when you go to bed, when you actually sleep and how you feel the next day. It is dull and it is the single most useful thing you can hand a specialist.
Then book someone. With private cover you go to the specialist directly rather than waiting on a referral:
