Many sleep problems can be diagnosed with a comprehensive sleep history. Lifestyle factors contributing to poor sleep such as excessive caffeine use, late-night exercise or eating and poorly managed stress should be identified.
All patients with insomnia should be screened for depression and treated accordingly, with questionnaires such as the Beck Depression Inventory as useful time-saving tools. The best long term outcomes for conditioned insomnia result from good sleep hygiene instruction and behavioural modification techniques eg. relaxation therapy. Sleeping pills are only recommended for short term relief (should not exceed 2-4 weeks) while patients are learning to implement good sleep practices.
In patients who have excessive daytime sleepiness or recurrent awakenings of unclear cause, a sleep study should be considered to rule out sleep apnoea and other causes of arousal. Difficult cases of chronic insomnia or daytime sleepiness, patients needing a sleep study, or patients with dependence on sleeping pills should be referred to specialist Sleep Disorders clinics.