Which Doctor Should I Talk to About My Sleep Problems?

In a perfect world, you would visit your primary care doctor once a year and spend a solid hour talking about your current health.

She’d ask how your family is doing, your marriage, are you getting regular exercise? Are you eating well and how are you feeling about your job? You might have a list of questions for her and you’d carefully go through each one together. She’d even ask how you’re sleeping at night and if you’re feeling rested.

In the real world, we’re lucky if we get a full 15 minutes of face-to-face time with our doctor each year.

Your doctor probably doesn’t remember your name until she sees your chart and she certainly doesn’t remember your spouse’s name or that you just sent your first child off to college. So, when is the right time to bring up your sleep issues? Should you even be talking to your primary care physician or do you need to see a specialist? Is there even such thing as a sleep doctor?

Who is a sleep doctor?

A sleep doctor is a medical doctor who has additional special training in sleep medicine. Typically, the doctor is primarily trained in internal medicine, pulmonology or neurology and then completed additional training in sleep medicine. In order to be boarded (ie: certified or credentialed) in sleep medicine, the doctor must pass a rigorous exam (you can check the certification of a doctor on the American Board of Internal Medicine site here).

Once a doctor is boarded in sleep medicine, he or she can interpret sleep studies and may build a sleep medicine practice. Usually this doctor will see patients with other medical conditions too such as pulmonary or neurological conditions (based on her training).

Alternatively, a physician may not obtain the sleep medicine credential required to interpret sleep studies, but has a special interest and pursues additional training in sleep medicine. These physicians can be primary care or internal medicine physicians, pulmonologists, psychiatrists, neurologists, ENTs or even dentists.

Your Primary Care Physician May or May Not Manage Sleep Issues

The primary care physician is usually considered a generalist who will refer patients with specific medical conditions out to specialist for disease management; however, many of these doctors are now managing many medical conditions, such as diabetes and hypertension themselves without referring to a specialist. This also applies to sleep.

Some physicians will manage the sleep issues of their patients. Some doctors will screen all of their new patients for sleep issues and incorporate sleep assessments into their new patient intake forms (check out the most common assessment, the Epworth Sleepiness Scale here). This doctor will ask how your sleeping. Better yet, she may ask your bed partner how you’re sleeping. Are you snoring? Gasping for air at night? Do you stop breathing during the night? These are all signs of sleep disorder. This doctor will then order a sleep study (either in-home or in a sleep center, read more about both options here). After your sleep study, she will receive the results and contact you to discuss next steps. If you have a sleep disorder like sleep apnea, this may include ordering CPAP therapy to treat your disease (learn more about that here).

With this type of doctor, you won’t need to see a specialist. It’s worth asking your primary care physician’s office staff  if he or she manages sleep disorders. If not, you may wish to ask for a referral to a specialist or find one on your own (depending on your insurance, you may need a referral to see a specialist).

Now we’ll talk about which specialists will manage sleep issues.

Pulmonologist

Pulmonologists are very familiar with sleep disorders such as obstructive sleep apnea (OSA) because it’s basically when you stop breathing while sleeping due to a blockage in the airway (learn more about that here). Pulmonologists manage other diseases such as COPD, asthma and other breathing disorders that may be related to sleep apnea; therefore, some pulmonologists will elect to become boarded in sleep medicine. They may be affiliated with a sleep center or run with own and interpret sleep studies for their own patients.

Neurologist

While obstructive sleep apnea is primarily a breathing issue, other sleep disorders such as central sleep apnea, narcolepsy and insomnia can be related to neurological issues. While you won’t typically get referred to a neurologist if your primary care physician suspects obstructive sleep apnea is the cause of your sleep issues (such as excessive daytime sleepiness, morning headaches, etc., read more about symptoms here), you’ll probably get referred to a different specialist like a pulmonologist or ENT. However, if you have other symptoms that may indicate a neurological cause of your symptoms, you may end up with a neurologist.

Like pulmonologists, neurologists may also be boarded in sleep medicine and some are affiliated with sleep centers and interpret their own sleep studies.

