Identifying the Causes of the Insomnia

The following pages contain tests and questionnaires that will help to identify possible causes for your sleep problems.

Sleep History Analysis

Review and answer the following questions. Be open-minded and truthful in the analysis Getting to the real cause is essential to treating your insomnia. Later pages will address specific recommendations.

#	Question	Comment
1	Do you have trouble getting to sleep? How long does it usually take for you to fall asleep?	If you usually take more than an hour to fall asleep: You may be excessively tense. Focus on managing stress and relaxation techniques. Your internal sleep-awake rhythm may have slipped. Focus on resetting the sleep clock.
2	How often do you wake up during the night? Do you usually have trouble getting back to sleep?	It is normal for good sleepers to awake 5-15 times during the night. However, they fall asleep again within few seconds and don't remember being awake. The problem is not waking up, but it is with what happens after. If you don't fall asleep right away, pay attention to the thoughts you have at that time. They may give you a clue to your sleep problem.
3	How many hours do you actually sleep, on average, during the night?	Some people need more sleep, others less. This question is only relevant if you are tired during the day.
4	Do you often feel exhausted during the day because of a lack of sleep? Does your sleep problem interfere with your work or social life? Have you ever had an accident or near-accident because you did not have enough sleep the night before?	This crucial question will help answer the big question: Do you really have insomnia? Not sleeping very much is not considered insomnia unless it impairs your daytime functioning or your physical or emotional well being. Some people are simply short sleepers, who don't sleep very long, which is normal. If you feel alert and energetic during the day, don't worry if you sleep less than most people. However, don't try to be a short sleeper if you are not.
5	Do you usually nap during the day? How long?	Napping is controversial. It hurts sleep at night for some people but not for others. Cut out the naps for a week, and see if you sleep better at night.
6	Do you do shift work?	Shift work is very tough on those who sleep poorly. (See later pages on dealing with shift work and jet lag).
7	Are you often bothered with waking up earlier and not being able to get back to sleep?	Besides other reasons discussed, it could simply mean that you are: a short sleeper, or going to bed too early.
8	When did your sleep problems begin? What was happening in your life at that time or the few months before?	The sleep problem may be associated with some important event in your life. Even if the event is positive, it may be connected to your insomnia. For example, you've received a promotion at work and have assumed more responsibility. It may have made you happy, but it may have also put you under more stress.
9	Are your sheets and blankets in disarray in the morning? Do you awake yourself by kicking limbs during the night? Has your bed partner ever complained about it?	You may have what is called periodic limb movements during your sleep.
10	Do you think you have trouble breathing during the sleep? Has your bed partner said that you are heavy snorer or that you occasionally stop breathing for more than 10 seconds?	You may have a condition called sleep apnea. (See later page on medical causes).
11	Do you often have nightmares or night terrors? Do you grind or clench your teeth? Have you wet the bed as an adult? Have you walked in your sleep as an adult?	The condition that sleep specialists call parasomnia is disturbing your sleep. Parasomniacs can be helped. (See later pages).