Diagnosis and Assessment
Table 2. Sleep Log
ÎÎ Fundamental for initial assessment of insomnia complaint; may be primary diagnostic
tool in some cases
ÎÎ Completed by patient each morning to describe previous night's sleep experience over
at least 1–2 weeks
ÎÎ More accurate assessment than global report of sleep
Sleep Log
Question
How tired were you at bedtime? (1–5)
(1—most tired; 5—not tired at all)
What time did you get into bed last night?
When did you try to go to sleep?
How long did it take you to fall asleep?
How many times did you awaken during the night?
What was the total time of these awakenings?
What time did you awaken for the day?
What time did you wish to awaken?
What time did you get out of bed?
Estimate your total sleep time for last night
How rested were you when you awoke? (1–5)
(1—very rested; 5—not rested at all)
What was the quality of your sleep last night? (1–5)
(1—most refreshing; 5—least refreshing)
Did you nap during the day? For how long?
Bedtime medication and dosage
Days of Week
Table 3. Some Contributing Medical Factors
ÎÎ Neurological
>> Alzheimer disease
>> Nocturnal headache
>> Parkinson disease
ÎÎ Pulmonary
>> Asthma
>> COPD
>> Dyspnea due to other pulmonary disease
ÎÎ Cardiac
>> Congestive heart failure
>> Nocturnal angina
ÎÎ Gastrointestinal
>> GERD
>> Peptic ulcer disease
ÎÎ Other
>> Allergies (nasal obstruction, itching)
>> Chronic renal disease
>> Hyperthyroidism
>> Incontinence (BPH overflow,
nocturnal enuresis)
>> Menopause/menstrual cycle
hormonal changes
>> Pain from any source
>> Pregnancy
Table 4. Some Contributing Psychiatric Disorders
ÎÎ Stress/Adjustment disorder
ÎÎ Psychiatric
>> Anxiety disorders
>> Mood disorder
`` Generalized anxiety
`` Bipolar disorder
`` Obsessive-compulsive disorder
`` Dysthymic disorder
`` Panic disorder (nocturnal)
`` Major depressive disorder
`` Post-traumatic stress disorder
>> Personality disorders
ÎÎ ADHD/autism/other child neuropsychiatric disorder
