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This information was reviewed and approved by Sheila Tsai, MD (3/1/2017).

Insomnia can be a symptom of many medical diseases, so your health care provider may first do tests to look for a variety of disorders that may be disrupting your sleep. 

If a sleep disorder is suspected, your health care provider may refer you to a sleep clinic for an evaluation by specialists who rely on information from the following to make a diagnosis:


Detailed History

A sleep specialist may ask you many questions about your health and symptoms. Your sleep partner will also be asked about your symptoms, such as snoring or movements during the night, since you may not be aware of many events that happen in your sleep.

Questions your sleep specialist may ask include:

  • How long has your insomnia lasted?

  • Do you have trouble falling asleep or staying awake, or do you wake up too early in the morning?

  • What factors have caused or contributed to your insomnia (stressful events, relationships with others, problems with money, etc.)?

  • What have you done in the past to help with your insomnia?

  • Do you use caffeine, alcohol or tobacco products?

  • What medicines do you take, including over-the-counter medicines and herbal remedies?

  • What is your sleep routine?

  • What is your evening routine (responsibilities at home, chores, childcare, exercise, eating times)?

  • What is your work schedule, including shift work or a "second" job?

  • What is your medical history (include any evaluation and treatment of a sleep disorder)?

  • Describe your bedroom.

  • Describe how you perform at work and/or school.


Physical Exam

A sleep specialist may give you a complete physical examination. Some things the doctor may look for include a deviated nasal septum, enlarged tonsils or a narrow throat. These can lead to obstructive sleep apnea, which may be contributing to your insomnia.


Sleep Diary

Your doctor may have you fill out a sleep diary. This may be done for one to two weeks before your office visit. In your sleep diary, you will record information about the quality and quantity of nighttime sleep and daytime naps, including:

  • The time you got into bed

  • The time you tried to sleep

  • How long it took you to fall asleep

  • The number of times you woke up during the night

  • How long you were awake

  • The amount of actual sleep during the night

  • The time you woke up in the morning

  • The time you got out of bed

  • Whether you dreamed during the night

  • How you felt about the quality of your sleep

  • Whether you took any medicines to help you sleep

  • Whether you drank coffee or alcohol before you went to bed

  • Whether you took any naps during the day

  • Whether there were any events during day that may have affected your sleep.



An actigraph is a device worn over the wrist like a watch. This device records a signal when movement is detected. Some actigraphs can also record light around the watch. It records a signal when movement is detected. There are no signals recorded during sleep or inactivity. Signals are recorded with motion or activity. This can provide information about periods of rest/sleep or activity. The device is worn for several days to weeks, if needed.


National Jewish Health experts provided information on this topic for use on the U.S. News & World Report website. 

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