Which pathway addresses sleep issues?
Sleep issues are routed by cause. Perimenopausal sleep disruption → BHRT (progesterone-led). GH-axis decline with shallow slow-wave sleep → sermorelin. Low-testosterone sleep fragmentation → TRT after sleep apnea screening.
Full answer
Sleep is screened for obstructive sleep apnea, restless legs, caffeine load, and circadian disruption first. Perimenopausal women with progesterone-pattern sleep disruption are evaluated for BHRT with progesterone-led therapy. Patients with documented GH-axis decline whose primary signal is shallow slow-wave sleep are evaluated for sermorelin. Men with confirmed low testosterone and sleep fragmentation are evaluated for Testosterone Optimization after OSA screening, because TRT can unmask untreated OSA. Every route is provider-reviewed.
Educational. Not a substitute for individualized provider review.
- Sermorelin pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29