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Insomnia

Diagnosis

Initial diagnostic tests for sleep disorders are usually performed by a general practitioner (GP) taking a patient history, and performing a physical examination and blood tests. The physician may also ask for information on signs and symptoms from the patient’s bed partner, and the patient may be asked to complete a ‘sleep diary’ over a period of a week or more, including additional information on daily routine, medications, exercise, diet, etc. All this background knowledge on the patient’s physical, emotional and mental circumstances is used to establish the cause of the sleep disorder and establish a diagnosis, which, in turn, determines the most appropriate treatment measures. During this preliminary diagnostic process, a sleep history/habits questionnaire (SHQ) is sometimes used to obtain patient information, and help align observations with the diagnostic criteria.

If the sleep disorder cannot be easily explained by environmental or medical factors, and is chronic and unresponsive to treatment, then the GP may initiate treatment or referral to a sleep specialist or assessment in a sleep laboratory may be the next stage of diagnosis. Sleep specialists monitor patients while they sleep, assessing brain activity, heart rate, breathing, muscle activity, etc.

This helps to determine any irregularities in the sleep cycle, and if a primary sleep pathology is responsible for the disorder. Again, use of one or more diagnostic classification systems may be employed at this stage.

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