What a sleep specialist actually does, and what to ask at your first appointment

Who is a sleep specialist, and how is one different from your own doctor?

Longetic keeps the note from the visit, what the doctor recommended and what they prescribed, which matters more than usual here, because a sleep specialist is not a single job. Sleep medicine is a subspecialty. The doctor trained first in internal medicine, pediatrics, psychiatry and neurology, or otolaryngology, and certified in sleep on top of that.

The certification is jointly owned, which is the part most people never hear. The American Board of Psychiatry and Neurology states that sleep medicine certification was developed by four boards together: the American Board of Internal Medicine, the American Board of Pediatrics, the American Board of Psychiatry and Neurology, and the American Board of Otolaryngology. One subspecialty, four front doors.

The route someone came by does not decide how good they are, and all four lead to the same subspecialty certification. It is still worth asking which one, because it tells you what the person across the desk looks at every day. In much of Europe and in Ukraine the same doctor is called a somnologist, which is the same role under a different name rather than a separate profession.

Your own doctor is usually the first step rather than a lesser one. A general practitioner handles a large share of sleep complaints without referring anyone, and the referral happens when the history points somewhere that needs equipment or a subspecialist opinion.

What will a sleep specialist ask you?

Expect three things: a structured history, one or two scored questionnaires, and a diary you fill in each morning. The questionnaires are public, short and free, so you can complete them before you go instead of in the waiting room. The diary is the one part that cannot be done on the day, because it needs a week or two of ordinary nights.

Two instruments do most of the work, and both are freely available. The Epworth Sleepiness Scale asks how likely you are to doze off in eight ordinary situations and produces a score from 0 to 24, where the reference range for adults without a chronic sleep disorder is 0 to 10. The STOP-BANG questionnaire screens for obstructive sleep apnea across eight yes or no items and sorts the total into low, intermediate and high risk.

Bring the medication list to the same appointment, with doses rather than names alone, because it is the item people most often reconstruct wrongly from memory and several common drugs also move laboratory numbers, which we covered in which medications change lab results. The diary itself is the standard Consensus Sleep Diary, published by Carney and colleagues in SLEEP in 2012 and still the reference version. It takes under a minute a morning, and it is deliberately dull: times, counts and one rating. That dullness is the point, because an answer you write the same way every morning can be compared across two weeks, while a score each vendor computes differently cannot. It also helps to have already tried the habits a clinic will ask you to change first, because that is the first thing the history will cover.

What should you ask the sleep specialist?

Ask four things: what you are being assessed for, which test is proposed and why, what the treatment plan is if the test confirms it, and when you are seen again. Everything in the list below is a version of one of those four, and each one has an answer a clinician can actually give rather than a conversation opener.

This is the gap worth naming. Patient guides routinely advise you to prepare questions and then print none, so the advice arrives without the thing it is advising. The ten below are built from what the guidelines actually say, which is why each of them lands somewhere.

Two of those are worth pressing on. The accreditation question you can answer yourself before you even book, because the American Academy of Sleep Medicine publishes a free directory of accredited facilities that anyone can search. And the record question matters because a summary is not a report, so ask for both, and what belongs in a doctor-ready summary sets out which sections a clinician expects to receive.

The last question is the one people forget and then need. A sleep plan is almost never finished in a single visit, and the interval between visits is where the plan quietly dies.

What happens after the appointment, and what changed in 2026?

Longetic keeps what comes out of the visit: the note, the recommendations, the prescriptions and the dates, in one searchable timeline, with reminders and re-check nudges so nothing slips between visits. That matters because sleep care is rarely one appointment. It is a plan with a review date, and the guidance behind the insomnia half of it moved in April 2026.

For chronic insomnia the direction has been settled for a decade. The American College of Physicians recommended in 2016, in Annals of Internal Medicine, that cognitive behavioral therapy for insomnia be the first-line treatment for adults with chronic insomnia, with the decision to add medication taken jointly and the medication kept short-term.

What is new is where combinations sit. On 13 April 2026 the AASM published a clinical practice guideline on combination treatment in the Journal of Clinical Sleep Medicine, with two conditional recommendations at low certainty of evidence: CBT-I with medication is suggested over medication alone, and CBT-I alone is suggested over the combination. Lead author Daniel Buysse put it plainly: "CBT-I by itself is the most efficacious first-line treatment for insomnia. However, using medication with CBT-I may provide modest benefit for some specific outcomes, such as total sleep time." If your plan involves both, that is the guideline to ask about by name.

All of which produces paperwork, and this is the part a health record is actually for. One visit generates a note, a set of recommendations, sometimes a prescription, and a date to come back. Longetic keeps blood tests, medical records, doctor visits and medications in one searchable timeline, and sends reminders and re-check nudges so nothing slips between visits. If the plan sends you for blood work as well, how many measurements make a trend explains why one value on its own rarely says much. Longetic does not track sleep and publishes no wearable integration, so the diary and the tracker stay where they are. As a disclosure, Longetic is our product, so weigh that mention accordingly.

None of this is medical advice, and none of it interprets your own symptoms or your own results. If your sleep is bad enough that you are reading this, the diary is the thing to start tonight, the questions above are what to take with you, and the clinician is the one to read both.

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