Insomnia or sleep difficulty should be considered when a patient presents with the following symptoms1:
- Excessive daytime sleepiness
- Major and/or minor depressive episode
- Generalized anxiety disorder
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.