When is a sleep diary indicated in the workup of insomnia?

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

A sleep diary is appropriate when a patient reports an irregular sleep schedule. Maintaining a sleep diary can be done in conjunction with wrist actigraphy. In the diary, patients should record estimates of the time at which they do the following:

  1. Go to bed

  2. Fall asleep

  3. Awaken during the night

  4. Lie in bed awake

  5. Get out of bed in the morning

Patients should also record when and how long they exercise, when they take medications, and when they consume caffeinated or alcoholic beverages. (Click on the image below to download a sample sleep diary form.)

Sleep diary. Sleep diary.

For diagnosis, the patient should maintain a sleep diary for 1-2 weeks. The 2008 American Association of Sleep Medicine (AASM) guideline recommends collection of sleep diary data both before and during active treatment and afterward if a relapse occurs or if the patient’s status needs to be reevaluated. [1] Although the sleep diary provides detailed information about sleep patterns, it can be confounded by the patient's subjective assessment of when they fall asleep and awaken during the night.


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