Module 3: Assessment

Lesson 3

Insomnia: Symptom assessment

Symptoms of insomnia include the following:

  • Difficulty initiating or maintaining  sleep, waking too early, or chronically non-restorative sleep
  • Above occurs despite adequate opportunity and circumstances for sleep
  • Involves at least one daytime impairment (For a complete list see Table 2, Schutte-Rodin et al., 2008)

Differential diagnosis of insomnia must take to account the clinical features.

  • Please refer to Table 9 of Schutte-Rodin et al. (2008) of describes the key features of ICSD-2 insomnia disorders.
    • Figure 1 presents a diagnostic algorithm for chronic insomnia based on the features described in Table 9
  • Comorbid insomnias and multiple insomnia diagnoses may coexist and require separate identification and treatment.

Diagnostic groupings in insomnia include:

  • Sleep disorders including sleep related breathing disorders (e.g., obstructive sleep apnea), movement disorders (e.g., restless legs or periodic limb movements during sleep) and circadian rhythm sleep disorders;
  • Insomnia due to medical or psychiatric disorders or to drug/substance (comorbid insomnia); and
  • Primary insomnias including psychophysiological, idiopathic, and paradoxical insomnia