Sleep Disorders and Health Conditions: Focus on Insomnia - Episode 6

Role of Patient Communication in Sleep Disorder Management

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Ashgan A. Elshinawy, DO, comments on engaging patients in conversations around managing sleep disorders with co-occurring health conditions.

C. Michael Gibson, MD: If I was a patient of yours, how would you communicate with me? Would I see you frequently in the office? Do you send emails or have telemedicine through Zoom? Ashgan, how do you communicate with your patients with sleep disorder?

Ashgan A. Elshinawy, DO: That’s a good question, and it varies from office to office and practice to practice. I have several ways that my patients can contact me, like traditionally calling the office and talking to my medical assistant. The message is redirected to me, and then I have the option of responding through the assistant or calling the patient back if it’s more complicated. In some situations, if I know it’s going to need a good conversation, I say, “Can you please come back to the office?” Or I say, “Let’s do a telehealth visit because this deserves more than a 2-liner response.”

Very often, if I start a medication or therapy, whether it’s CPAP [continuous positive airway pressure] or a dopamine agonist for restless legs, I don’t defer them for a few months because I know questions are going to come up. I preempt it by scheduling a follow-up visit, usually within the first 3 to 4 weeks. It saves time on a lot of phone calls with patients who have concerns and questions because I want to quickly evaluate. One, is it working for you? Two, are there any adverse effects? Three, do I need to titrate the dose, and how do I educate you in doing so? You can’t do that if you say, “I’ll see you in 3 months.” At that point, they’ve lost confidence and have thought, “This is as good as it gets, so I’m going to give up. I’m going to not show up to my next appointment.” You’ll see that in a lot of practices when they’re thrown too far into the future.

We have the portal, which is helpful because it allows the person to write as much as they want in a message directly to the doctor. I like that approach because I can see everything in front of me, and I can respond to all their points—usually in real-time within 24 hours.

C. Michael Gibson, MD: I thank both of you. This has been a great discussion. It’s very lively and informative for me as a cardiologist and a sleep patient.

Transcript edited for clarity