One of the most underutilized tools for understanding patients’ sleep issues is the sleep diary. Sleep diaries are best completed before a patient is seen for a sleep issue, and are great tools to start an open dialogue about sleep patterns and habits.
Sleep diaries can also be used to monitor your patient’s progress after treatment for a specific condition is assigned. Information from the sleep diary can objectively assess whether a sleep aid has been helpful, as well as problem areas for further discussion during sleep hygiene counseling.
Health-care providers who use sleep diaries often design their own; however, there are several available online that can be adopted for your needs. Consider keeping the length of the questionnaires short, as patients tend to give up easily if it’s too complicated.
Using a sleep diary often helps patients recognize patterns before they visit the sleep clinic. Providers can also use information from the log to point out inconsistencies and to help patients make important changes, as well as to make accurate diagnoses.
Look to see if the patient is keeping a regular sleep schedule. This is one of the first places to start when educating patients, as most do not. Ascertain how late a patient is eating or consuming caffeine. If a patient noted that they did not have a good night’s sleep, check how they rated their mood the next day. Were they more anxious? Also, be sure to verify whether patients are watching television or using a computer close to bedtime, as this can contribute to insomnia.
Keeping a sleep diary also puts the onus back on patients to take responsibility for their own well being. Many patients have no idea that the activities they engage in may be interrupting their sleep until they see it on paper. A sleep diary is an excellent visual reminder, and a record that can aid in changing behavior.
Have patients complete a diary for one to two weeks before their first visit, and then again for several months after the visit to see if they continued to follow your recommendations for good sleep hygiene.
Here is a sample sleep diary that you can download to give to your patients: Sleep Diary Patient Handout.
Another colorful well-organized sleep diary is available for download from the National Sleep Foundation, here: http://sleep.buffalo.edu/sleepdiary.pdf.
And why not complete one yourself? You might find you have several sleep habits that could be improved upon.
Sharon M. O’Brien, MPAS, PA-C, works at Presbyterian Sleep Health in Charlotte, N.C. Her main interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.