What are Sleep Disorders?
Sleep disorders are conditions that affect the quality, timing, or amount of sleep, leading to daytime impairment and health problems. Common sleep disorders include insomnia (difficulty falling asleep or staying asleep), obstructive sleep apnea (repeated breathing interruptions during sleep due to airway blockage, causing loud snoring, gasping, and fragmented sleep), restless leg syndrome (uncomfortable sensations in legs with urges to move that interfere with sleep), and circadian rhythm disorders (misalignment between your natural sleep-wake cycle and your schedule). While occasional poor sleep affects everyone, chronic sleep problems deserve medical attention. Quality sleep is essential for physical health, mental health, cognitive function, and overall wellbeing. Your primary care provider can evaluate your sleep problems, order diagnostic testing when indicated, provide initial treatment, and refer to sleep specialists for complex cases requiring specialized care like sleep studies or CPAP titration.
Why is it Important?
Addressing sleep disorders is crucial because sleep profoundly affects every aspect of health. Chronic sleep deprivation and sleep disorders increase risk of numerous serious health problems including obesity, type 2 diabetes, cardiovascular disease, high blood pressure, stroke, depression, anxiety, weakened immune function, and earlier death. Obstructive sleep apnea is particularly concerning—when untreated, it dramatically increases risk of heart attack, stroke, irregular heart rhythms, and sudden cardiac death. Beyond these serious long-term risks, sleep problems significantly impair daily functioning: decreased concentration, memory problems, slowed reaction times (increasing accident risk, particularly motor vehicle accidents), reduced work performance, irritability, relationship problems, and diminished quality of life. Many people don't realize how much their sleep problems affect them until treatment restores normal sleep and they experience dramatic improvement in energy, mood, cognitive function, and overall wellbeing. Additionally, sleep disorders often indicate or worsen other health conditions. For example, sleep apnea makes blood pressure harder to control, poor sleep worsens blood sugar control in diabetics, and insomnia frequently accompanies depression or anxiety. Treating sleep problems often improves these coexisting conditions. Your provider can identify whether sleep problems result from poor sleep habits, medical conditions, medications, or true sleep disorders requiring specific treatment.
What to Expect
Your sleep evaluation begins with a detailed sleep history: difficulty falling asleep versus staying asleep, how many hours you sleep, whether sleep is restful, daytime sleepiness or fatigue, snoring or witnessed breathing pauses during sleep (ask your bed partner), movements during sleep, bedtime and wake time (including weekdays versus weekends), caffeine and alcohol consumption, screen time before bed, bedroom environment, and how sleep problems affect your daytime functioning. Your provider will review your medical history, medications, and mental health, as many conditions and drugs affect sleep. A physical examination may identify anatomical factors contributing to sleep apnea, such as enlarged tonsils or excess weight. For suspected sleep apnea, your provider may order a sleep study (polysomnography)—either an overnight study at a sleep center or, increasingly, a home sleep apnea test using portable monitoring equipment you take home. Treatment depends on your specific diagnosis. Insomnia treatment emphasizes cognitive-behavioral therapy for insomnia (CBT-I), the most effective long-term treatment, which addresses thoughts and behaviors that interfere with sleep. This includes sleep hygiene education, stimulus control, sleep restriction, and relaxation techniques. When medications are needed, your doctor may prescribe sleep aids for short-term use. Obstructive sleep apnea is most commonly treated with CPAP (continuous positive airway pressure) therapy, which keeps airways open during sleep. Alternative treatments include oral appliances from specialized dentists, positional therapy, weight loss, or in some cases, surgery. Restless leg syndrome responds to various medications and sometimes iron supplementation if deficiency exists. Your provider will schedule follow-up to assess treatment effectiveness and make adjustments as needed.
How to Prepare
Before your sleep appointment, keep a sleep diary for at least one to two weeks, recording bedtime, time you actually fall asleep (estimate), number of awakenings, final wake time, total sleep time, and how rested you feel. Note daytime naps, caffeine intake (including timing and amount), alcohol consumption, and exercise. Rate your daytime sleepiness. If you have a bed partner, ask them whether you snore, stop breathing during sleep, gasp or choke, or move excessively. Consider videotaping yourself sleeping if you sleep alone and suspect sleep apnea. Download and complete the Epworth Sleepiness Scale, a standard questionnaire measuring daytime sleepiness. Bring a complete medication list including over-the-counter drugs and supplements, as many affect sleep—some medications interfere with sleep while others cause daytime drowsiness. Note your typical caffeine consumption, including coffee, tea, energy drinks, and soda. Be prepared to describe your bedroom environment: temperature, light levels, noise, mattress comfort, and electronic devices present. Think about when your sleep problems started and any life changes or stressors that coincided with symptom onset. If you've tried treatments or strategies to improve sleep, note what you tried and whether it helped. If you're already using CPAP, bring your compliance data and information about any problems you're experiencing with treatment. Consider what aspects of poor sleep most affect your life—whether it's daytime fatigue, relationship problems from snoring, or cognitive difficulties—as this helps prioritize treatment approaches.
Have questions about sleep disorders? Contact Advanced Cardiovascular Specialists & Primary Care at (203) 334-2100 to schedule your appointment.
