What Tests are Used to Diagnose Insomnia?
Insomnia can be a very frustrating condition to live with because it can make it difficult for you to get a good night's sleep, but it can also lead to other health problems.
If you are having trouble sleeping, it is important to see your doctor for diagnosis and to find out what is causing your insomnia.
There are a couple of different ways that your doctor can utilize different tests to help diagnose insomnia and we will discuss them in detail below.
We will also discuss several different ways to treat insomnia and give you tips on how to prevent it.
Insomnia is a sleep disorder where you have trouble sleeping.
If you have insomnia, you may have trouble trying to fall asleep or stay asleep and it is possible to have a mix of both too.
There are several different ways to classify insomnia and the most common include:
When you have short-term insomnia due to a specific event or stressor in your life this type of insomnia is also called acute insomnia.
Once the stressful event has passed or been resolved, your sleep will usually return to normal.
Chronic insomnia is insomnia that happens at least three nights a week for at least three months.
It can be caused by an underlying health condition, another sleep disorder, or lifestyle choices.
Primary insomnia is insomnia that is not caused by another underlying health condition.
An example of this would be not being able to sleep because you are looking forward to an event the following day.
Secondary insomnia is insomnia that is caused by another health condition that causes sleep disturbances.
For example, if you can not fall asleep due to pain from your arthritis then this would be considered secondary insomnia.
There are also certain risk factors that may make you more likely to suffer from insomnia.
Women are more likely to have insomnia than men due to hormonal changes while the elderly are also more likely to have it due to changes in their sleep schedule, a lack of physical activity, and having to take more medications.
What are the symptoms of insomnia?
The symptoms of insomnia can vary from person to person but generally, they can be classified as either trouble falling asleep or staying asleep.
The most common symptoms of insomnia may include:
- Having trouble falling asleep
- Waking up frequently during the night
- Waking up too early in the morning and not being able to fall back asleep
- Not feeling well-rested after a night of sleep
- Having daytime sleepiness
- Impaired memory and concentration issues
- Lethargy or malaise
If you have these symptoms and think you may have insomnia please talk to your doctor or health care provider about it as insomnia can be a serious problem and can lead to other health problems if not treated.
What are the causes of insomnia?
The most common causes of insomnia include:
- Chronic pain
- Medications such as antidepressants or supplements containing caffeine such as cough/cold medicines and weight loss supplements
- Unhealthy sleep habits such as looking at phone/laptop/TV screens while in bed
- Poor bedroom environment that is not conducive to sleep
- Chronic diseases such as cancer, diabetes, asthma, and heart disease
- Chronic pain from health conditions such as arthritis or fibromyalgia
- Family history as there can be a genetic component to insomnia
- Changes in hormones that can happen with age, menstruation, thyroid disease, pregnancy, or other health conditions
- Having a travel or work schedule that rotates to different parts of the day and night
- Jet lag from traveling
- Neurological disorders such as Alzheimer's disease, Parkinson's disease, and autism
- Sleep disorders such as obstructive sleep apnea which causes disruptions in breathing as you sleep or restless legs syndrome
- Gastrointestinal problems such as acid reflux, heartburn, and gastroesophageal reflux disease (GERD)
If you think one of these causes may be the reason you can not sleep please talk to your doctor or health care provider as they will be able to help you treat the cause and improve your sleep quality.
What are the complications of insomnia?
Treating insomnia is important as it can lead to adverse effects if left untreated. These complications caused by insomnia may include:
- Weight gain or obesity
- Heart disease
- High blood pressure
- Type 2 diabetes
- Difficulty performing at your work or school
- Increased risk of motor vehicle accidents
- Risk of falling down
- Substance abuse such as alcohol dependence to fall asleep or reliance on benzodiazepine therapies (sleeping pills)
It is important to talk to your doctor or health care provider if you think you have insomnia as it is a treatable condition and these complications can be prevented.
How is insomnia diagnosed?
If you think you may have insomnia your doctor or health care provider will ask you questions about your medical history and sleep habits and how they affect your life which may come in the form of a sleep questionnaire.
They will also ask about any medical conditions or medications that you are taking as these can also cause insomnia.
Your doctor may also ask you to keep a sleep diary for a period of up to two weeks to help track your sleep patterns.
