Insomnia is itself often a symptom of other problems. Typical patterns of insomnia include the inability to fall asleep or stay asleep at night, waking up earlier than usual, and daytime fatigue. Most people with insomnia don't fall asleep in inappropriate situations, like driving. If this does occur, it may signal that a medical disorder is the cause of insomnia.
Excessive daytime sleepiness is the primary symptom. Some people will deny sleepiness but feel fatigued. Other symptoms are snoring, snorting, and gasping sounds when you sleep -- often first noticed by a sleeping partner. Restless or unrefreshing sleep is also typical, as are headaches in the morning.
Excessive sleepiness during the day, alleviated by naps, is a symptom of narcolepsy. Dreaming during naps and experiencing dream-like hallucinations as you fall asleep are also warning signs. Loss of muscle control (called cataplexy) that occurs with emotion, such as laughing or anger, and the inability to move as you're going to sleep or waking up (called sleep paralysis) are also symptoms.
Restless Leg Syndrome
The primary warning sign is the irresistible urge to move your legs shortly after you get into bed, in the middle of the night after awakening, or even when wide awake during the day. It usually feels better if you get up to walk around or rub your leg. "Creepy-crawly" or twitching feeling in your calves, feet, thighs, or arms are symptoms of restless leg syndrome -- the sensations of discomfort can be quite varied. Kicking or twitching leg movements during sleep, and sometimes while awake, may be warning signs.
Call Your Doctor If:
Epworth Sleepiness Scale
- Your sleep does not improve with self-help techniques, such as establishing good sleep hygiene, cutting down on caffeine, exercising, and using relaxation techniques.
- You think your sleep problems may be related to an underlying condition, such as depression or heart failure.
- You snore loudly or make snorting or gasping noises while you sleep -- or your partner observes these things while you're asleep.
- You fall asleep doing normal activities, such as talking or driving.
- You regularly feel unrefreshed on awakening and are constantly fatigued. Sleep disorders are among the many possible causes for fatigue.
- You suspect your medication is causing your sleep problems.
The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. A score of 10 or more is considered sleepy. A score of 18 or more is very sleepy. If you score 10 or more on this test, you should consider whether you are obtaining adequate sleep, need to improve your sleep hygiene and/or need to see a sleep specialist. These issues should be discussed with your personal physician.
Use the following scale to choose the most appropriate number for each situation:
0 = would never doze or sleep
1 = slight chance of dozing or sleeping
2 = moderate chance of dozing or sleeping
3 = high chance of dozing or sleeping
Print out this test, fill in your answers and see where you stand.
Situation / Chance of Dozing or Sleeping
Sitting and reading ____
Watching TV ____
Sitting inactive in a public place ____
Being a passenger in a motor vehicle for an hour or more ____
Lying down in the afternoon ____
Sitting and talking to someone ____
Sitting quietly after lunch (no alcohol) ____
Stopped for a few minutes in traffic while driving ____
Total score (add the score up)