More Doctors Should Ask About Sleep

A good primary care doctor will ask  good questions about your medical problems, but quality of life issues, especially involving chronic medical conditions, is not asked about. This conclusion was found in a recent article published in the Mayo Clinic Proceedings. Jane Brody of the  New York Times wrote an excellent article summarizing the findings. However, I was disappointed that she didn’t mention anything about the importance of asking about sleep. I can argue that lack of quality sleep (or quantity) can aggravate, if not cause almost every medical condition that she mentions in her article (diabetes, arthritis, ADHD, IBS, cancer, urinary problems, sexual dysfunction, anxiety, depression).

In medicine, it’s commonly assumed that chronic disease can cause poor sleep. But there are numerous studies that show that poor sleep can cause or aggravate each of the medical conditions mentioned above. Furthermore, since such a high proportion of the population has undiagnosed obstructive sleep apnea (24% of men and 9% of women, and over 50% as seniors), it’s a travesty that doctors almost never ask about sleep, and even if they do ask, most end up prescribing a sleeping pill.

Does your doctor ask about how well you sleep? If so, how is it addressed?






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2 thoughts on “More Doctors Should Ask About Sleep

  1. I agree that doctors should ask, but it isn’t on their radar if they don’t know much about sleep medicine. Someone on cpaptalk recently wrote that upon looking at the Harvard Medical School curriculum, it appears that doctors-in-training only receive about 2 hours of coursework about sleep. Perhaps the better question would be why aren’t medical schools covering this more thoroughly?

    I complained of extreme fatigue and sleep issues for over 10 yrs to my family doctor, and it was chalked up to other issues…perimenopause, thyroid, etc. Once I was diagnosed by a specialist with OSA, I took some time to present, to my family doctor, my disappointment with her not picking up the signs and obvious red flags over the last decade. I was calm and professional in my discussion, and my purpose was not to place blame over water that had already passed under the bridge, but to ask her to be more careful in screening patients for this disorder.

    It made not one bit of difference….she had excuses and was somewhat defensive about it being hard to get insurance to approve sleep studies…etc. Needless to say, I was very disappointed. She is a good doctor on so many levels, but it was obvious to me she was out of her depth when it came to sleep.

  2. Emilia,

    There are always exceptions to the rule, but your experience, as well as my unsuccessful efforts at educating other doctors, has led me to spread my message directly to the general public. Sleep is such a nebulous subject for doctors, and that means spending more time with patients.

    You don’t have to learn sleep medicine as a primary care doctor, but knowing what we know about sleep and it’s effects on almost every common medical condition out there, at least ask about and and if you don’t have time, refer to a sleep specialist. Too many patients are just given sleeping pills.

    I had one close friend who was suffering from repeated sinus infections, fatigue, and weight gain for 10 years, and he kept asking his doctor for a sleep evaluation, thinking he may have sleep apnea. But the doctor kept refusing, saying he doesn’t fit the mold for someone who has sleep apnea. Sure enough, he had it, and after treatment, slept much better and even his sinus problems improved.