Insomnia Diagnosis

Insomnia can be either secondary, a symptom of another disorder such as depression, or be a primary condition. As a primary condition, it is often classified based on how long it lasts, acute or chronic insomnia. A common form of short-term insomnia is jet lag, which occurs after travelling across time zones.

Typical symptoms include:

• Trouble falling asleep at night.
• Falling asleep or feeling tired during the day.
• Waking up in the morning still feeling tired.
• Repeatedly waking up at night.

Insomnia can also result in:

• Forgetfulness
• Problems concentrating
• Irritability
• Anxiety about sleeping
• Low energy or reduced motivation
• Problems with interpersonal relationships
• Poor job performance

Insomnia is also frequently a side effect of many medications or supplements such as:

• Stimulants; present in certain medications, herbs, caffeine, nicotine, cocaine,amphetamines, methylphenidate, aripiprazole, MDMA and modafinil
• Fluoroquinolone antibiotic drugs
• Antidepressants such as SSRI's

• Mental disorders such as depression, anxiety, OCD, dementia, PTSD
• Any condition that causes pain
• Sleep Apnea
• Restless Leg Syndrome
• Hormone Imbalances
• Allergies
• Neurological disorders like Parkinsons disease and Alzheimers disease

Environmental factors that can cause insomnia include:

• Noise.
• Travel
• disruption of your Circadian Rhythms.>
• BrightLighting.
• Temperature extremes

People with insomnia are usually desperate for more sleep. However, the more they try to sleep, the more distressed and frustrated they get and the harder it becomes for them to actually fall asleep. They may also have an impaired sense of sleep and feel they have not slept even though testing shows they have. This may be related to a problem with the body’s sleep-arousal system.

Evaluation

A thorough medical history and physical exam are usually the only things needed to diagnose insomnia. Your doctor or health care provider will ask about how many hours of sleep you get and if you have problems falling asleep or waking up early or too often. You may be asked to keep a sleep log, a record of how may hours you slept, for one or two weeks.

A sleep study that is done overnight (called polysomnography) may be needed to help rule out the other kinds of sleeping disorders, like sleep apnea or periodic limb movement disorder. This can be done in a sleep lab or at home with special monitoring equipment.

The following test (Epworth Sleepiness Scale) will help you determine how serious your sleep problem is:

How likely are you to doze off or fall asleep in the following situations: (Never=0, slight chance=1, moderate chance=2, high chance=3)

1. Sitting quietly and reading
2. Watching TV
3. Sitting quietly in a public place
4. As a passenger in a car for an hour
5. Lying down in the afternoon
6. Sitting and talking to someone
7. Sitting quietly after lunch (when you did not have an alcohol)
8. In a car while stopped in traffic for a few minutes

Results:

• 1-5 You are getting enough sleep
• 6-8 This is average but you probably need more sleep
• 9-15 You are very sleepy and should see your doctor
• 16 + You are dangerously sleepy and should see your doctor