What should be the focus of patient history in the evaluation of insomnia?

Updated: Sep 11, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

A careful sleep history should be obtained, addressing the following:

  • Timing of insomnia

  • Patient’s sleep habits (commonly referred to as sleep hygiene)

  • Presence or absence of symptoms of sleep disorders associated with insomnia

A thorough medical history should be obtained, including a review of systems.

A thorough psychological history should be obtained to screen for psychiatric disorders, focusing particularly on anxiety and depression.

A family history should be obtained, with particular attention to the following:

  • Risk of fatal familial insomnia (FFI): Though rare, this condition should be considered if first-degree relatives are affected

  • Risk of heritable conditions that may contribute to more common causes of insomnia (eg, psychiatric disorders)

A social history should be obtained, addressing the following:

  • Transient or short-term insomnia: Recent situational stresses

  • Chronic insomnia: Past stresses or medical illnesses

  • Use of tobacco, caffeinated products, alcohol, and illegal drugs


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