Physical Exam and Symptom History

Reviewed by: HU Medical Review Board | Last reviewed: June 2020

Sleep disorders are usually diagnosed using a combination of an in-person exam, a sleep history, and sometimes blood or sleep tests.

Any tests your doctor orders will depend on the type of sleep problem your doctor suspects you may have. Blood work may be needed to rule out certain health conditions that can lead to poor sleep. But, getting a diagnosis of a sleep disorder will start with a good medical history and a physical exam.

Health history and physical exam

A physical exam usually begins with some basic checks of your weight and blood pressure. Your doctor may then ask about a wide variety of things that can impact sleep, including:1-5

  • Daytime energy
  • Concentration levels
  • Whether you get up to go to the bathroom
  • Whether you feel pain or cramps at night
  • What medicines you take
  • Exercise habits
  • How often you nap
  • Your moods
  • Whether you smoke or drink alcohol at night
  • How much caffeine or alcohol you drink
  • If you use a sleep aid
  • Whether you work shift work
  • If you have morning headaches
  • If you jerk or kick in your sleep
  • If you have been told you snore, gasp, or cough while sleeping
  • If you fall asleep at work or in social settings
  • How long you have felt tired or had problems sleeping

The answers to these questions may suggest that you have one of the more common sleep disorders: insomnia, sleep apnea, restless legs syndrome, or narcolepsy. Your answers may also tell the doctor if you have another health condition that causes sleep problems.

Health conditions that often cause sleep problems include:1,2,6

  • Acid reflux
  • Depression
  • Diabetes
  • Enlarged prostate
  • Heart disease
  • Lung disease
  • Menopause
  • Multiple sclerosis
  • Obesity
  • Parkinson’s disease
  • Thyroid disorder
  • Substance abuse

Many drugs can affect sleep too. An exam will help rule these conditions in or out.

Sleep diary

A sleep diary is another important tool that will help your doctor. A sleep diary is simply a record of your sleep habits. Usually your doctor will ask you to track your sleep habits for 1 to 2 weeks. A sleep diary includes:1-5

  • What time you go to bed
  • How long it takes to fall asleep
  • Number of times you wake up
  • How long it takes to go back to sleep
  • What time you wake up and get out of bed
  • Whether you have bad dreams
  • Whether you are sleepy or tired during the day
  • How many naps you take and for how long
  • How much caffeine you consume
  • If you use a sleep aid
  • How much alcohol you consume

Wearable devices, such as smartwatches, may offer helpful information about your sleep. However, some studies show these devices are not accurate.2

Be ready to talk with your doctor about where you sleep. Many things can make good sleep difficult, such as:1-2

  • Noise, temperature, television, and light in the room
  • Comfort of the mattress and bedding
  • Whether you sleep with a partner or pets

Sleep questionnaires

Your doctor may also ask you to take a short test to see what you think about your sleep problems. Some samples of these tests include:1-4

Talking with you about how you are feeling and running some tests are the first steps in an exam to diagnose a sleep disorder.

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