June 05, 2008
Paying close attention to your sleep habits—and writing them down—for two weeks can help determine your problem.

Paying close attention to your sleep habits—and writing them down—for two weeks can help determine your problem.(ISTOCK)

Diagnosing a sleep disorder can be trickybecause some of the most typical symptoms—fatigue, loss of concentration, irritability—are often overlooked or dismissed by doctors and patients alike. People tend to blame their personality changes on stress, being overworked, or the fact that "it's just the way I am."

These same symptoms, however, can also be the sign of a different type of sleep problem: deprivation. While sleep needs are different for every person, not getting the right amount for you can wreak havoc on your physical and emotional health, whether you realize it or not.

"A large percentage of Americans think they function just fine on six hours of sleep, but theyre not getting the duration of sleep that they need," says Jed Black, MD, director of the Stanford Sleep Disorders Clinic in Palo Alto, Calif. "Its really quite remarkable how many sleep deprived people there are."

When patients come to Dr. Black's office complaining of fatigue or a potential sleep disorder, he screens for conditions such as sleep apnea, narcolepsy, and restless legs syndrome. If his evaluation doesnt uncover anything and his patients report getting less than seven and a half hours of sleep a night, he sends them home and tells them to truly devote eight hours to sleep every night. If people are used to getting by on less than that, they may start to feel more refreshed right away.

"That takes care of a large subset of the folks who have sleepiness during the day," he says; they learn to readjust their schedules and can treat themselves.

On the other hand, some of these patients will be unable to sleep, even when they make time for it. This may lead to an insomnia diagnosis, in which case cognitive-behavioral therapy or short-term medication may be appropriate treatment options. If other patients do sleep the full eight hours each night and are still excessively tired during the day, they might need a sleep study to determine what's keeping them from being fully rested in the morning: It may be a parasomnia (a relatively uncommon disorder) or a more subtle form of one the disorders covered in the initial screening.

Before you see a doctor, monitor your sleep schedule for two weeks and ask yourself the following questions. Does it take you longer than 30 minutes to fall asleep? If you get up during the night does it take you more than 30 minutes to fall back asleep? How early do you get up in the morning? And most important, How do you feel during the day? It may help to write down your sleep patterns—and any daytime habits that might affect them—in a sleep diary.