Diagnosis

Insomnia or sleep difficulty should be considered when a patient presents with the following symptoms1:

  • Fatigue
  • Excessive daytime sleepiness
  • Major and/or minor depressive episode
  • Generalized anxiety disorder
  • Memory/concentration
  • Pain

The diagnosis of insomnia is primarily based on patient-derived and family or caregiver complaints, as determined by a clinical interview, ideally with a patient diary97. The complaints would comprise: difficulty in initiating and/or maintaining sleep, or non-restorative sleep that results in daytime impairment3.

Insomnia Diagnostic criteria3

  • A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one or more of the following symptoms:

    • Difficulty initiating sleep.
    • Difficulty maintaining sleep, characterised by frequent awakenings or problems returning to sleep after awakenings.
    • Early-morning awakening with inability to return to sleep.
  • The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioural, or other important areas of functioning.
  • The sleep difficulty occurs at least 3 nights per week.
  • The sleep difficulty is present for at least 3 months.
  • The sleep difficulty occurs despite adequate opportunity to sleep.
  • The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder.
  • The insomnia is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication).
  • Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.

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from Flynn Pharma Ltd in the UK.

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