Which pathway addresses poor sleep?
Sleep is addressed first as a foundational lever — sleep hygiene, apnea screening, alcohol, caffeine, and shift-work review. Peri/menopausal sleep disruption routes to BHRT. Confirmed low testosterone in men routes to TRT.
Full answer
Sleep is the foundation under every other pathway. The screen reviews sleep hygiene, obstructive sleep apnea risk (STOP-BANG), alcohol and caffeine timing, shift work, and medication. Apnea is referred for evaluation when risk is elevated. Peri/menopausal sleep disruption tied to vasomotor symptoms and matching biomarkers is addressed with BHRT. Men with confirmed low testosterone and matching sleep patterns are evaluated for TRT. Behavioral therapy for insomnia (CBT-I) is the most effective non-pharmacologic option and is encouraged.
Educational. Not a substitute for individualized provider review.
- BHRT Optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03