Approach

A medical and sleep history are often sufficient enough to diagnose the condition.

Sleep diaries and actigraphy performed for several days may aid diagnosis, particularly when the sleep history is inconsistent or unreliable. Polysomnography is not routinely indicated but may be considered in patients with suspected obstructive sleep apnoea or periodic limb movement disorder, or when insomnia is poorly responsive to conventional treatments, such as cognitive behavioural therapy for insomnia (CBT-I) or hypnotic agents.

High prevalence warrants incorporating screening for insomnia by primary care physicians during annual physical examinations. The Insomnia Severity Index (a 7-item questionnaire with a point system identifying the presence of clinical insomnia)[70] has good reliability, validity, and responsiveness.

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