Medication prescribing

[Attending1985]

This question is for practicing sleep medicine physicians. Do you prescribe medications frequently or rarely? I’m trying to get a gauge for how heavily sleep physicians prescribe meds.

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[Shikima]

Situationally based. Some are rigid, some are not. Depends on your background and experience.

 

[Attending1985]

Situationally based. Some are rigid, some are not. Depends on your background and experience.

Can you elaborate?

 

[Bobblehead]

It depends on your practice, how much insomnia you're seeing, how many individuals with narcolepsy you'll follow and how comfortable you are with dispensing stimulants for sleep apnea.

I think you'll need to be more specific with the context of your question.

 

[Attending1985]

It depends on your practice, how much insomnia you're seeing, how many individuals with narcolepsy you'll follow and how comfortable you are with dispensing stimulants for sleep apnea.

I think you'll need to be more specific with the context of your question.

To be more specific sleep physicians in my area do not treat patients insomnia. They are referred to an NP or psychologist for behavioral interventions. I’m wondering if In other areas sleep physicians are prescribing a lot of z drugs and such.

 

[Bobblehead]

I think it depends on your practice area. If you're not comfortable giving out meds you won't. If you're working with psychiatrists and they're sending you their insomnia patients because they need to hear the sleep hygiene and BBTI talk from someone else before going on med trials then you might be handing out a lot more meds.

 

[Attending1985]

I think it depends on your practice area. If you're not comfortable giving out meds you won't. If you're working with psychiatrists and they're sending you their insomnia patients because they need to hear the sleep hygiene and BBTI talk from someone else before going on med trials then you might be handing out a lot more meds.

Good to know. Evidence is a poor and harm is high for sleep meds so I would rather refer to Cbti.

 

[Sushirolls]

Meds for narcolepsy: This is the specialty that is supposed to do this and gets bulk, but isn't exactly a common condition, so rarely is this done.

Meds for insomnia. Some simply don't prescribe meds for this but hammer on CBTi. There are a handful of (older) docs who shell out the Zs.

Meds for RLS. Usually PCPs are treating, but a small percentage of sleep practice. PCPs may even take over.

Meds for OSA. Rare. The sleep docs I've been around, basically don't or if they do, they have like 5 or less or some rediculous low number of these pts.

Meds for RBD. So few patients. Benzo meds can also be easily assumed by PCPs or psych.

Meds for various parasomnias. Rare.

In grand summary rarely are meds prescribed in this specialty, but even with so few Narcolepsy patients the nuances of needing them on a monthly basis requires some effort to complete this task.

 

[Sushirolls]

Personally I hope/wish that sleep docs do and would take a more active role in doing the tapers from insomnia polypharmacy soup patients.