Can I get help with my sleeping problems online?

Written on February 3, 2023 by Theresa Vuskovich, DMD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• Types of sleep disorders
• Tests for sleep disorders
• Treatments for sleep disorders
• Everlywell offers virtual care visits for sleeping problems
• Related content

You may be wondering, “Can I get help with my sleeping problems online? Yes, if you're one of the 50 to 70 million Americans with sleeping problems, you can get help online. Online treatment options depend on the type and severity of your sleeping problems. Let's explore common sleeping disorders, tests for sleeping disorders, and treatments available online.

Types of sleep disorders

First, let's discuss common sleeping problems. Sleeping problems may indicate you have a sleep disorder. There are over 100 types of sleep disorders [2]. Due to the wide range of sleeping disorders, it is important to discuss your lifestyle, health history, and specific sleep problems with your healthcare provider. Your healthcare provider may diagnose you with one of the following sleeping disorders [3-6].

Insomnia

Insomnia affects up to 30% of American adults, with females having a higher risk of developing insomnia [3]. If you have trouble falling asleep or staying asleep at least three times a week for three months, you may have chronic insomnia [4]. Symptoms of insomnia include feeling tired all the time, having problems at work or school, and feeling distressed when you cannot sleep [2].

Treatment for insomnia includes behavioral therapy and medication. You can prevent insomnia by practicing healthy sleep hygiene, such as going to bed at the same time every night and avoiding large meals before bedtime.

Restless Legs Syndrome

Restless legs syndrome (RLS) occurs when your legs throb or itch at night, keeping you awake. RLS doesn't have a cure, but exercise, dietary changes, and stretching at night can improve symptoms [2]. You cannot prevent RLS since the cause is unknown. RLS usually requires medication management [10].

Parasomnias

Parasomnia describes a range of unusual behaviors occurring before, during, or after sleep [2,6]. Examples of parasomnias include night terrors, sleepwalking, sleep talking, sleep eating, and sleep paralysis [6].

Different treatment options are available depending on the type of parasomnia you have. Parasomnias are not preventable since researchers have not yet determined what causes them. Parasomnias tend to run in families, so genetics may play a role [6].

Narcolepsy

Narcolepsy is characterized by chronic sleepiness caused by the loss of brain cells that produce orexin, a hormone responsible for sleep and wakefulness [2,7]. When you have narcolepsy, you have "sleep attacks," a sudden sleepiness followed by a short sleep period.

Narcolepsy is a rare disease, and a cure does not exist. However, you may be able to take medications to manage your symptoms. Receiving a narcolepsy diagnosis requires a physical exam and sleep tests.

Sleep breathing disorders

Sleep breathing disorders (SBDs), or sleep apneas, are common sleeping problems that often go undiagnosed [2,8]. SBDs are divided into central sleep apnea, obstructive sleep apnea (OSA), and complex sleep apnea [8]. OSA is the most common form of sleep apnea, characterized by periods of not breathing while sleeping. As a result of OSA, serious health effects can occur, including stroke, heart problems, and depression [8].

Having a sleep test called a polysomnogram (PSG) will help your healthcare provider diagnose you with sleep apnea [8]. The causes of OSA are carrying excess weight, sleeping on your back, and having a small lower jaw [8]. There are multiple treatments for OSA, including devices, therapy, and medications.

Tests for sleep disorders

Here's how to get a diagnosis and treatment for your sleeping problems online. During a virtual sleep consultation, a healthcare provider will review your health history, discuss your sleep symptoms, and recommend tests.

Questionnaires

A questionnaire can determine whether you have a sleep disorder and its severity [9,10]. Multiple questionnaires are available for identifying sleep disorders. The STOP-BANG questionnaire is the most common sleep questionnaire to identify OSA [9]. Other questionnaires your healthcare provider may ask you to complete are the Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS) [9].

Sleep tests

Depending on your sleep questionnaire results, your healthcare provider may want you to have an at-home sleep test or an in-laboratory PSG (iPSG). Sleep tests can identify your sleep-wake cycles and whether you stop breathing at any point during the night [8,10].

Lab Tests

While taking a lab test won't provide a diagnosis, at-home lab sleep tests offer insight into the quality of your sleep. Everlywell's sleep and stress at-home test measures hormones that regulate your stress response and sleep-wake cycle.

Treatments for sleep disorders

Once you have a diagnosis, your healthcare provider may recommend behavioral therapy, medications, lifestyle changes, appliances, or a combination of these treatments. Treatment for sleeping disorders is not one-size-fits-all, and how you adhere to your treatment will determine its success [8-12]. Your healthcare provider can prescribe most of these treatments online, but some may require an in-person visit.

