Sleep quality
Poor sleep is a symptom, not a diagnosis. Obstructive sleep apnoea, thyroid disease, iron deficiency and hormonal factors all present as unrefreshing sleep and daytime fatigue, and each is managed differently. Sedating medication prescribed before these are excluded can mask a serious problem.
What a provider evaluates
- Screening for obstructive sleep apnoea, including snoring and witnessed apnoeas
- Thyroid function and ferritin
- Caffeine, alcohol and screen behaviour, which frequently explain a large part of it
- Mood, since insomnia and depression are closely linked
- Testosterone in men, where other symptoms point to it
What treatment may involve
- Referral for sleep study where apnoea is suspected
- Behavioural and sleep-hygiene interventions as first-line
- Management of an identified underlying cause
- Referral for cognitive behavioural therapy for insomnia
Whether any of these is appropriate is determined by a licensed provider after reviewing your history and laboratory results.
Markers on this panel
What each marker measures and why your provider tracks it.
Questions about sleep quality
Can you prescribe sleeping tablets?
Sedative-hypnotics are controlled substances and are generally not appropriate for routine telehealth prescribing, particularly before underlying causes have been excluded. The evaluation focuses on identifying what is driving the sleep problem — apnoea, thyroid disease, iron deficiency, mood, or behavioural factors — and addressing that. Cognitive behavioural therapy for insomnia has better long-term evidence than medication for chronic insomnia.
Why screen for sleep apnoea before treating poor sleep?
Obstructive sleep apnoea is common, frequently undiagnosed, and presents as unrefreshing sleep and daytime fatigue — the same complaint that prompts most requests for a sleep medication. Sedating medication can worsen it. It also carries cardiovascular and metabolic consequences that treating the symptom would leave unaddressed. Screening first is why a proper evaluation is worth more than a prescription.