ENT

An ENT (Ear, Nose and Throat) or otolaryngologist is a specialist who deals with issues in the ears, nose and throat. You may visit this doctor if you have a deviated septum or your child needs her tonsils removed or sticks a Lego up her nose. Because sleep apnea and snoring are caused by blockage in the throat, the ENT may actual see these issues during examination. ENTs have typically recommended surgery to treat sleep apnea or snoring. While these procedures work well for children (sleep apnea in children is usually caused by enlarged adenoids or tonsils that can be surgically removed to eliminate sleep apnea, learn more about that here) the surgery has mixed results for adults (learn more about surgery for sleep apnea here).

Many ENTs will order sleep studies and recommend CPAP for their patients with sleep apnea. If CPAP is not effective, isn’t tolerated, or the patient finds that he only suffers from snoring and not sleep apnea, surgery may be considered.

Dentist

No doctor looks into more mouths on a daily basis than a dentist. On top of that, you’re likely to see your dentist twice per year, more than any other doctor. For these reasons, dentist have a great opportunity to address sleep issues from obstructive sleep apnea (blockage in the airway that affects breathing during sleep) and bruxism (grinding teeth while sleeping). Dentists are also very interested in offering options to the gold standard treatment for obstructive sleep apnea, CPAP. Although CPAP is the only treatment for sleep apnea that is 100% effective, it isn’t easy and there are some patients that may be able to reduce their apnea with an oral appliance (read more about that here). Oral appliances can work for some patients and may be covered by insurance, including Medicare. If you suffer from snoring only and not sleep apnea (learn about the relationship between the two here), you can learn about oral appliances that stop or reduce snoring.

Dental sleep medicine is growing. It is estimated that there are currently XXX dentists specializing in sleep medicine in the U.S. You can easily find one online (here’s a great resource).

Psychiatrist

This final category of doctors may sound surprising, but psychiatrists may have the largest share of patients with sleep disorders ranging from insomnia to narcolepsy and sleep apnea. Insomnia is very common and may be a symptom of sleep apnea. All of these sleep disorders can cause excessive daytime sleepiness which can affect mood, anxiety, depression, sex drive and more. Therefore, a psychiatrist is likely to ask you how you’re sleeping and has an opportunity to identify if you are at risk for a sleep disorder. If this is the case, he or she may refer you for a sleep study at a testing facility or to one of the other specialists we’ve discussed above.

Learn more about the physicians who interpret sleep studies for us here.

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Comments

  1. Trayson Evans Reply

    I like what you say about looking into a dentist when it comes to your sleep apnea treatment. Having someone that is familiar with your mouth and throat sounds like a great idea. I haven’t been sleeping well lately and I’m wondering if it may be sleep apnea. It might be time to see the dentist.

    • Emily Lewis Reply

      My father was diagnosed with sleep apnea about two years ago. He followed the usual path of getting hooked up to a ventilating machine which, for him, was a bit of hell on earth. It wasn’t until he stumbled upon this natural remedy ( sleep-apnea.1cure.info ) after trying it, it helped him to reverse his sleep-apnea and keep him off that machine, it was worth trying, really.

  2. Callum Palmer Reply

    Considering how common sleep issues can be it really helps to know which doctor you should be talking to. Although, I have to admit that I had no idea that there were certain cases where a neurologist could help. Although, I do suppose that that makes sense if there is something wrong with your brain that is keeping you from falling asleep.

  3. Gloria Van Dyke Reply

    I believe I need help for the longest time now I have had terrible bad bad dreams that frighten me to the point I end up sitting up all night long…..and get so sick to my stomach and my heart hurts and my nerves are really awful, this happens almost every night, what type of doctor should I see, I can not go any longer like this. I am 72 years old.

  4. Jawad Lee Reply

    Nice Post. Info helped me a lot.

  5. Susan Reply

    I have had sleep apnea now for 7 years. For past 3,4 months I wake up very tired, and I have leg and arm joint pain, unbalanced and weak at times. If I do house cleaning the next day I’m so tired and weak I sleep for about 16 hours. I have a Cpap machine I use every night . Do you think my machine is not working correctly. I called the company but they say it’s working. What do you think . I have a fib and svt and mild asthma.

