Why You Need a Sleep Specialist, Not Just Your Primary Care Doctor

Dr. Audrey Wells of Super Sleep MD says sleep apnea patients should seek a sleep specialist—and explains how to find one.

Many patients who suspect they have sleep apnea (or who are fed up or worried by persistent poor sleep, daytime sleepiness, snoring, or other symptoms) start by making an appointment with their primary care doctor. That’s a logical step. But when it comes to sleep apnea, it may not be enough.

“Your primary care doctor has a lot of things to review with you, and typically a 15- to 30-minute visit to cover all that,” said Dr. Audrey Wells, who is board-certified in both sleep medicine and obesity medicine. “And, typically, those in primary care don’t receive a whole lot of education on the nuances of sleep symptoms and sleep disorders and might not order sleep testing, testing, and treatment options.”

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If you suspect you have sleep apnea or another sleep-related disorder, Dr. Wells said it makes sense to start by asking your primary care doctor for a referral to a sleep specialist, who is trained to look deeper.

The Role of a Referral

Even though many insurance plans now allow patients to schedule with a sleep specialist directly, a referral can still be useful.

“I think part of the referral conversation is a kind of collaboration about your symptoms,” Dr. Wells said. “So if your symptoms are non-specific, for example, you can get the guidance of your primary care provider to determine whether you need a referral and whether there is something you might be able to do even as you wait for the referral appointment.”

That collaboration also helps ensure that other health problems aren’t overlooked. Fatigue, irritability, or poor focus could be linked to sleep apnea, but they also might stem from other medical conditions, such as thyroid issues or depression.

“Even though we all sleep, we have this tangential experience of our sleep, because it is literally a state of unconsciousness,” Dr. Wells explained. “We only are exposed to the after-effects of good sleep or bad sleep or interrupted sleep. So that conversation that includes the referral decision is oftentimes helpful just to get a more comprehensive perspective of what’s going on.

“Any time you have medicine being done in silos, there’s an opportunity for people to fall through the cracks or a missed chance for education or reinforcement,” Dr. Wells added.

The bottom line: a referral isn’t always required, but it can help coordinate your care.

Choosing a Sleep Specialist

If you decide to see a sleep specialist directly, how do you know you’re choosing the right one?

“I recommend that people go to sleepeducation.org/sleep-center to find an accredited sleep center,” Dr. Wells advised. The site is operated by the American Academy of Sleep Medicine, the United States’ only professional society devoted solely to sleep medicine.

Dr. Wells noted that an accredited center generally will provide a more comprehensive assessment that includes sleep apnea testing but also considers other potential issues.

That detailed approach is important. “An accredited sleep center is going to be more of a medical sleep home,” Dr. Wells said. “It’s not uncommon for people to have more than one sleep issue at play at the same time, so it’s important to be efficient by getting experts on your case.”

The Benefits of Expertise

Specialized knowledge in sleep medicine doesn’t just provide more accurate diagnosis—it also improves testing efficiency and can allow for more personalized treatment, Dr. Wells said.

“Medical professionals with expertise and experience in sleep medicine are positioned very well to help you in a way that is going to save your money, save your time, and save your stress and frustration,” she explained. For patients who are already navigating the challenges of fatigue, daytime sleepiness, and possible insurance hurdles, saving time and preventing stress can come as a particular relief.

Getting Ready for Your First Visit

Once you’ve booked an appointment with a sleep specialist, there are some things you can do ahead of time to make your visit more efficient and productive.

●      Collect information about your medical history and sleep habits.  “It’s worthwhile to come into it prepared to answer a long intake form about your medical history, medications, and sleep schedule,” Dr. Wells said. “It’s also really helpful to talk to people who have had the opportunity to observe or hear you sleeping, like a bed partner or someone you’ve been on vacation with, because that perspective can add a little bit of nuance to what tests might be most appropriate or what treatment options might be available to you.”

●      Check your insurance. “A lot of insurance companies have different coverages for sleep or even for sleep testing,” Dr. Wells noted, so a call to your insurance provider before your appointment can help clarify what options are covered and what would require prior authorization.

●      Write down your symptoms. “Jot down exactly what your symptoms are, related to your sleep—symptoms like fatigue, daytime sleepiness, lack of motivation, irritability—so that they’re top of mind and accessible when you’re talking to the provider,” Dr. Wells said. “Some of those things can be connected to poor sleep the night before, and if those symptoms seem consistent, that can make notes about your history more

accurate.”

Build Your Sleep Team

If you think you might have sleep apnea, don’t stop with your primary care doctor. Primary care physicians play an important role in your overall health, but sleep specialists bring training, tools, and focus that make diagnosis and treatment more accurate, personalized, and effective. Adding a sleep-certified doctor to your health care team can help you get on your best path toward better sleep.