Sleep disorder (insomnia)

doi:10.1136/bmj.a1245

Published 28 November 2008, doi:10.1136/bmj.a1245
Cite this as: BMJ 2008;337:a1245

Practice

10-Minute Consultation

Sleep disorder (insomnia)

Bruce Arroll, professor¹, Antonio Fernando, III, senior lecturer in psychological medicine¹, Karen Falloon, academic registrar¹

¹ Department of General Practice and Primary Health Care, University of Auckland, Private Bag 92019, Auckland, New Zealand

Correspondence to: B Arroll b.arroll@auckland.ac.nz

The first 150 words of the full text of this article appear below.

A 53 year old man comes to you complaining of not having sleptwell for many years. He always feels tired the next day. Hehas tried sleeping pills, which sometimes help, but he is notkeen on taking them continually and has found that the benefitsthey give him don’t last. He spends about 9-10 hours inbed each night (going to bed about 9 30 pm or 10 pm and gettingup at 7 am) and has trouble getting to sleep. His actual hoursof sleep are 5.5 to 6 each night. He wakes about three timesa night and describes the quality of his sleep as poor.

Rule out secondary causes. To assess whether he has depressionor anxiety, for example, ask screening questions, take a fullhistory of depression and anxiety, or use a scale such as theHospital Anxiety and Depression Scale, which gives a . . . [Full text of this article]

Common causes
Causes of unknown prevalence in primarycare

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