It’s common in this country to look to drugs to treat our problems. This is as much a failing among patients as doctors, although it’s often put on doctors. Ideally, all parties should agree that when drugs aren’t working, a different treatment should be attempted.
One area where drugs often fail is in the treatment of insomnia. Many people who take drugs for insomnia find that they are ineffective. They may help a person fall asleep, but they don’t help them stay asleep.
That’s because many people who talk to their doctors about insomnia actually have sleep apnea. This is especially true of people trying insomnia drugs. In a recent article, about 90% of those who didn’t see results from their insomnia drugs actually had sleep apnea.
Look for the Symptoms of Sleep Apnea
If you have recommended drugs for insomnia but aren’t getting good results, then you should move on to a home sleep test. As noted above, there’s at least a 90% chance that this patient will have sleep apnea. You should also be cognizant of other potential symptoms of sleep apnea to watch out for, such as:
Research has shown that when asked why people woke up, they list many different potential causes, such as:
- Being too hot or cold
- Racing thoughts
But when these people are given a sleep test, it turns out that breathing events are the main reason why they are waking up at night. They just aren’t aware of the breathing problems that are causing them to wake up.
Guide Diagnosis and Treatment
Observing the interaction between patients and doctors shows that, in many cases, people try to steer their doctor to the diagnosis they favor. They tell their doctor they have insomnia and that they want something “to help them sleep.” In many cases, they’re not satisfied until they get a prescription for sleep aids.
However, if their problem is really sleep apnea, these sleep aids won’t be helpful. They may actually make the problem worse. Instead, order a sleep test, to confirm or rule out sleep apnea, and see if this is indeed the underlying issue.
Don’t Stick with a Failing Treatment
If you’ve recommended sleep aids and they aren’t helping, don’t stay with it. You may want to give it a reasonable amount of time to allow the patient to adapt, say a few months, but then you should move on to another treatment.
This is also true if you are recommending sleep apnea treatments. CPAP is often the first line of treatment, but it doesn’t work for everyone. If it’s not working for your patient, it’s time to consider an alternative, such as an oral appliance.