eMedicine Specialties > Psychiatry > Psychosomatic

Sleep Disorders: Follow-up

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
Coauthor(s): Curley L Bonds II, MD, Adjunct Associate Professor and Chair, Department of Psychiatry and Human Behavior, Charles Drew University of Medicine and Science; Associate Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles; Michael A Lucia, MD, FAASM, Owner/CEO, Pulmonary, Allergy and Sleep Medicine, Sierra Pulmonary and Sleep Consultants, LLC
Contributor Information and Disclosures

Updated: May 21, 2009

Follow-up

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.)

Deterrence/Prevention

  • 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.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Patients should be warned to not drive or operate machinery while taking sedative-hypnotic medications. Document these admonitions clearly in the medical record.
  • Caution is advised in the treatment of patients who are elderly and others who may be at increased risk for falls.
 


More on Sleep Disorders

Overview: Sleep Disorders
Differential Diagnoses & Workup: Sleep Disorders
Treatment & Medication: Sleep Disorders
Follow-up: Sleep Disorders
References
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References

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Further Reading

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Keywords

sleep disorders, primary sleep disorders, disorders of initiating and maintaining sleep, DIMS, dyssomnias, insomnia, parasomnias, sleep-wake cycle disturbances, sleep apnea, obstructive sleep apnea, OSA, REM sleep, non-REM sleep, polysomnography, sleep maintenance, sleep onset, circadian rhythm, circadian cycle, nightmare, sleepwalk, sleepwalking, hypersomnia, narcolepsy, somnambulism

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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, Adjunct Associate Professor and Chair, Department of Psychiatry and Human Behavior, Charles Drew University of Medicine and Science; Associate Clinical Professor, Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles
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.

Medical Editor

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

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Iqbal Ahmed, MBBS, Professor, Department of Psychiatry, John A Burns School of Medicine, University of Hawaii
Iqbal Ahmed, MBBS is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, and American Psychiatric Association
Disclosure: Nothing to disclose.

CME Editor

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 Honoraria Speaking and teaching; AstraZeneca Honoraria Speaking and teaching; Pfizer Grant/research funds Speaking and teaching; Northstar Grant/research funds Research; Novartis Grant/research funds research; Pfizer  Speaking and teaching; Sanofi-avetis Grant/research funds research; Otsuke Grant/research funds reseach; GlaxoSmithKline Grant/research funds research

Chief Editor

Stephen Soreff, MD, President of Education Initiatives, Nottingham, NH; Faculty, Metropolitan College of Boston University, Boston, MA
Stephen Soreff, MD is a member of the following medical societies: American College of Mental Health Administration and American Psychosomatic Society
Disclosure: Nothing to disclose.

 
 
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