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