Table 1.
Evaluation of sleep complaints and pertinent clinical history
| SLEEP COMPLAINT | EXPLORING PERTINENT HISTORY |
|---|---|
| Difficulty falling asleep | Habitual bedtimes (sleep onset/offset on weekdays and weekends/holidays) |
| Time taken to sleep onset; “desired” bedtime | |
| Duration, frequency, and severity of complaints | |
| Inappropriate nap schedules | |
| Family history | |
| Negative associations (fears, worries) with distressing sensorimotor symptoms of restless legs syndrome, nightmares | |
| Difficulty staying asleep (and/or multiple nocturnal awakenings) ± early morning awakenings | Difficulty sleeping through the night (nighttime awakenings, early morning awakenings), activities during the awakenings |
| Screen for mood and anxiety symptoms | |
| Screen for primary sleep disorders (sleep apnea) | |
| Family history | |
| Use of alerting substances at bedtime | |
| Excessive daytime sleepiness (EDS) | Total duration of nocturnal sleep |
| Quality of morning awakenings | |
| Difficulty to stay awake in the classroom, while driving, watching TV, eating meals | |
| Persistent use of stimulants (e.g., nicotine, caffeine) to stay awake | |
| Exploring other potential symptoms associated with disorders of excessive sleepiness (such as cataplexy, sleep paralysis, sleep attacks, hallucinations) | |
| Daytime consequences of sleepiness (poor academic performance, learning difficulties, impaired concentration, disruptive behaviors, mood symptoms) | |
| Family history | |
| Medication use (long-acting psychotropic medications with “hangover” effects) | |
| Substance use (alcohol and other illicit drugs, over-the-counter medications) | |
| Poor sleep routine and sleep hygiene due to environment and psychosocial variables | Occupation (odd hours at employment, shift-work schedules) |
| Social environment (co-sleeping/sharing bedroom, sleep patterns of parents and other children, pets in bedroom) | |
| Housing (light, noise, and temperature) | |
| Activities at bedtime (computer/telephone, homework completion, TV viewing) | |
| Substance use (alcohol and other illicit drugs, caffeine intake, nicotine use, over-the-counter medications) | |
| Parental involvement (limit setting, adult supervision) |