The doctor will begin an evaluation of insomnia with a good medical history.
- The doctor will seek to identify any medical or psychological illness that may be contributing to the patient's insomnia. A thorough medical history and examination including screening for psychiatric disorders and drug and alcohol use is paramount in evaluation of a patient with sleep problems.
- For example, the patient may be asked about chronic snoring and recent weight gain. This may direct an investigation into the possibility of obstructive sleep apnea. In such an instance, the doctor may request an overnight sleep test (polysomnogram). Sleep studies are frequently done in specialized "sleep labs" by doctors trained in sleep medicine, frequently working under pulmonary (lung) specialists. This test is not part of the routine initial workup for insomnia, however.
- The diary will include the patient's personal assessment of their alertness at various times of the day on two consecutive days within the two week period.
- For example, the patient may be asked about chronic snoring and recent weight gain. This may direct an investigation into the possibility of obstructive sleep apnea. In such an instance, the doctor may request an overnight sleep test (polysomnogram). Sleep studies are frequently done in specialized "sleep labs" by doctors trained in sleep medicine, frequently working under pulmonary (lung) specialists. This test is not part of the routine initial workup for insomnia, however.
- The Epworth Sleepiness Scale is an example of a validated questionnaire that can be used to assess daytime sleepiness.
- Actigraphy is another technique to assess sleep-wake patterns over time. Actigraphs are small, wrist-worn devices (about the size of a wristwatch) that measure movement. They contain a microprocessor and on-board memory and can provide objective data on daytime activity.
