INSOMNIA

Question 1

insomnia key hx: timing

Answer 1

duration

Question 2

insomnia key hx: character

Answer 2

description (difficulty falling asleep vs multiple awakenings vs early-morning awakening)

Question 3

insomnia key hx: assoc sxs

Answer 3

daytime sleepiness
arthritis (pain keeping awake)
diabetes (polyuria)
evidence of common sleep d/o (sleep apnea, restless leg syndrome)
loud snoring
nightmares
depression
psych sxs (grandiose delusions, irritability)
daytime fx

Question 4

insomnia key hx: soc hx

Answer 4

caffeine, alcohol, medication, recreational drug use
work/lifestyle (jet lag/shift work)
stressors
sleep environment/hygiene

Question 5

insomnia key PE

Answer 5

VS
MSE
thyroid

Question 6

stress-induced insomnia ddx

Answer 6

caffeine-induced insomnia
insomnia with circadian rhythm sleep d/o
insomnia related to mdd

Question 7

stress-induced insomnia w/u

Answer 7

polysomnography
ur tox
cbc
tsh

Question 8

OSA ddx

Answer 8

daytime fatigue in primary hypersomnia
insomnia with circadian rhythm sleep d/o
insomnia related to mdd

Question 9

OSA w/u

Answer 9

polysomnography
ecg
cbc
tsh

Question 10

insomnia related to mdd ddx

Answer 10

primary hypersomnia

insomnia with circadian rhythm sleep d/o

Question 11

insomnia related to mdd w/u

Answer 11

tsh
cbc
polysomnography