Your doctor will take a sleep history over both a 24-hour period, and a week that includes1:
1. Sleep time
- Time at which you go to bed
- How long it takes you to fall asleep
- What time you wake up in the morning
- Nap times and lengths
2. Sleep problems
- Number of times you woke up during the night
- How long you stayed awake when you woke up during the night
- How long the problem lasted
3. Symptoms of disturbed sleep e.g. daytime sleepiness or fatigue (extreme tiredness)
Your doctor may ask other questions to try and identify the cause of your insomnia e.g. snoring, restless feelings in your legs when relaxing at night, medications you are using, caffeine and alcohol intake, whether you smoke. They will also perform a physical examination to check if there are medical, psychiatric, or neurological conditions which could be causing or worsening your sleep problems.1,2
You may be asked to keep a daily sleep log (or sleep diary), which is a record of sleep times (including time spent in bed and time spent actually sleeping), times that you finally woke up each day, and the quality of your sleep over 1 to 2 weeks.2,3
You can use a questionnaire like the Insomnia Severity Index (ISI) to determine the severity of your symptoms. You can share these results with your doctor.1,4 Download a copy of the Insomnia Severity Index
In some instances, your doctor may request laboratory (lab) tests to help identify any underlying medical or sleep problems (disorders) like2:
Polysomnography: This is a sleep study done in a sleep lab. Monitors are attached to your body to record movement, brain activity, breathing, and other body (physiologic) functions. This test may be recommended when your doctor suspects that there may be an underlying sleep disorder or if your insomnia has not responded to treatment.2
Actigraphy: A monitor or motion detector worn on your wrist throughout the day and night over 1 to 2 weeks, records your activity and movement. This test is done at home to gather estimates about how much and at what times you are sleeping.2
Bonnet MH. Evaluation and diagnosis of insomnia in adults. 18 June 2021. UpToDate. Available online at https://www.uptodate.com/contents/evaluation-and-diagnosisof-insomnia-in-adults. [Accessed 16 September 2022].
Bonnet MH, Arand DL. Patient education: Insomnia (Beyond the Basics). 14 December 2020. UpToDate. Available online at https://www.uptodate.com/contents/insomnia-beyond-the-basics. [Accessed 16 September 2022].
Morgan K, David B, Gascoigne C. Daily Sleep Diary. 2007. Clinical Sleep Research Unit. Loughborough University. United Kingdom. Available online at https://www.nhs.uk/livewell/insomnia/documents/sleepdiary.pdf. [Accessed 16 September 2022].
Morin CM. Insomnia Severity Index. Available online at https://www.ons.org/sites/default/files/InsomniaSeverityIndex_ISI.pdf. [Accessed 16 September 2022].