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Brandon Peters, M.D.

30 Days to Better Sleep: See a Sleep Doctor

By January 30, 2013

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At the conclusion of 30 days spent in an effort to sleep better, you may find yourself continuing to struggle. Through no fault of your own, restorative rest may still elude you. You may still struggle to sleep at night or wake feeling unrefreshed. What should you do now to improve your sleep? When should you see a sleep doctor?

There are many things that you can do to improve your sleep. As observed over the past month, you can sleep better by keeping a regular sleep schedule. You can improve your sleep environment by removing electronics, pets, and even the alarm clock. You can meet your sleep needs, pay off your sleep debt, and sleep at the right time for you. By recognizing sleepiness, you can create a relaxing buffer zone and go to bed only when sleepy. You can sleep better by cutting out caffeine, alcohol, and nicotine. You can exercise at the right time, avoid peeing frequently during sleep, and eliminate heartburn at night. By eliminating stress and addressing mood problems, you can limit wakefulness in bed and sleep more. Exposure to morning sunlight and prioritizing sleep can also be helpful. If after all these changes, and more, you continue to have difficulty sleeping, you may need additional professional assistance.

Persistent difficulty falling or staying asleep or sleep that is not refreshing should be evaluated by a physician. If you are too sleepy during the day, struggling with frequent naps and compromised function, you may need help. Problems that last more than a month should be further assessed. Although you might start by speaking with your primary care doctor, you may benefit from speaking with a specialist. Who should you see to discuss your problem?

Seek out a board-certified sleep specialist who is a medical doctor who has completed fellowship training in sleep medicine. A sleep medicine fellowship is 1 to 2 years of additional training after a primary residency has been completed. These doctors may have previously been trained in pulmonary medicine, neurology, or psychiatry. They then take a board examination that certifies their expertise in the discipline. The clinic or lab that you visit should be further certified by the American Academy of Sleep Medicine (AASM), a marker of the quality of care you should expect. Many professionals may express an interest or promote an expertise in sleep medicine, but you deserve to see someone who has the training and credentials necessary to help you. Not all "sleep experts" are created equal.

After speaking with a verified sleep specialist, it may be recommended that further testing be conducted. Most often, an overnight sleep study called a polysomnogram may be performed to identify a sleep disorder such as sleep apnea. Additional tests may be used to diagnose restless legs syndrome, narcolepsy, and other sleep disorders. There are many effective treatment options available once the condition has been properly identified.

You do not need to suffer from difficulty sleeping. There are sleeping pills as well as behavioral treatments, including: sleep restriction, stimulus control, and cognitive therapy. For these latter options, it can be helpful to work with someone who has training in these therapies, such as a certified psychologist. Surgical options and medical devices such as light boxes or CPAP may also have a role. A well-trained specialist will assess your individual needs and provide guidance for what therapy best suits your situation.

If after making a good-faith effort to improve your sleep, you still find yourself falling short, don't give up. Targeted advice and adjunctive treatments may be just what you need. Seek out some professional assistance and you will be able to finally sleep better, a goal that is most worthy of your efforts.

Check out the entire series, "How to Sleep Better in 30 Days."

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