What Doctor for Insomnia, and How Is It Diagnosed?

You lie awake for an hour, wake again at three in the morning and drag yourself through the day. At some point you wonder who actually deals with this, and what happens at the appointment. Until then, you can jot down trouble falling asleep, waking in the night and daytime sleepiness on paper. Or log them per day in Sam's symptom diary and create a monthly report of them as a PDF.

This article covers the route to a diagnosis. It explains who to see, how insomnia is assessed, when a sleep study is considered and what a sleep diary holds. The ISI questionnaire, which the European Insomnia Guideline calls an established tool, is explained in how to use the ISI. What Sam keeps when sleep is the problem is on the insomnia overview.

What doctor should you see for insomnia?

Start with your GP or primary care doctor. The NHS says a GP will try to find the cause, so you get the right treatment. Many people never take this step. The European Insomnia Guideline cites German health insurance data on this. They suggest that no more than 30 percent of people with insomnia have ever sought medical help.

Others join in when the assessment calls for it.

• A sleep clinic or sleep specialist. The NHS says you may be referred there if you have symptoms of another sleep disorder, such as sleep apnea. The European guideline adds other reasons, such as insomnia that has not responded to treatment.
• A clinician trained in CBT-I. The European guideline recommends cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for chronic insomnia. It can be delivered in person or digitally. The American Academy of Sleep Medicine (AASM) says behavioral treatment is ideally delivered by a clinician specifically trained in it. That may mean a referral to a behavioral sleep medicine specialist.
• Other specialties. Many physical, neurological and mental health conditions can disturb sleep. The guideline notes that the work-up may need several specialties working together.

Whatever the treatment turns out to be, the guideline says a proper assessment comes first.

Do you have to wait three months before you go?

No. The DSM-5, ICSD-3 and ICD-11 criteria for chronic insomnia start with a complaint. You have trouble falling asleep, staying asleep or waking too early, despite enough chance to sleep. It comes with daytime effects such as fatigue, poor concentration or irritability. It happens several times a week, at least three nights in DSM-5 and ICSD-3. And it has lasted at least three months. ICD-11 also has a category for short-term insomnia.

These are criteria for clinicians, not a test to run on yourself, and not a waiting period. Missing one of them is no all-clear. The NHS suggests seeing a GP in three cases. Changing your sleep habits has not helped. You have had trouble sleeping for months. Or it makes daily life hard to cope with.

Do not wait for a routine appointment if any of these apply.

• Loud snoring with pauses in breathing, heavy daytime sleepiness or suddenly falling asleep during the day: get it checked promptly. These signs can point to sleep apnea.
• Drowsiness at the wheel: do not keep driving. If sleep apnea with excessive sleepiness is confirmed, the NHS says you must not drive until it is under control.
• Thoughts of harming yourself: contact your doctor right away or call your local emergency number. Samaritans answer on 116 123 (UK and Ireland) around the clock. In the US, call or text 988.
• Life-threatening symptoms: call your local emergency number (112 in the EU, 999 in the UK, 911 in the US). For urgent problems that are not life-threatening when your practice is closed, call its out-of-hours number or, in the UK, NHS 111.

If your symptoms get worse or new ones appear, contact your practice sooner.

How is insomnia diagnosed?

According to the European Insomnia Guideline, the diagnosis rests solely on a clinical history and your own account. There are no fixed numbers to meet for time to fall asleep, sleep duration or awakenings. What counts is that you sleep badly despite enough time and a quiet place to sleep. You are unhappy with it and struggle by day. The 2023 guideline lists these steps.

1. Sleep history: how long and how often, how your days go, and whether you work shifts or nights. A bed partner's account of snoring, breathing pauses, leg movements or restlessness counts too.
2. Health history: past and current illnesses, your life situation, medicines, alcohol, caffeine, nicotine and drugs. The doctor will also ask about your mood.
3. A sleep diary and questionnaires: a diary for at least 7 to 14 days and a severity questionnaire such as the ISI. A sleep apnea screening questionnaire, such as STOP-Bang, belongs here too.
4. Physical exam and blood tests where indicated. The guideline names, for example, blood count, thyroid, liver and kidney values, CRP, ferritin and vitamin B12. An ECG or EEG can follow if needed.
5. Overnight tests: only for specific questions, covered in the next section.

The AASM's 2008 guideline on evaluating chronic insomnia points the same way. It asks for a two-week sleep log and a questionnaire on medical, psychiatric and medication history. A sleepiness scale such as the Epworth Sleepiness Scale comes on top. It adds that the physical exam should look specifically for risk factors for sleep apnea.

Many medicines can disturb sleep, the European guideline notes. So bring a complete list, including anything you buy over the counter. In Sam you can keep it in the medication list, with intake times or "as needed". Do not stop a prescribed medicine on your own; raise it with your doctor. For everything else worth bringing, see the doctor appointment checklist.

When is a sleep study considered?

