Definition and Overview

A sleep medicine follow-up is an appointment with a sleep specialist and/or a general physician following the initial consultation and completion of various diagnostic tests including a sleep study. The main goal is to establish the cause of the patient’s sleep problems and to figure out the best treatment methods. This consultation is also conducted to check if the current treatment plan is working and if the patient develops new symptoms that were not addressed on previous follow-ups.

Who Should Undergo and Expected Results

A sleep medicine follow-up is recommended for:

  • Those who have undergone diagnostic tests including a sleep study – A sleep study is an investigation of a person’s sleeping pattern, behavior, or habit. This is necessary to diagnose a disorder, which includes insomnia or sleep apnea. This helps the sleep doctor correctly identify the main cause of the sleeping disorder, so appropriate measures can be undertaken to treat the condition and prevent the possible harmful consequences of poor sleep.

  • Patients whose medication or treatment plan does not work – In cases wherein sleep medicine interventions did not yield the expected results, patients are encouraged to go back to their doctors for a follow-up so appropriate adjustments can be made to their treatment plan.

A follow-up ensures that the patient fully understands the diagnosis, completes or commits to the treatment, and experiences better health and quality of life. This can also be beneficial to sleep doctors and general physicians since it gives them more information that can help them better understand the condition.

How Does the Procedure Work?

A sleep medicine follow-up comes immediately after a sleep study and various diagnostic procedures. In the majority of cases, GPs and sleep specialist work together to understand the condition and in formulating the best treatment method for the patient while taking into consideration the patient's unique needs and circumstances.

During the follow-up, the attending physician will review the patient’s medical and family history, medications taken, lifestyle, and symptoms being experienced.

The doctor then walks the patient through the results of the tests. At this time, he may either provide a clear diagnosis or request for more tests to come up with a more conclusive result. Either way, follow-up consultation will typically include the discussion of the possible treatment or management plan.

The treatment may include medication or the use of a machine such as for those who have sleep apnea, who may require a CPAP machine that opens up the air’s passageway, so they are able to breathe properly at night. In such cases, the doctor would also orient the patient on the machine, especially on how it is used, as well as how to wear the mask and take care of the equipment.

The sleep doctor may also refer a patient to a psychologist or a psychiatrist, particularly if sleep problems are caused by mental disorders like depression. The psychiatrist or the psychologist may then initiate cognitive behavior therapy (CBT) wherein the mindset is modified so the patient adopts a better way of thinking.

The succeeding follow-up sessions will then focus on tracking the patient’s progress while under the proposed treatment plan.

Possible Risks and Complications

A sleep follow-up requires multiple visits, which can be tiring and frustrating for some patients. Eventually, they may fail to follow the treatment plan, worsening their condition. The problem can be compounded if the patient doesn’t have a solid relationship with the doctor. The doctor may also not take a proactive approach and reach out to the patient and schedule follow-up sessions.

The waiting period in between follow-up appointments can also increase the level of anxiety for the patient, which incidentally can affect sleeping habits. Normally, follow-up consultations are spaced between two and four weeks apart.

References:

  • Balkin TJ. Performance deficits during sleep loss. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 65.

  • Carskadon MA, Dement WC. Normal human sleep. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 2.

  • Centers for Disease Control and Prevention. Sleep and Sleep Disorders. Updated March 12, 2015. www.cdc.gov/sleep/index.html. Accessed September 21, 2015.

  • Drake CL, Wright KP. Shift work, shift-work disorder, and jet lag. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 71.

  • Philip P, Sagaspe P, Taillard J. Drowsy driving. In: Kryger MH, Roth T, Dement WC. Principles and Practice of Sleep Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 69.

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