The following symptoms and complaints may indicate insomnia (sleep disorder):
Leading symptoms
- Difficulty falling asleep – when it takes longer than 30 minutes to fall asleep.
- Trouble sleeping through – waking up prematurely, respectively, when you sleep through less than four hours
If necessary, also sleep-associated motor phenomena (see also under restless legs syndrome, RLS).
There are various forms of insomnia (sleep disorders), the symptoms or complaints of which are presented below for some forms based on the ICD-10.
Nonorganic parasomnias are abnormal episodes that occur during sleep (disturbances of awakening (arousal), partial awakening, or sleep stage change):
- Sleepwalking (moonstruck, somnambulism):
- During a somnambulic episode, the individual leaves the bed, often during the first third of the night’s sleep, walks around, shows lowered consciousness, decreased reactivity and dexterity.
- After awakening, there is usually no memory of sleepwalking.
- Night terrors (night terrors; Pavor nocturnus):
- Nocturnal episodes of extreme fear and panic with violent crying, movements, and strong autonomic arousal.
- The affected person sits up or stands up with a panic cry, usually during the first third of night sleep. She often rushes to the door as if to escape, but usually without leaving the room.
- After awakening, the memory of what happened is absent or limited to one or two fragmentary figurative ideas.
- Efforts by others to influence the affected person during the episode are unsuccessful or result in disorientation and perseverative (insistent) movements.
- An episode lasts up to 10 minutes.
- Nightmares (anxiety dreams):
- Dream experience full of anxiety or fear, with very detailed memory of the dream content. This dream experience is very vivid, themes include threats to life, safety, or self-esteem.
- There is often a repetition of the same or similar frightening nightmare themes.
- During a typical episode, there is autonomic stimulation but no perceptible crying or body movements.
- Upon awakening, the patient quickly becomes animated and oriented.
Organically caused sleep disorders (insomnia or hyposomnia) include:
- Difficulty falling asleep
- Trouble sleeping through
Complaints that may be the result of sleep disorders:
- Daytime sleepiness / increased daytime sleepiness possibly also sudden falling asleep during the day.
- Weakness in performance and concentration
- Freezing
- Cephalgia (headache)
- Mood swings, such as irritability.
- Increase in sensitivity to pain (chronic pain, if necessary)
Warning signs (red flags)
- Anamnestic information:
- Age > 50 years of life → think of: Climacteric (menopause in women); Andropause (menopause in men).
- Alcohol dependence
- Nocturia (increased urination at night) → think of: Heart failure (cardiac insufficiency); benign prostatic hyperplasia (BPH; benign prostatic enlargement).
- Pain
- Shift work
- Daytime sleepiness → think of: Sleep apnea syndrome (breathing pauses during sleep).
- Clinical evidence of depression
- Abnormal weight loss + tachycardia (heartbeat too fast: > 100 beats per minute) → think of: Hyperthyroidism (overactive thyroid gland).
