2. The History and Physical Examination of the Sleep Patient

  1. Douglas B. Kirsch MD, FAASM2,3
  1. Sheila C. Tsai MD

Published Online: 11 OCT 2013

DOI: 10.1002/9781118764152.ch2

Sleep Medicine in Neurology

Sleep Medicine in Neurology

How to Cite

Tsai, S. C. (2013) The History and Physical Examination of the Sleep Patient, in Sleep Medicine in Neurology (ed D. B. Kirsch), John Wiley & Sons, Oxford. doi: 10.1002/9781118764152.ch2

Editor Information

  1. 2

    Harvard Medical School, Boston, MA, USA

  2. 3

    Division of Sleep Neurology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA

Author Information

  1. Department of Medicine, National Jewish Health, University of Colorado Denver, USA

Publication History

  1. Published Online: 11 OCT 2013
  2. Published Print: 7 OCT 2013

ISBN Information

Print ISBN: 9781444335514

Online ISBN: 9781118764152



  • insomnia;
  • physical examination;
  • sleep history;
  • social factors


In this chapter, important aspects of the history and physical examination that can help pinpoint the diagnosis are discussed. The authors also review helpful points to consider when evaluating patients in order to avoid making common mistakes. A number of sleep disorders exist; the categories range from disorders of sleepiness, or hypersomnia, to disorders resulting in insomnia. Also included are circadian rhythm abnormalities and sleep-related breathing disorders. In obtaining the sleep history, one should start by determining the presenting symptom or primary reason the patient has come for evaluation. The majority of sleep complaints can be divided into excessive sleepiness, difficulties with falling asleep or staying asleep, and abnormal behaviors or sensations associated with sleep. Social factors such as work schedules, caffeine, nicotine, and alcohol use, and stressors have sleep-related implications. Sleep disorders often have a genetic or familial tendency.