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How
to diagnose Insomnia ?
Medical
History
Diagnosing
sleep disturbance and its cause is the most important step in restoring
healthy sleep. The physician should begin an interview with four basic
questions: How would the sleep problem be described? How long has the
sleep problem been experienced? Does it occur every night? How does it
affect daytime functioning? In addition, the physician should find out
whether the person snores, has any medical or psychologic conditions,
takes medications, or has recently undergone any significant changes. A
diagnosis of restless legs syndrome or nocturnal leg cramps can
generally rely solely on the patient's description of the symptoms.
Sleep
Diary
Keeping
a sleep diary is a helpful diagnostic tool. Every day for two weeks, the
patient should record all sleep-related information: when sleep occurs,
how long it takes to fall asleep, how restful the sleep was, how often
it was interrupted, waking behaviors, descriptions of treatments,
stimulant consumption, mood states, and any stress factors. A bed
partner can help by adding his or her observations of the patient's
sleep behavior.
Sleep
Disorders Centers
If
unexplained insomnia persists after treatment or there is evidence of
sleep-disordered breathing, the physician may recommend a sleep
specialist or a sleep disorders center and also Patients should
investigate centers carefully, being sure that they offer full sleep
studies. Among the reasons for attending a sleep disorders center are
insomnia due to psychologic disorders, sleeping problems due to
substance abuse, sleep apnea, severe restless legs syndrome, and
persistent daytime sleepiness. At most sleep disorders centers patients
undergo an in-depth analysis, usually supervised by a multidisciplinary
team of consultants who can provide both physical and psychiatric
evaluations. Brain waves, body movements, breathing, and heartbeats may
be electronically monitored during sleep.
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