  6. Carol Reply

    I don’t believe I have sleep apnea . I believe it’s more hormonal or from chemical. Who do I see then?

  7. High Rated Gabru Reply

    Awesome sleep blog. Thanx!!

  8. Jewels Jade Reply

    Fabulous article. Thank you.

  9. Susan Reply

    I have a problem falling asleep and staying asleep for the last five years .I feel it is time to see a doctor.can someone help me what kind of doctor I have to see.

  10. SEO Articles Reply

    Awesome sleep blog. thanks a lot!

  11. Persimmon Reply

    Great news. please keep it up guys.

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  13. MG Meghana Reply

    Not going to sleep at night 21 years old age girl I am studying B formacy 4 final year my living area zaheerabad dist sangareddy telangana state 502220 Mobile number 9492304320

  14. geometry dash Reply

    A sleep specialist is a doctor who diagnoses and treats sleep disorders. Most sleep specialists train in internal medicine, psychiatry, pediatrics, or neurology during residency. After completing residency, they complete a fellowship program in sleep medicine.

    • Jim Davidsom Reply

      Great comment bring lucky enough to have respiratory therapist and dentist in the family. They both use CPAP therapy, if you are properly diagnosed and go to a sleep lab that’s part of your healthcare system and not a stand alone facility you stand a great chance in proper diagnosis and improved health. I see a pulmonologist trained in sleep medicine and have never looked back. My cpap is fitted correctly, yes the first week is difficult but after that I fell right to sleep. I use it every night and my life has improved in many ways. Blood pressure, overall outlook, A1c, blood lipids all improved with use of my cpap. Being rested makes me want to be more active…a vicious positive cycle .
      Home tesr leave too much to chance. Primary diagnosis is best done in a sleep lab. Let’s rule out all the bad stuff in one night of accurate testing by people who do it as a vocation.. Home test ate the invention of my insurance companies…most insurance cover preventative screens and it’s a preventative screen.

  15. Tree Services Reply

    Agree..

  16. Renovations Reply

    Yes! The first doctor you should see about your sleep problems is your primary care physician, or family doctor.

  17. Shruthi Reply

    Nice information, without proper sleep one will get week and unhealthily. Concern Pulmonology doctor at Maa ent hospital for better result

  18. sonu ali Reply

    it’s the great knowledge in the post.
    You should seek the advice of your primary care physician or family physician regarding sleep problems because sleep is important for a healthy life for everyone.

    • Parwaiz Palh Reply

      I have read your post about sleep disorder, really you shared a excellent, informative, and helpful article for every readers.

  19. sonu ali Reply

    This is great information about a sleeping problem, which doctor should I see regarding my sleep problem. Sleep plays a vital role in our physical and mental well-being.

  20. Michaela Hemsley Reply

    It’s good to know that a sleep doctor is a physician that has specific training and qualifications for sleep medicine. Lately, my husband has been feeling like no matter how much sleep he gets, he still wakes up tired. I think it would be smart for him to look into going to a clinic or specialized doctor that can help him figure out what’s going on so that he can finally feel better and well-rested.

  21. Judy Colvin Reply

    I’ve been on 10 mg Zolpidem for 25 yrs. Plus they gave me 4 mg tizanidine plus alprazolam 0.5 to get me to go to sleep. I still have problems. Doctors are not willing to help me.i want to know why I can’t sleep and how to get off of this crap.

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  28. Woodali Harikumar Reply

    Did you know that there are five key sleep disorders in the United States? If you don’t already know, Chicago’s Top 5 Sleep Disorders Solutions is a blog article about the top five common sleep disorders in the US. Learn how to identify them and what your options are for treatment and which doctors to be consulted. A sleep doctor is a medical doctor who has additional special training in sleep medicine. Typically, the doctor is primarily trained in internal medicine.

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  33. slope run Reply

    If you have sleep problems, you should tell your doctor because good health requires a good night’s sleep

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  38. Christina miller Reply

    I have severe insomnia. I can not fall asleep. Can I see a pulmonologist for treatment

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