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.