Sleep Disorder Treatment

Sleep disorder care in primary care is mostly screening, first-line treatment, and referral. The vast majority of sleep medicine starts here, but complex cases, anything requiring a sleep study, and most CPAP titration belong with a board-certified sleep specialist.

At Good Health NC, our role is:

1. Screening — identifying which sleep problem you actually have using validated tools and a careful history
2. First-line treatment — sleep hygiene, behavioral approaches for insomnia, and medication management when appropriate
3. Targeted referral — to sleep medicine for sleep studies and CPAP, and to mental health when anxiety, depression, or PTSD are driving the sleep problem

For a clear overview of how sleep disorders are diagnosed, the American Academy of Sleep Medicine is the specialty's professional society and a trusted source.

The most common sleep complaints we see, and where we fit in:

• Insomnia — trouble falling asleep, staying asleep, or waking too early. We diagnose and treat this directly. Cognitive behavioral therapy for insomnia (CBT-I) is first-line; we'll refer for that and consider short-term medication if needed.
• Suspected obstructive sleep apnea (OSA) — loud snoring, witnessed pauses in breathing, morning headaches, daytime sleepiness. We screen (STOP-BANG, Epworth Sleepiness Scale), then refer for a sleep study.
• Restless legs syndrome (RLS) — uncomfortable urges to move the legs at rest. We diagnose, check iron and ferritin, and start treatment.
• Circadian rhythm issues — shift work, jet lag, delayed sleep phase. Behavioral interventions and timed light exposure.
• Sleep problems driven by another condition — pain, GERD (acid reflux), depression, anxiety, PTSD, menopause, or medication side effects. Often the most useful thing we do is fix the upstream issue.

Your first sleep visit takes about 30 minutes. Here's how we use that time:

1. Sleep history. Bedtime, wake time, time to fall asleep, awakenings, snoring (a bed partner's input helps), daytime sleepiness, and how long this has been going on.
2. Screening tools. STOP-BANG for sleep apnea risk, Epworth Sleepiness Scale for daytime impact, and ISI for insomnia severity.
3. Physical exam. Neck circumference, oropharynx, BMI, and blood pressure — all relevant to apnea risk.
4. Targeted labs. Iron studies, thyroid, vitamin D, and others as indicated.
5. Plan. Could be sleep hygiene plus a CBT-I referral, a sleep study referral, a medication trial, or some combination. We'll be clear about which.

Most patients leave with a written plan and a follow-up scheduled.

What we treat in-house

• Insomnia — sleep hygiene coaching, CBT-I referral (most effective long-term), short-term hypnotics when appropriate, treating any underlying anxiety or depression
• Restless legs syndrome — iron repletion when ferritin is low, lifestyle adjustments, and medication when symptoms warrant it
• Sleep complaints driven by medical conditions — managing the underlying hypertension, thyroid, GERD, pain, or hormone issue that's wrecking your sleep
• Sleep complaints driven by mental health — coordinated treatment of PTSD-related nightmares (often with prazosin), depression-related insomnia, and anxiety-driven sleep disruption

When we refer to a sleep specialist

• Any suspected sleep apnea — needs a sleep study (home or in-lab) for diagnosis and CPAP titration
• Suspected narcolepsy, parasomnias, REM behavior disorder, or other less common conditions
• Insomnia that hasn't responded to first-line treatment
• Patients already on CPAP who need follow-up sleep medicine care

The CDC's sleep and sleep disorders resource covers why sleep matters and what untreated sleep disorders cost. Strokes, heart attacks, accidents, and worse chronic disease control all sit downstream.

Come in when:

• You've had trouble sleeping for more than three to four weeks
• You snore loudly, gasp, or have been told you stop breathing during sleep
• You wake up unrefreshed no matter how long you slept
• You're sleepy enough during the day that it affects work, driving, or safety
• You have morning headaches, dry mouth on waking, or high blood pressure that isn't well controlled
• You have restless, uncomfortable feelings in your legs at night
• Sleep problems started or worsened with a new medication, life event, or medical issue

Untreated sleep apnea raises the risk of heart attack, stroke, atrial fibrillation, and accidents. Untreated insomnia worsens almost every chronic condition we manage. Sleep is foundational, so it's worth getting right.

Three things make our approach to sleep different:

1. We sort it out fast. A 30-minute visit and a few targeted questions usually identify which sleep disorder is in play. You don't waste months guessing.
2. We connect the dots. A lot of sleep problems are really thyroid, mental health, medication, or chronic pain problems in disguise. Treating the upstream cause is often what fixes the sleep.
3. We refer well. When a sleep study or specialist input is needed, we have a working referral network and we share notes so nothing falls through.

Most major commercial insurance, Medicare, and Medicare Advantage plans are expected to be accepted at opening. We're located at 330 Sugar Magnolia Ln, Knightdale, NC 27545.