I am tremendously interested in sleep. I do not have board certification in sleep medicine, I do not have a sleep lab, nor do I read sleep studies. My interest in sleep is clinically selfish: Knowing a little about sleep makes me a better psychiatrist.
Just about every psychiatric condition (perhaps just about every medical condition) can be impacted by sleep. Understanding sleep disorders and doing what we can to make sure that sleep disorders are evaluated and treated can help patients significantly.
I usually assault my patients with questions about their sleep patterns. My initial patient assessment includes a significant number of questions about sleep, including:
- What time (or range of times) do you go to bed?
- How long does it take you to fall asleep?
- Do you wake in the middle of your sleep cycle? How frequently? Why? For how long?
- What time do you awaken?
- Do you feel well rested after your sleep?
- Do you take anything (prescription or over the counter) to help you stay awake or fall asleep?
- Has anyone told you that you snore significantly, choke, or stop breathing while you are asleep?
- Do your extremities jerk or move involuntarily when you are in bed?
- Do you feel the overwhelming need to move your extremities to be comfortable when you are trying to go to sleep?
- Do you have intense dreams or visions on the cusp of falling asleep or waking up?
- Do you ever feel paralyzed or intensely weak when you first awaken?
- Do you work a non-traditional shift or need to be awake when you should be asleep?
- How often and long do you nap?
- How is your energy level during the day?
Untreated sleep problems make most of the conditions we treat harder to treat and less likely to respond to interventions. I believe that asking these questions as a matter of routine can provide important clinical data that can put us in the position to be of more help to our patients.
We will explore specific sleep disorders and their impact on psychiatric conditions in upcoming posts. In the comments, let me know if you have any other important sleep questions you usually ask your patients.
Chris Bojrab, MD, is the president of Indiana Health Group, the largest multidisciplinary behavioral health private practice in Indiana, established in 1987. He is a board certified psychiatrist and a Distinguished Fellow of the American Psychiatric Association who treats child, adolescent, adult, and geriatric patients. His areas of interest include psychopharmacology, sleep disorders, and gambling addiction. For more information and disclosures, visit www.chrisbojrabmd.com
The views expressed on this blog are solely those of the blog post author and do not necessarily reflect the views of Psych Congress Network or other Psych Congress Network authors.