By vgreene, 17 March, 2018 Consider DDx;1 use general medical/psych/medication questionnaire to help identify comorbid conditions:
By vgreene, 17 March, 2018 Assess for treatable secondary causes of insomnia such as depression, pain; BPH, substance abuse disorders, and other sleep disorders (OSA, RLS) before recommending that pts initiate/continue insomnia meds5
By vgreene, 17 March, 2018 If comorbidities (neuro, psych, fatigue): Use clinical judgment to decide whether to treat insomnia or comorbid condition first, or both concurrently2
By vgreene, 17 March, 2018 Diagnose1 insomnia by clinical eval incl hx exam consider DDx identify comorbid conditions
By vgreene, 17 March, 2018 If circadian rhythm disturbance (incl depression-assoc insomnia) suspected: consider actigraphy1
By vgreene, 17 March, 2018 If sleep breathing (eg, OSA) or movement (eg, RLS) disorders suspected: order polysomnography2 (otherwise not routinely1,4); consider also when initial dx is uncertain,1 when sudden arousals occur w/ violent/injurious behavior,1 for at-risk occupations (e
By vgreene, 17 March, 2018 Assign 2-wk sleep log to identify sleep-wake times, general patterns, and day-to-day variability1,2,4