Lifestyle changes

The most common recommendations for managing sleep problems are to stop sleeping on your back, practice healthy sleep habits, lose weight, undergo behavioral therapy, quit smoking, and reduce alcohol consumption [10].

Positive airway pressure therapy

Continuous positive airway pressure (CPAP) therapy is considered the gold standard for treating SBDs [8,10]. If you are diagnosed with OSA, your healthcare provider may prescribe a CPAP machine to use every night. You cannot purchase a CPAP online without a prescription from a healthcare provider.

Oral appliances

Wearing a CPAP every night is often tricky. As a result, you may need an oral appliance to manage your SBD [10]. The American Academy of Sleep Medicine (AASM) recommends oral appliances as an alternative to CPAP for some patients with OSA [10]. Depending on the severity of your OSA, dentists can design oral appliances for sleeping disorders, but a customized oral appliance requires an in-person visit [10]. If you travel often, your healthcare provider may recommend a CPAP for home and an oral appliance for travel [10].

Behavioral therapy

Cognitive behavioral therapy via the internet (digital CBT-I) is a type of behavioral counseling you can receive online, which can help alleviate some of your symptoms [11]. Digital CBT-I is not a cure for sleeping disorders, but it can help you more effectively manage the condition [11].

Medications

Medications are typically used only as a last resort to treat sleep problems. You may receive a prescription for a benzodiazepine receptor agonist (BZRA) for insomnia or a stimulant if you have OSA [12]. A new medication for narcolepsy and OSA is Sunosi, a dopamine and norepinephrine reuptake inhibitor (DNRI) that improves wakefulness in adults [13]. Sunosi is used in conjunction with your CPAP, oral appliance, and lifestyle changes [13]. Your healthcare provider will review your health history and may request a physical examination before prescribing a sleep medication.

Everlywell offers virtual care visits for sleeping problems

Everlywell offers virtual care visits with a nurse practitioner who can help you with your sleeping problems. Your healthcare provider will create a specialized treatment plan based on symptoms. Due to the wide variety of sleeping disorders, it is important to speak to a healthcare provider to identify your specific sleeping disorder. Your dream of a restful night's sleep is within reach.

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References

1. Weir K. Diagnosing and treating sleep disorders. American Psychological Association.URL. Published July 1, 2022. Accessed January 31, 2023.
2. Pacheco D. Sleep disorders. Sleep Foundation. URL. Published November 2, 2020. Accessed January 31, 2023.
3. Suni E. Sleep statistics. Sleep Foundation. URL. Published October 25, 2021. Accessed January 31, 2023.
4. Rosenberg R, Citrome L, Drake CL. Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies. Neuropsychiatr Dis Treat. 2021;17:2549-2566. Published 2021 August 6. doi:10.2147/NDT.S297504. URL.
5. Meadows A. Treatments for insomnia. Sleep Foundation. URL. Published October 18, 2018. Accessed February 1, 2023.
6. Singh S, Kaur H, Singh S, Khawaja I. Parasomnias: A Comprehensive Review. Cureus. 2018;10(12):e3807. URL. Published 2018 December 31. doi:10.7759/cureus.3807.
7. Mahoney CE, Cogswell A, Koralnik IJ, Scammell TE. The neurobiological basis of narcolepsy. Nat Rev Neurosci. 2019;20(2):83-93. doi:10.1038/s41583-018-0097-x. URL.
8. Slowik JM, Sankari A, Collen JF. Obstructive Sleep Apnea. URL. StatPearls Publishing; 2022.
9. Klingman, K.J., Jungquist, C.R., Perlis, M.L., 2017. Questionnaires that screen for multiple sleep disorders. Sleep Medicine Reviews 32, 37–44.. doi:10.1016/j.smrv.2016.02.004. URL.
10. American Academy of Sleep Medicine guidelines. American Academy of Sleep Medicine – Association for Sleep Clinicians and Researchers. URL. Published July 27, 2017. Accessed February 1, 2023.
11. Erten Uyumaz B, Feijs L, Hu J. A Review of Digital Cognitive Behavioral Therapy for Insomnia (CBT-I Apps): Are They Designed for Engagement?. Int J Environ Res Public Health. 2021;18(6):2929. URL. Published 2021 Mar 12. doi:10.3390/ijerph18062929.
12. Pharmacotherapy for insomnia in adults. UpToDate. Uptodate.com. URL. Accessed February 1, 2023.
13. Prescribing Information for SUNOSI. Sunosi.com. URL. Accessed February 1, 2023.