Getting A Diagnosis: How To Know If You Have Insomnia

The occasional sleepless night is something everyone can relate to at some point in their life.

But, what happens when sleeplessness occurs more often, or every night? This may be a sign of insomnia.

What is insomnia?

Sleep disorders are common in America, affecting about 70 million people each year. Of those, 33% to 50% show signs of insomnia.¹

Insomnia is a lack of good quality sleep due to the inability to fall asleep, stay asleep through the night, or both.

During sleep, the body restores itself and takes care of maintenance. If a person does not get enough, it can result in sleep that is not refreshing or restorative. Without diagnosis and treatment, chronic insomnia may cause serious health problems.²

There are two main types of insomnia: primary and secondary.

Primary insomnia

Primary insomnia is the least commonly diagnosed form of insomnia. This type of sleeplessness is not caused by something else. Instead, it is just consistent sleeplessness on its own. This usually occurs for at least a month or longer.

Secondary insomnia

The second type of insomnia is when the sleep disruptions are symptoms of something else. This may be just about anything from a new baby in the house to a medication that makes sleeping more difficult. Secondary insomnia is most commonly diagnosed.

The good news is that insomnia is highly treatable in most cases, and it can often be cured.² Sometimes, all you need to do is make a few lifestyle changes. Other times, it may be necessary to see a specialist for a proper diagnosis to get a good night's sleep.

Insomnia can also be classified as chronic or short-term. Chronic insomnia is when sleeplessness lasts longer than three months. Short-term insomnia usually resolves within three months.³

How to know if you have insomnia

If you need to know if you have insomnia, you can talk to your primary care physician. They can perform a medical exam and run some lab work to determine a medical cause for your sleeplessness. They can also ask you about any signs or symptoms you might be experiencing.

Some common signs and symptoms of insomnia include:

  • Not being able to go to sleep

  • Lying in bed for hours staring at the clock

  • Waking up throughout the night

  • Waking up too early

  • Sleeping through the night but still feeling unrested

  • Groggy and irritable throughout the day

  • Forgetfulness or brain fog

If you suspect that insomnia is the cause of your sleeplessness, you may want to seek a diagnosis to figure out which treatment is appropriate for you.

How is insomnia diagnosed?

While many people choose to self-diagnose, it is best to seek advice from a health care professional. If your primary care physician rules out the common medical causes for sleep disturbances, they will refer you to a sleep specialist.

The sleep specialist will perform tests to determine if you have insomnia or any other sleep disorder. Here are some of the ways that a sleep specialist makes their diagnosis:

Sleep log

This is a type of sleep journal. You will need to keep track of all the times you go to bed, wake up throughout the night, and anything unusual you might experience. They may also want to know when you're eating your meals and other lifestyle questions. 

Sleep study

A sleep study is performed while you sleep. The sleep specialist will attach electrodes to your scalp and body. You will be put in a quiet, dark room to sleep for the night. Cameras and computers keep track of every move, twitch, and vital sign.

With these two main tests, your sleep specialist will be able to determine what your brain and body are doing while you sleep. The doctor may also want to run more tests depending on what the sleep study shows.⁴

If you want to start tracking your sleep before seeing your doctor, The National Heart, Lung, and Blood Institute has a free sleep diary you can print.⁵

How to know if something is causing you to have insomnia

There are several causes of insomnia. Sleep disturbances can be due to medical conditions, mental health, and lifestyle.

 Medical causes of insomnia:

  • Diabetes

  • Thyroid disorder

  • Sleep apnea

  • Asthma, allergies, breathing issues

  • Brain injury

  • Neurological conditions

Emotional causes of insomnia:

  • Stress

  • Anxiety

  • Depression

  • Trauma

Lifestyle causes of insomnia:

  • Exercising before bed

  • Eating right before bed

  • Sedentary lifestyle

  • Smoking before bedtime

  • Drinking before bed

These are just some of the common reasons for sleeplessness. Your doctor will have a lot of questions to help them gauge what may be causing your insomnia.

Who are the doctors and specialists involved with diagnosing insomnia?

Depending on the extent of your insomnia, you may have one doctor or a team of different specialists. Here are some specialists that may be involved in your care:

  • Primary Care Physician, PCP – For many people, their PCP is the first person they consult for health concerns. They can help figure out if the problem is medical and which specialist is suitable for a referral.

  • Sleep specialist – This type of doctor specializes in sleep patterns and sleep disorders. They are the ones most likely to order a sleep study and request a sleep log.

  • Pulmonologist – If the lungs or breathing are the reason for lack of sleep, they can help figure out why.

  • Endocrinologist – These specialists study and treat hormonal diseases and disorders like diabetes and thyroid problems. 

What happens after you get a diagnosis of insomnia?

After getting an official diagnosis, you and your doctor will discuss treatment options. These treatments will depend on the type of diagnosis you receive.

Lifestyle changes:

  • Stress reduction, like mindful breathing and meditation

  • Avoiding alcohol, smoking, or caffeine near bedtime

  • Changing exercise or eating times

Cognitive behavioral therapy (CBT):

  • May help establish healthy sleep habits

  • Change the way you feel about sleep

  • Help manage stress and triggers of stress

Medication:

  • Prescription sleep aids 

  • Over-the-counter sleep aids

  • Antidepressants

Your doctor may also decide to put you on other types of medications or treatments if a medical condition causes your symptoms of insomnia.⁴

The lowdown

Understanding if you have insomnia can help you decide whether to seek medical help.

A visit with your doctor may come with an official insomnia diagnosis, which can then determine what treatments to use for the sleeplessness.

There are many different types of treatments to discuss with your sleep specialist.

  1. Insomnia | Cleveland Clinic

  2. Insomnia: Symptoms, Causes, and Treatment | Help Guide

  3. Insomnia | NIH: National Heart Lung and Blood Institute

  4. Insomnia | Medline Plus

  5. Sleep Diary | NIH: National Heart Lung and Blood Institute



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