This article relays information regarding assessment of sleep disorders, including clarification, inclusion of other causes, such as social difficulties and physical symptoms.
Before initiating the intervention for sleep enhancement aimed at restoring a comfortable pattern of sleep, assessment of the problem is necessary. Assessment of sleep disturbance includes both objective and subjective measures. These may include family, medical, social histories, sleep history, sleep diary, paper-pencil measures of sleepiness, and physical examination. Sleep laboratory data including polysomnography and the multiple sleep latency test may be necessary to make a definitive medical diagnosis.
Clarifying Subjective Data
A full description of the sleep complaint is important to assess. People are asked to describe their sleep problem-the duration, the circumstances under which it developed, factors that precipitate or accentuate it, previous treatment, and what the impact of the problem is on their lives and family. If the person says that he or she is not sleeping well, a first step is to clarify what is meant by that statement.
Is it that the person has trouble falling asleep or remaining asleep, or is it that the quality of the sleep that is a problem? If they are awakening during the night, how many times do they awaken? Can they describe what it is that wakes them up? It is helpful to question the personís bed partner or roommate in order to get information on snorting, gasping or apneic periods or the apparent presence of bad dreams, restlessness, leg movements, or sleepwalking. Because the sleep environment is also important, a description of the room and surroundings in which the person usually sleeps should be obtained.
In-Depth Introspection Of Other Contributors
Other factors should be examined. Find out whether that person takes concerns such as those related to their job to bed with them. Probe to determine whether or not this is related to some specific recent change. Are there any other emotional concerns such as those related to interpersonal or family relationships or financial problems that can be contributing to disrupted sleep? Are disturbing dreams or nightmares a cause of awakening, or is the anticipation of them keeping the person from falling asleep.
Correlation Of Sleep Disturbances To Physical Symptoms
Physical symptoms are a frequent cause of sleep disruption, and sleep problems due to specific symptoms need to be addressed and relieved if possible. The sleep problem secondary to the symptom may then be resolved. Does the person have to get out of bed because of the need to use the bathroom? Is the person having trouble falling or staying asleep because of pain, cramping, or other physical symptoms? Such symptoms as heartburn or gastric pain may cause difficulty when the person lies down.
Respiratory problems such as shortness of breath or wheezing may contribute to problems. People may recall awakening because of choking or difficulty in breathing or because of their own snoring. Does the person complain of discomfort in the feet and legs that is relieved by getting up and walking around?
For longer or chronic sleep disturbances, it is often helpful for the person to keep a sleep diary. This can be of assistance in establishing the sleep patterns for that particular individual and triggering event that disturb sleep.