Fast Five Quiz: Insomnia Management

Jasvinder P. Chawla, MD, MBA


October 13, 2020

A patient history—including a complete sleep history, medical history, psychiatric history, social history, and medication review—is the most important component of the evaluation for insomnia. Sleepiness assessments such as the Epworth Sleepiness Scale are commonly used, as well as a 2-week sleep log to define sleep-wake patterns and their variability.

Insomnia is a clinical diagnosis. Although diagnostic studies can be conducted, they are indicated principally to clarify comorbid disorders. Studies for hypoxemia, such as oximetry or an arterial blood gas test, should be performed for patients with a history suggestive of chronic obstructive pulmonary disease and insomnia.

Daytime multiple sleep latency testing and polysomnography are not routinely indicated for the workup of insomnia. However, polysomnography should be performed for patients with a history of sleep apnea or patients experiencing treatment failure.

Although actigraphy can help document sleep patterns and circadian rhythms, its role in insomnia evaluation has not been well established.

Learn more about the workup and differential diagnosis of insomnia.


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