In some cases, they may refer you to a sleep specialist for further testing. There are several different tests that may be used for insomnia and these include:
Performing a physical exam of your body will help your doctor rule out any other medical conditions that may be causing insomnia.
A polysomnography test is done in a sleep lab where you stay overnight and are hooked up to machines that measure your brain waves, heart rate, breathing, and blood oxygen levels and is used to find out if you have insomnia or another sleep disorder.
An actigraphy test is done by wearing a small device on your wrist or ankle that tracks your sleep-wake cycles and is used to find out if you have insomnia or another sleep disorder and is similar to a polysomnography test but is conducted from the comfort of your own home over a period of a few days up to a couple of weeks.
The results are then analyzed by a sleep specialist.
If your doctor suspects that there may be a medical condition causing your insomnia they may order blood tests to rule out any other causes.
What are the treatment options for insomnia?
Treatments of sleep disorders and in particular insomnia can vary due to a plethora of different causes for it. There are several treatments for insomnia and these include:
Cognitive behavioral therapy for insomnia (CBT-I)
CBT-I is a form of insomnia treatment that focuses on changing the thoughts and behaviors that are causing it and has minimal risk. There are several different forms of CBT-I for the management of insomnia and they include the following:
Stimulus control therapy
Using stimulus control therapy for behavioral treatment focuses on creating a sleep-friendly environment, avoiding naps, and teaching you how to associate your bed with only sleep and sex.
Sleep restriction therapy
When you practice sleep restriction therapy you focus on reductions in sleep time and the time you spend in bed to match the amount of sleep you are actually getting.
It is used to increase the quality of sleep by making sure you only spend a certain number of hours in bed awake.
Sleep restriction therapy ultimately uses sleep deprivation for the treatment of insomnia to help alter your sleep schedule so you sleep through the night.
Relaxation therapy uses different relaxation techniques to help you relax your mind and body such as progressive muscle relaxation, deep breathing exercises, meditation, and biofeedback.
Staying passively awake
It may seem counterintuitive but staying passively means you go to bed thinking about staying awake instead of sleeping to help remove the anxiety of trying to fall asleep.
Light therapy uses a light box that emits a bright light similar to sunlight which can help regulate your sleep-wake cycle by resetting your internal clock.
There are several different types of medications called sedative-hypnotics approved by the U.S. Food and Drug Administration (FDA) that can be used to treat insomnia but these sleeping pills are usually only prescribed as a last resort after trying other treatments.
They are typically considered short-term treatments as some medications, specifically benzodiazepine therapies, run the risk of substance abuse and physical dependence which can lead to withdrawal symptoms when you are not taking them.
Over-the-counter sleep aids
There are some over-the-counter sleep medications and supplements that may help you sleep, including antihistamines that make you drowsy and melatonin supplements for treatment.
As always, talk to your doctor first before starting any new medications or supplements.
What are the best ways to prevent insomnia?
There are a few things you can do to help prevent insomnia and these include:
- Stick to a regular sleep schedule as much as possible by going to bed and waking up at the same time every day, including on weekends
- Avoid caffeine, nicotine, and alcohol before bed
- Exercise regularly (but not right before bed) and eat a healthy diet; both have numerous health benefits which include helping to prevent insomnia
- Treat underlying conditions such as taking medications to reduce pain for pain-associated insomnia
- Wind down for at least 30 minutes before bedtime by creating a relaxing sleep routine which may include reading, listening to soothing music, meditation, or taking a warm bath
- Create a sleep-friendly environment in your bedroom that is dark, quiet, and cool, and only use your bed for sex or sleep
- Limit your exposure to bright screens such as TV, computers, and phones at least 30 minutes before bedtime
- Avoid large meals or drinking too many beverages before bed
- Avoid naps
Insomnia is not always preventable but following these tips may help with improvements in sleep.
If you think you may be suffering from insomnia, the first step is to speak with your primary care physician.
Diagnosis of insomnia usually starts with a sleep history and physical exam and your doctor will ask you questions about your sleep habits, medical history, and any medications you are currently taking.
Your doctor can then refer you to a sleep specialist for further testing and treatment options if necessary.
There are several different tests used for the evaluation of insomnia and diagnosis which we discussed in this article.
Based on the results of your tests, your doctor will then develop a treatment plan for insomnia that is catered toward you. If you have any more questions regarding insomnia, how it is diagnosed, or the treatment options for it, please talk to your doctor or health care provider.
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