- Thought Leadership
Symptoms versus causes: “peeling the onion” of insomnia and hypersomnia
Jeffrey Durmer, MD, PhD | August 25, 2021
Sleep is complex. Evaluating a patient for a sleep disorder and then determining treatment requires a holistic approach to determine the root cause of a disturbance. Sleep physicians often need to integrate a patient’s sleep healthcare with other physicians and with treatments for conditions outside of sleep medical care.
Hypersomnia, also known as excessive daytime sleepiness (EDS), is a perfect example. We’ve all experienced sleepiness during the day from time to time, and there are a myriad of causes. There are also a number of sleep and wake disorders that cause EDS that can easily be confused with the symptom of EDS. Likewise, insomnia refers not only to a category of sleep disorders, but it’s also a very common symptom that can be caused by other medical, psychological and behavioral conditions.
Finding the root cause
The first step to understand a symptom like insomnia or EDS is a comprehensive sleep evaluation conducted using telemedicine in the SleepCharge program. Sleep physicians consider the medical, sleep, family and social history of a patient in combination with a full review of symptoms and exacerbating and mitigating factors.
After formulating a hypothesis about what might be causing a sleep or wake symptom, a SleepCharge physician may prescribe a sleep test to quantify and/or diagnose specific issues such as sleep-disordered breathing (i.e., obstructive sleep apnea), restless legs syndrome (RLS), parasomnias (unexpected behaviors during sleep), sleep-stage interruptions due to psychophysiologic insomnia or sleep-related movement disorders such as periodic limb movement disorder (PLMD).
As part of the workup, our physicians may also order blood work to evaluate other medical conditions that can lead to the symptoms of hypersomnia or insomnia, including thyroid disease, metabolic disorders (i.e., diabetes, metabolic syndrome), cardiovascular disease (i.e., arrhythmias, heart failure, hypertension), depression or vitamin and mineral deficiencies.
Applying the right treatment first
Once one or more diagnoses are rendered, treatment is tailored to the individual. The term “precision medicine” is often used to describe therapies that are designed to treat specific types of disease or disorders, rather than a one-size-fits-all approach. Every SleepCharge patient receives a detailed treatment plan designed specifically for his or her sleep or wake issue(s). By treating the right issues with the most appropriate therapies, we deliver precision sleep healthcare to eliminate the cause of a symptom.
The precision sleep healthcare approach includes both the coordination of sleep therapies and also medical and even surgical therapies when necessary. For example, if an evaluation for EDS reveals untreated sleep apnea, as well as iron deficiency and hypothyroidism, treatments will not only include the elimination of the sleep apnea but also a thorough investigation into the cause of the iron deficiency and hypothyroidism. Based on additional testing, adjunctive therapies may be prescribed that together will result in a targeted and lasting solution.
At SleepCharge, we treat every patient individually and integrate care through several channels. First, through patient consultations with our sleep medicine physicians, we can diagnose and treat many cases of hypersomnolence and insomnia within the SleepCharge program. Second, some cases involve our medical management team coordinating care with other physicians. And in some instances, we work with the patient’s primary care physician to establish other diagnoses, initiate treatments and/or coordinate additional specialist evaluations.
The bottom line of the SleepCharge program is our delivery of personalized, precision sleep healthcare. No matter who is rendering treatment — a SleepCharge physician or collaborating medical professional — our team takes the lead in order to coordinate a successful treatment plan for each patient.
By closing the loop for our patients with other specialists and their own primary care physician, we ensure that sleep issues are addressed holistically and integrated with a patient’s overall care. Sleep healthcare coordination is unusual in the current fragmented healthcare system. Unfortunately, without this coordination, patients are left to self-navigate in search of a cure, which often results in wasted time, money and frustration.
By eliminating the guesswork for patients and coordinating their care across the multiple spheres of modern healthcare, we remove a burden from our patients and proactively make their care our priority at SleepCharge.
For further press inquiries, please get in touch.