How are sleep onset problems and sleep maintenance problems differentiated?
Sleep onset difficulties are often related to anxiety, changes in the phases of sleep, poor sleep hygiene, and restless-legs syndrome. Sleep maintenance problems, by contrast, are often associated with chronic alcohol or medication use, advanced sleep phase, depression, or a primary sleep disorder such as sleep apnea. • When may referral to a sleep specialist be indicated? Referral to a sleep specialist may be indicated when: obstructive sleep apnea is suspected; the patient has symptoms of restless legs syndrome or periodic limb movement disorder that interfere with falling asleep or that disrupt sleep maintenance, or limb jerking at night that is associated with daytime sleepiness; and the patient exhibits agitated behavior, personality changes, or parasomnia. • What is a key feature in care planing for patients with sleep disorders? A key feature of patient care planning that may reduce the incidence of sleep problems is to offer patients choices about when to go to bed, get up, and
