Insomnia Diagnosis

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If not getting enough sleep is affecting your daily activities, talk to your doctor. You may be diagnosed with insomnia if you have difficulty falling or staying asleep for at least 3 nights a week. Insomnia is considered chronic (long-term) when it occurs 3 or more nights a week and lasts for 3 months or longer. Your doctor may do more tests to see whether your insomnia is causing any other health problems.

It may be helpful to keep a sleep diary for 1 to 2 weeks before seeing your doctor. A sleep diary can help your doctor understand the problems you’re having and whether certain activities are affecting your sleep. Write down when you go to sleep, wake up, and take naps each day. Also write down how sleepy you feel throughout the day, when you drink caffeine or alcohol, and when you exercise.

Your healthcare provider will want to learn about your symptoms, risk factors, health history, and family health history. To better understand your sleep problems, you may be asked for some details about your sleep habits, such as: 

• How often you have trouble sleeping and how long you’ve had the problem
• When you go to bed and get up on days you go to work as well as days off
• How long it takes you to fall asleep, how often you wake up at night, and how long it takes you to fall back asleep
• How refreshed you feel when you wake up and how unrested you feel during the day
• Whether you use electronic devices or watch TV before bed, as the light that comes from these sources can affect your sleep
• Whether you snore loudly and often or wake up gasping or feeling out of breath

To find the cause of your sleep problems, your provider may also ask whether you:

• Have any new or long-standing health problems
• Take any medicines
• Are pregnant or going through menopause
• Use caffeine, nicotine, alcohol, or illegal drugs

Your healthcare provider will do a physical exam to rule out other medical problems that might affect your sleep. They will listen to your heart and lungs and look for risk factors for sleep apnea, such as large tonsils or a large neck circumference.

• A sleep study looks for other sleep problems, such as circadian rhythm disorders, sleep apnea, and narcolepsy.
• Actigraphy looks at your periods of rest and activity and measures how well you sleep. This requires you to wear a small motion sensor on your wrist for 3 to 14 days.
• Blood tests check for thyroid problems or other medical conditions that can affect sleep.