You're Getting Very Sleepy: Our Guide to Sleep Telemedicine

Although most sleep experts will tell you to turn off your digital devices for a good night’s sleep, it turns out the key to better rest may actually be on those screens after all. Sleep issues are some of the most vexing because poor sleep affects every aspect of our lives, both physical and mental, and can even shorten our lives. The US alone loses over $400 billion each year to the effects of sleep deprivation. The National Sleep Foundation reports that 1/3 of US adults have problems falling asleep or staying asleep almost every night. Struggling with sleep can have serious consequences. The Centers for Disease Control and Prevention (CDC) has said that sleep deprivation has the same effect on your immune system as smoking or being inactive. Sleeping poorly means that you are not going to be able to function optimally. 

So many factors can affect the quality of our sleep. If after addressing the basics of “sleep hygiene” (getting at least 7 hours, turning off digital devices, keeping a cool room temperature, etc.) you still are having problems falling and staying asleep, it may be time to see a professional.

Providers are now offering sleep medicine services on their telemedicine platforms and patients are benefitting from ease of access. For patients who suffer from sleep apnea, insomnia or other conditions related to their sleep, the ability to speak with a doctor via a secure platform that puts them at ease is a huge benefit. Providers are finding that enabling telemedicine services through their platforms helps create a better experience for patients and it’s not hard to see why.

There are many different sleep disorders that sleep clinicians use telemedicine to treat. Common sleep disorders that doctors treat include sleep apnea, insomnia, narcolepsy and Restless Leg Syndrome (RLS).

What kinds of treatment are available?

For acute, chronic, or transient insomnia, many quick, convenient, and affordable options are available via telemedicine. The first line treatment for insomnia is cognitive behavioral therapy (CBT-I). CBT-I addresses the thoughts and behaviors that can negatively affect your ability to fall and stay asleep. It encompasses a wide range of techniques and typically requires 6-8 sessions.

If you require medication, most on-line providers are able to prescribe non-controlled prescription medication such as Vistaril and Desyrel. Although controlled substances such as Ambien typically require an in-person medical evaluation to be prescribed, the recent public health emergency declared by the Secretary of Health and Human Services in response to the Covid-19 pandemic allows controlled substances prescription via virtual visits. Practitioners must be DEA-registered. Check with your provider to see what they are able to provide.

If you are experiencing symptoms of sleep apnea, such as loud snoring, waking up with a dry throat/mouth, and restless sleep, on-line sleep center Singular Sleep offers home sleep apnea tests $295 with follow-up appointments at $105. Healthcare digital marketplace Sesame Care is offering a video sleep consult with an at-home sleep study bundle at just over $200. Although no prescription is needed for an at home sleep test, a prescription is needed for CPAP therapy, which can be given by your primary care doctor or a sleep specialist.

Is Sleep Telemedicine Effective?

Telemedicine in general has been found to be just as effective as in-person treatment for a wide range of medical conditions and sleep disorders in this regard are no different. Harvard Health Publishing recently highlighted a study which found CBT-I delivered by telemedicine to be just as effective as in-person treatment for insomnia. Other studies have shown similar results, and have even demonstrated its long-term effectiveness up to a year over a wide range of health outcomes. In fact, telemedicine platforms offer several advantages over office visits as they allow providers to see the patient's sleep environment and hear from their sleep partner which can provide valuable insight into the issues that are causing concern.

What are the Limitations of Sleep Telemedicine?

Home sleep testing is a wonderful convenience but it does have its limitations. Patients may need to be referred to an in-lab overnight sleep study for the evaluation of certain medical conditions. It is further recommended that patients with certain complex medical conditions such as COPD and heart failure be tested in-lab. These sessions can be quite expensive, running into the thousands of dollars, so it’s best to start with an in-home test when possible. Additionally, as noted above, if the prescription of a controlled-substance such as Ambien is needed, an in-person evaluation may be required.

Quality sleep is one of the most essential components to living a healthy life. Over the past year we have seen telemedicine expand as both patients and providers become more comfortable with virtual care. If you are having problems with sleep, a video visit may be the easiest and most cost effective way to treat it. And of course if you're looking for sleep telemedicine jobs, you can always find the latest remote jobs here!