Diagnosing sleep disturbance and its cause is the most important step in restoring healthy sleep. There is little agreement, even among experts, however, on the best methods for effectively assessing a patient's insomnia.
● How can a person know for sure that they have insomnia?
A major difficulty in diagnosing this problem is its subjective nature. One study showed that there was no difference in sleep behaviors between people who said they were insomniacs and people who said they weren't.
People who believe they have insomnia may have actually had frequent brief awakenings during sleep that they perceive as being continuously awake.
Some experts recommend, however that any individual should be treated aggressively if he or she believes they have insomnia and also is suffering daytime fatigue and impaired concentration and memory.
- How would the sleep problem be described?
- How long has the sleep problem been experienced?
- How many times a week does it occur?
- How restful is sleep?
- Does the difficulty lie in getting to sleep or in waking up early?
- What is the sleep environment like (Noisy? Not dark enough?)?
- How does insomnia affect daytime functioning?
- What medications are being taken (including the use of self-medications for insomnia, such as herbs, alcohol, and over-the-counter or prescription drugs)?
- Is the patient taking or withdrawing from stimulants, such as coffee or tobacco?
- How much alcohol is consumed per day?
- What stresses or emotional factors may be present?
- Has the patient experienced any significant life changes?
- Does the patient snore or gasp during sleep (an indication of sleep apnea)?
- Does the patient have leg problems (cramps, twitching, crawling feelings)?
- If there is a bed partner, is his or her behavior distressing or disturbing?
- Is the patient a shift worker?
You might also be given a Multiple Sleep Latency Test. The multiple sleep latency test (MSLT) employs a machine that measures the time it takes to fall asleep lying in a quiet room during the day.
The patient takes four or five scheduled naps two hours apart. People with healthy sleep habits fall asleep in about 10 to 20 minutes. The test can detect changes in sleepiness associated with sleep deprivation in patients with insomnia.
It has limitations, however, and does not take into consideration any situations that may affect the patients' mental state and therefore their ability to fall asleep.
It is used mainly after other sleep disorders have been ruled out and the doctor is uncertain whether or not insomnia is a correct diagnosis.
In cases where a physician is unable to help with your insomnia, you may be referred to a sleep disorder clinic for diagnosis and treatment.
● Are there any at-home, or online, tests that a person can do to diagnose insomnia?
A bed partner can help by adding his or her observations of the patient's sleep behavior.
Here’s what you should include in your sleep diary:
- Time you went to bed and woke up
- Total sleep hours
- Quality of sleep
- Times that you were awake during the night and what you did (e.g. stayed in bed with eyesclosed or got up, had a glass of milk and meditated)
- Amount of caffeine or alcohol you consumed and times of consumption
- Types of food and drink and times of consumption
- Feelings - happiness, sadness, stress, anxiety
- Drugs or medications taken, amounts taken and times of consumption.
There are also online tests you can take to diagnose insomnia. Examples of these online test are below: