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Insomnia and Sleep Disorders in Primary Care Settings - Episode 4

Patient Referrals for Sleep Disorder Management

Paul Doghramji, MD, FAAFP, discusses best practices for referring patients with sleep issues to a sleep specialist.

Paul Doghramji, MD, FAAFP: There are instances when we should refer our patients to a sleep clinic. First and foremost is in situations where you don't feel comfortable dealing with a particular patient's sleep problem. Just like with anything else that you don't feel comfortable with, you can get them to see a sleep specialist. If you're suspecting a patient that has obstructive sleep apnea, that's not insomnia of course, but obstructive sleep apnea, one of the commonest things you should refer and get that patient tested and treated. More into the insomnia situation. If you have a patient where you have done a good sleep history, you have maybe initiated treatment with cognitive behavioral therapy, or maybe you've initiated treatment with medication, initiated treatment dealing with the comorbidities and the patient continues to struggle with either getting to sleep and/or staying asleep, feeling unwell during the day, it's a good idea then to have the patient referred to a sleep clinic that is especially adept at insomnia. This is something which primary care providers need to know which is that not all sleep clinics are as adept at treating insomnia as other clinics are. You might want to make a phone call and discuss with that sleep clinic. How well do you do, or do you like to deal with patients with insomnia and how do you approach them and that sort of stuff? There's a large portion of sleep clinics that are more sleep apnea clinics and there are others that are fuller service that will tackle any kind of sleep disorder, including insomnia. The PCP needs to know that this is going on and you might want to do a little extra work in finding out about a sleep clinic or a sleep specialist if they have interest in insomnia or not before proceeding to refer a patient to that provider.

Transcript Edited for Clarity