Standard Interview Format for the Evaluation of Insomnia

Edward J. Stepanski, PhD
Sleep Disorder Service and Research Center
Rush-Presbyterian-St. Luke's Medical Center

Definition of the Problem

• What time do you go to bed? What time is your final awakening?
• How long does it take you to fall asleep?
• Do you awaken during the night? If yes, how many times?
• How much total sleep time do you get?
• How much total sleep time do you need to feel rested?
• How long have you had this sleep pattern?
• What was your sleep like before you developed this problem?
• What treatments have you tried for your sleep problem?
• Did any of these treatments help?

Behavioral Insomnia

• Do you watch television, read, work, or eat during the night? In bed?
• How do you sleep away from home (e.g., on vacation)?
• Do you fall asleep more easily on the couch than in the bed?
• Are you easily awakened by noise or light?
• What do you do while awake at night?
• Was there a precipitating event when your insomnia first began (e.g., hospitalization, stressful event)?
• Do you take naps during the day?
• Do you look at the clock during the night?

Cognitive Features

• Do you feel frustrated or tense when seeing your bed or bedroom?
• Do you think about your sleep difficulty during the day?
• Are you afraid of not sleeping? What do you think will happen to you?
• How does difficulty sleeping affect your life?

Medical

• Do you have any medical problems? (Review of systems)
• Do you have any pain at night?\
• What medications do you take? What dosages? How often?

ETOH/Drugs

• Do you drink alcohol? How much? How often?
• Do you take any non-prescribed drugs? Diet pills?
• Have you tried medication for your sleep problem?
• How much coffee do you drink?

Restless Legs / Periodic Leg Movements

• Have you noticed muscle twitches in your legs at night?
• Do you ever have painful or itching sensations in your legs that prevent you from sleeping?
• Has your bed partner ever noticed leg movements while you were sleeping?

Sleep-Disordered Breathing

• Do you snore?
• Do you ever awaken gasping for breath?
• Has your bed partner noticed any unusual breathing pattern?
• Do you have any difficulty breathing through your nose?
• Have you ever had surgery on your nose or throat?

Psychiatric

• Have you ever been treated for emotional or psychological problems?
• Have you felt depressed recently?
• How is your appetite? Has your weight changed lately? How much?
• Do you have any phobias? Panic attacks?
• How is your marriage? Does your spouse understand the problems you have been having with your sleep?
• Do you have an active sex life? Does this affect your ability to sleep?
• Do you have a stressful job? Stressful life?

Circadian Rhythms

• Do you find it difficult to get out of bed in the morning?
• Do you sleep later on weekends (or days off)?
• What are your work hours?
• Do you ever change work shifts?

Daytime Sequelae / Misc

• How does poor sleep interfere with your performance the following day?
• Is your job performance affected?
• Do you fall asleep at unexpected times during the day?
• What would you like to see changed about your sleep?
• How would improved sleep affect your daytime functioning?
• Do any family members have insomnia, excessive sleepiness, or another sleep disorder?
• Do you and your bed partner have similar bedtimes?
• Does your sleep ever improve under certain circumstances?