Sleep Disorders Follow-up

Author: Roy H Lubit, MD, PhD; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych (UK) more...

Updated: Jan 9, 2012

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Further Inpatient Care
Further Outpatient Care
Inpatient & Outpatient Medications
Deterrence/Prevention
Complications
Prognosis
Patient Education
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Further Inpatient Care

Inpatient care is rarely, if ever, required for treatment of insomnia. Only a severe underlying medical, psychiatric, or substance abuse disorder would warrant inpatient care.

Further Outpatient Care

Multiple possible medical etiologies of sleep disorders make them difficult to diagnose and necessitate regular appropriate follow-up care until final diagnosis has been made and successful treatment has been implemented. Several medical specialists may be needed for care and consultations and can be coordinated by the patient's internist, personal physician, or medical sleep specialist.

Inpatient & Outpatient Medications

Regular follow-up care, even if infrequent, is necessary once appropriate medication is successfully in use. (However, medication may be unnecessary.)

In addition to specific treatment for diagnosed sleep disorders, good sleep hygiene should be taught to every patient (and this information should be publicly available). Just as with dental hygiene, appropriate sleep habits should be cultivated by all individuals at all times.
See Medical Care for more information.

Complications

Mood and anxiety disorders may develop from untreated sleep disturbances, and current medical literature supports the theory that these brain-based mental status changes are risk factors for morbidity and mortality from a host of medical conditions (eg, cardiovascular disease).

Prognosis

The prognosis varies widely depending on the etiology of the insomnia or other sleep disorder. For example, insomnia due to obstructive sleep apnea resolves with successful treatment of the apnea, while insomnia due to refractory major depression is itself refractory until a successful treatment can be found for the depression.

All individuals should be taught and encouraged to practice good sleep hygiene, as outlined in Medical Care.
Educating the patient's family about proper sleep hygiene is imperative, especially because the patient's spouse can be adversely affected by sleep disorders such as sleep apnea.
Use the bed for sleep and sex only (no television watching or reading in bed).
For excellent patient education resources, visit eMedicine's Mental Health and Behavior Center and Sleep Disorders Center. Also, see eMedicine's patient education articles Disorders That Disrupt Sleep (Parasomnias), Insomnia, Primary Insomnia, REM Sleep Behavior Disorder, Understanding Insomnia Medications, Sleep Disorders in Women, Sleep Disorders and Aging, and Sleeplessness and Circadian Rhythm Disorder.

Contributor Information and Disclosures

Author

Roy H Lubit, MD, PhD Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice

Disclosure: Nothing to disclose.

Coauthor(s)

Curley L Bonds II, MD Associate Professor and Chair, Department of Psychiatry and Human Behavior, Charles Drew University of Medicine and Science; Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Curley L Bonds II, MD is a member of the following medical societies: American Medical Association and American Psychiatric Association

Disclosure: Nothing to disclose.

Michael A Lucia, MD, FAASM Owner/CEO, Pulmonary, Allergy and Sleep Medicine, Sierra Pulmonary and Sleep Consultants, LLC

Michael A Lucia, MD, FAASM is a member of the following medical societies: American Academy of Sleep Medicine, American Association of Cardiovascular and Pulmonary Rehabilitation, and Nevada State Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Denis F Darko, MD Executive Director, Clinical Research and Development, Global Neuroscience, AstraZeneca

Denis F Darko, MD is a member of the following medical societies: American College of Physicians and American Psychiatric Association

Disclosure: AstraZeneca Salary Management position

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Harold H Harsch, MD Program Director of Geropsychiatry, Department of Geriatrics/Gerontology, Associate Professor, Department of Psychiatry and Department of Medicine, Froedtert Hospital, Medical College of Wisconsin

Harold H Harsch, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: lilly Honoraria Speaking and teaching; Forest Labs None None; Pfizer Grant/research funds Speaking and teaching; Northstar None None; Novartis Grant/research funds research; Pfizer Honoraria Speaking and teaching; Sunovion Speaking and teaching; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research; Merck Honoraria Speaking and teaching

Chief Editor

Iqbal Ahmed, MBBS, FRCPsych (UK) Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych (UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, American Psychiatric Association, American Society of Clinical Psychopharmacology, and Royal College of Psychiatrists

Disclosure: Nothing to disclose.

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