Sleep Specialists: When to See One and What to Expect

Many types of healthcare providers can become sleep specialists. A "sleep doctor" may train in fields such as internal medicine, neurology, pediatrics, family medicine, psychiatry, otolaryngology, or anesthesiology before completing a fellowship in sleep medicine.

The main goal of a sleep expert is to diagnose and treat sleep disorders. Some providers focus on all aspects of sleep, while others treat just one type of sleep disorder. For example, you may see a pulmonologist (lung expert) for obstructive sleep apnea (OSA).

In this article, you’ll learn when you should see a sleep specialist, how to find the right one, and what to expect at an appointment.

When to See a Sleep Specialist

If you have or suspect a sleep disorder, the first step is to let your primary care provider know about it. Sleep problems that you should bring up include:

• Waking up gasping for air or due to loud snoring
• Regularly taking 30 minutes or more to fall asleep
• Frequently waking up at night and struggling to get back to sleep
• Waking up too early in the morning to feel rested
• Feeling especially tired even after a full night's sleep
• Being unable to function during the day due to fatigue
• Falling asleep at inappropriate times (such as while driving)
• Sleep paralysis (being aware of your surroundings but unable to move)
• Frequent nightmares, especially if they’re associated with sleep paralysis or falling asleep
• Sleepwalking or other abnormal sleep behaviors
• Getting creeping, tingling, crawling, or “twitchy” feelings in your legs as you relax
• Episodes of sudden muscle weakness or collapsing (cataplexy) when you experience a strong emotion
  

Your primary care provider may try to diagnose and treat your sleep disorder or your provider may send you to a specialist.

How to Find a Sleep Specialist

Your primary care provider may refer you to a sleep specialist, or you may need to find one on your own.

First, check with your health insurance company to see what sleep experts in your area are covered. You may also want to ask friends and family for recommendations.

In the United States, the average cost for an appointment with a specialist is about $250. An overnight sleep study can cost hundreds or even several thousand dollars. Much or all of that may be covered by insurance.

As you search, keep in mind any possible diagnoses you or your healthcare provider suspect. That can help you narrow your focus to the sleep experts who treat the right types of sleep disorders.

Types of Sleep Specialists

Several types of healthcare providers can specialize in one or more sleep problems. Full-time sleep specialists include:

• Board-certified sleep medicine physician: Diagnoses and treats all sleep disorders and may be the head of a multidisciplinary team
• Sleep technologists: Helps the doctor with specialized diagnostic tests and ongoing care of your sleep disorder
• Sleep surgeon: Performs procedures to help with snoring and sleep apnea

Other specialists who may treat some sleep disorders include:

• Pulmonologists and respiratory therapists: Breathing-related problems (sleep apnea)
• Behavioral sleep medicine specialists (psychologists and psychiatrists): Sleep-related thoughts and behaviors (poor sleep hygiene, insomnia, parasomnia)
• Neurologists: Problems of the brain and nervous system (CSA, insomnia, narcolepsy, and RLS)
• Otolaryngologists: Problems related to the ear, nose, and throat (snoring, palate stiffening, obstructive tonsils or adenoids, nasal breathing problems)
• Dentists and oral/maxillofacial surgeons: Problems with the mouth and jaw (sleep apnea, tooth grinding)
• Pediatricians: Sleep problems in children

Depending on your symptoms or diagnosis, you may see one or more of these specialists.

What to Expect During a Sleep Specialist Appointment

When you see a sleep specialist, one of the first things they’ll likely ask you to do is keep a sleep journal. This should list: 

• Your sleep habits, such as bedtime routines
• The times you go to bed and wake up
• How long it takes you to fall asleep
• How often you wake up
• Symptoms you may notice overnight
• How you feel upon waking

You may want to start tracking this before you see the specialist. It might speed up the diagnostic process.

The specialist will likely:

• Perform a physical exam and/or neurological exam
• Review your medications and supplements for anything that could cause your symptoms
• Ask about lifestyle factors that could be contributing

Questions to Ask a Sleep Specialist

Before you go to your appointment, it's helpful to write down a list of questions to ask the sleep specialist. This can help you better understand your sleep disorder and how best to treat it. Questions may include:

• What caused my condition?
• Will I need a sleep study or other test to diagnose my condition?
• How should I prepare for any diagnostic tests?
• What are the potential risks of my condition?
  
• Will lifestyle changes help my symptoms?
• What treatment options are available?
• How often will I need follow-up appointments?

Sleep Studies

Some sleep disorders, such as insomnia, are diagnosed based on your symptoms and medical history. Others may include polysomnography (a sleep study).

Sleep studies are done overnight with special equipment, either in a sleep clinic or in your home. This is typically done to diagnose sleep apnea or circadian rhythm disorders, and confirm a diagnosis of insomnia, narcolepsy, RLS, or other sleep disorder.

During the study, machines will gather information on your:

• Brain waves
• Eye movements
• Breathing rate
• Blood pressure
• Heart rate
• Electrical activity in the muscles

The sleep specialist may also order tests of your blood and/or urine to rule out other conditions that may be causing your symptoms.

Summary

Sleep specialists diagnose and treat sleep disorders. You may need to see one if you have trouble sleeping, have excessive daytime fatigue, or experience other symptoms tied to sleep. Many types of healthcare professionals can treat sleep problems. The type of provider you see will depend on your symptoms. Further testing may eliminate other possible conditions.