How Is Insomnia Diagnosed?

Your doctor will usually diagnose insomnia based on your medical history, sleep history, a physical exam, and a sleep study if the cause of your insomnia is unclear.

Medical History

Your doctor will ask questions to find out whether there is a medical cause for your insomnia. These include questions about whether you:

• Have any new or ongoing health problems
• Have painful injuries or health conditions (such as arthritis)
• Take any medicines (over-the-counter or prescription)

Other questions are aimed at finding work or leisure habits that might be causing your insomnia. Your doctor may ask about your work and exercise routines; your use of caffeine, tobacco, or alcohol; and your long-distance travel history.

Your doctor also may ask whether you have any new or ongoing work, personal problems, or other stresses in your life. In addition, you may be asked whether you have other family members with sleep problems.

Sleep History

To get a better sense of your sleep problem, your doctor will ask you details about your sleep habits, including:

• How often you have trouble sleeping and how long the problem has persisted
• When you go to bed and get up on workdays and days off
• How long it takes you to fall asleep, how often you wake up at night, and how long it takes to fall back asleep
• If you snore loudly and frequently, or wake up gasping or feeling out of breath
• How refreshed you feel when you wake up, and how tired you feel during the day
• How often you doze off or have trouble staying awake during routine tasks, especially driving

You may be asked to keep a sleep diary for 1 to 2 weeks so you can answer these questions easily. Your bed partner may help you keep the sleep diary.

To see what might be causing or worsening your insomnia, your doctor will also ask you:

• Whether you worry about falling asleep, staying asleep, or getting enough sleep
• What you eat or drink, and whether you take medicines before going to bed
• What routine you follow before going to bed
• What the noise level, lighting, and temperature are like where you sleep
• What distractions, such as a TV or computer, might be in your bedroom

Physical Exam

Your doctor will do a physical exam to rule out other medical problems that might cause insomnia. You may also need blood tests to check for thyroid problems or other conditions that can cause sleep problems.

Sleep Study (Polysomnogram)

A polysomnogram is a recording of your breathing, movements, heart function, and brain activity during sleep. For this study, you sleep overnight at a special sleep center. Your doctor usually will recommend a sleep study if you have signs of another sleep disorder, such as sleep apnea or restless legs syndrome.