Posted , 3 users are following.
Just wondering.. Spouse has severe and anxiety and it effects his sleep. He won't see a Doctor for his anxiety but will see a sleep doctor for better sleep. Do they prescribe medication? Just hoping this sleep doctor may give him an antidepressant to help with sleep.
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john89229 kelly55079
Posted
In order for your spouse's desire to see a doctor versed in sleep issues - that would be a psychiatrist, I know of no other medical doctor who deals exclusively with sleep - he/she must see a GP in the first instance. Should your GP feel it necessary or if your spouse's troubles are not satisfied with what the GP has to say then you will probably get a referral to see a psychiatrist who then will address sleep along with any precipitating symptoms. Medication is one approach to your spouses problems as would be CAB or Mindfulness and should that be the road to follow then the psychiatrist will refer your spouses to a psychologist or OT practitioner. Medication can be used in such psychological situations but not for any protracted length of time because of addiction.
Best wishes
John
will08432 john89229
Edited
I agree with John, the first step is to see his/her GP, but I must stress that it is quite difficult to see a psychiatrist on the NHS. Due to this, I would definitely write down all of the issues that your spouse faces in detail and to try and make a really strong case to his/her GP for why he needs help.
Some of the most effective treatments for insomnia, as John mentioned, are CBT (cognitive behavioural therapy), stimulus control therapy and relaxation training. Mindfulness can also help, though you can access this yourself online without seeing a doctor. Another useful service is called Sleepstation, they offer online CBT for insomnia but you can usually access it for free via the NHS. I don't believe you need to see a GP first, all you have to do is sign up on their website and they will send the request directly to your GP.
Medication is typically only offered after psychological therapies have failed, though this is very dependent on the individual opinion of the doctor that your spouse may see. The main issue is that most medication for sleep (e.g. benzodiazepines and "Z" drugs) is very addictive and can form dependence and tolerance, where you need more and more of the medication to achieve the same result.
Some medication offered for insomnia isn't addictive, but these medications would be used "off license" where the medication wasn't intended to be used for the treatment of insomnia. Some examples of these include low-dose mirtazapine (an antidepressant) and low-dose quetiapine (an antipsychotic). Many doctors believe this is not the right medication for insomnia, though there are many that do - it depends on their individual opinion.
The one medication that isn't addictive and is licensed to treat insomnia is called melatonin. Melatonin is a natural hormone that regulates the sleep-wake cycle in your brain, it is usually released when your environment becomes dark. It is only licensed to treat those aged 55 and over in the UK, but is used by many many doctors to treat insomnia in patients of all ages. I'm not sure if a GP can prescribe it off-license, but a psychiatrist certainly can if you get to that stage. It's worth noting that melatonin is sold as a natural supplement in the USA and has very few side effects.
Please let me know if you need any help or have any questions.
I hope for all the best for your spouse,
Will