Module 3: Assessment
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
- Schutte-Rodin, S., Broch, L. Buysse, D., Dorsey, C., & Sateia, M. (2008). Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults. Journal of Clinical Sleep Medicine, 4(5), 487–504.