Diagnostic Tools and Testing in the Sleepless and Restless Patient

Abstract

Sleep diaries are valuable tools in assessing sleepless or restless patients (Fig. 9.1a). A sleep diary is designed to get the information about a patient’s sleep pattern. It has the potential of reducing recall or report bias. The patient self-monitors his/her sleep every night and records it. This helps in the initial assessment as well as in tracking treatment effect of different interventions. Actigraphy utilizes a wristwatch-like portable device which contains an accelerometer, a clock, internal memory, and a photo sensor. It records the rest/activity cycle which may correspond to the sleep/wake cycle. It may assist to determine the sleep patterns in normal healthy adult population, to evaluate patients suspected of advanced sleep phase syndrome (ASPS), delayed sleep phase syndrome (DSPS), shift work sleep disorder, and other circadian sleep disorders including jet lag and non-24 h sleep/wake syndrome. It is used to determine the circadian rhythm patterns in patients with insomnia (including insomnia associated with depression) and hypersomnia.