Medical history: A doctor will ask the individual experiencing insomnia questions to evaluate the medical history. Questions investigate mental health problems, medications (supplements, prescription and non-prescription), history of pain, leisure habits, work and home situation, and others.
Sleep history: The doctor will also inquire about the individual's sleep history. Questions inquire about length and severity of the sleeping problem, routines before sleeping, snoring, and noise levels.
Physical exam: The doctor will also give the individual a full physical exam, including blood tests for conditions that may interfere with sleep including thyroid problems.
Sleep study (Polysomnogram): A polysomnogram is a recording of the breathing, movements, heart function, and brain activity during sleep. For this study, the individual sleeps overnight at a sleep center or hospital. A sleep study will be recommended if there are signs of sleep apnea or restless legs syndrome (RLS).
Other: The Epworth Sleepiness Scale is an example of a validated questionnaire that can be used to assess daytime sleepiness. It asks questions about the chances of dozing off during various daily functions such as watching TV, sitting and reading, or driving a car. 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. Actigraphs measure day-to-day activity of an individual, recording movement being made during waking and sleeping hours along with light, sound, and temperature. Actigraphy is useful for assessing daytime sleepiness in situations where a laboratory sleep latency test is not appropriate. Actigraphy is used to clinically evaluate insomnia, circadian rhythm sleep disorders, excessive sleepiness, and restless leg syndrome. It is also used in the assessing of the effectiveness of treatments for these disorders.
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