The European guideline says polysomnography, the overnight study in a sleep lab, is neither necessary nor sufficient to diagnose insomnia. The AASM guideline also leaves it out of the routine evaluation. The European guideline recommends it in these cases.

• Another sleep disorder is suspected, such as sleep apnea or periodic limb movements in sleep.
• The insomnia has not responded to several treatments.
• Fatigue puts you at risk of accidents, for example as a professional driver.
• There seems to be a large gap between how you experience your sleep and what is measured.

Actigraphy, a measurement with a medical-grade movement sensor worn on the wrist, is not part of the routine work-up in the European guideline either, though it can help tell an irregular sleep-wake pattern apart from insomnia. The AASM's 2018 actigraphy guideline suggests it can estimate sleep in adults with insomnia, though it is not required for the routine diagnosis.

What about your Apple Watch? The European guideline says the validity of watches and similar wearables for diagnosing insomnia has not been satisfactorily shown. It says sleep trackers should in general be discouraged for people with insomnia. That holds until their accuracy against polysomnography is validated. The guideline also mentions that such devices might affect sleep behavior negatively.

If you wear a watch anyway, Sam shows its Apple Health estimates in the same app. If the numbers unsettle you, raise it at your appointment. Sam's sleep score is the app's own calculation from those estimates, not a measurement. For the diagnosis, your own account counts, not a score. How accurate the watch's sleep stages are is covered in Apple Watch sleep stages vs polysomnography. Why hours alone say little is in why sleep duration alone misleads.

What goes in a sleep diary for your doctor?

The guideline recommends supporting the assessment with a sleep diary kept for at least 7 to 14 days. It points to the Consensus Sleep Diary, a standard format that sleep researchers proposed in 2012. Each morning you note five things.

• When you got into bed and when you tried to fall asleep.
• How long it took to fall asleep.
• How often you woke and how long you were awake.
• When you finally woke and when you got up.
• How well you slept.

The expanded version adds naps, alcohol, caffeine and medicines. The times are your own estimates. That is the point: your doctor wants to know how the night felt to you. Ask which template your practice uses.

Sam is not that kind of sleep diary. The symptom diary keeps symptoms per day, with no time of day, no count of awakenings and no notes. A split like this works:

Will your doctor check for sleep apnea too?

Sleep apnea and insomnia can feel alike and can occur together. The European guideline therefore calls for a sleep apnea screening questionnaire in every insomnia assessment. If it is positive, a home sleep apnea test or a sleep lab study is needed for a valid diagnosis. How snoring, sleep apnea and insomnia connect is covered in sleep apnea vs snoring.

There is no self-test table here, on purpose. Which one you have, or whether you have both, is for your doctor to decide. How sleep apnea is worked up is covered in what to log for your sleep doctor. What Sam keeps for it is on the sleep apnea overview.

What should you bring to the first appointment?

• Your sleep diary from the last one to two weeks.
• A list of all your medicines, including over-the-counter ones.
• How much alcohol, caffeine and nicotine you have.
• What a bed partner notices at night: snoring, breathing pauses, restless legs.
• Earlier test results and doctor's letters.
• Your questions, for example whether a sleep apnea questionnaire makes sense or whether CBT-I could suit you.

From Sam you can add the monthly report. You create it yourself for the previous month. It shows your symptom days as a calendar and your five most frequent symptoms. It needs notifications turned on, Apple Health access and an answer about chronic conditions ("none" counts). From the second report on, you also need to log how you felt on at least 15 of the last 30 days. Symptom entries do not count for this. The report's sleep page prints general tips from the app, such as keeping a regular bedtime. That is not treatment and not CBT-I.

Log your sleep symptoms in Sam and take them to your appointment

You walk in with weeks on record instead of a hazy memory. Your symptoms sit in one app, each with its date.

• Instead of recalling it in the exam room: difficulty falling asleep and waking during the night go into the symptom diary per day. Daytime sleepiness gets mild, moderate or severe.
• Instead of a stack of notes: you create the monthly report as a PDF yourself. It holds a calendar of your symptom days and your five most frequent symptoms.
• Instead of a list from memory: your medicines, including over-the-counter ones, sit in the medication list.
• Instead of loose papers: test results and doctor's letters are at hand in Health Records.

Sam is not a sleep diary with bedtimes, doesn't measure sleep like a sleep lab and doesn't diagnose. More on the insomnia overview.

Try Sam for free

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any condition or health state. Always consult qualified professionals for medical decisions.

Related reading

• How to use the ISI Insomnia Severity Index
• Sleep apnea: what to log for your sleep doctor
• Sleep apnea vs snoring: what sets them apart
• Insomnia in menopause: what to note before your visit
• Apple Watch sleep stages vs polysomnography
• Doctor appointment checklist for a chronic condition

Sources

Updated: October 2026

• NHS: Insomnia (last reviewed 19 March 2024)
• NHS: Sleep apnoea (last reviewed 11 May 2026)
• Riemann D et al.: The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023, Journal of Sleep Research 2023;32:e14035 (sections 3 and 4.1.1, tables 2 to 5)
• Schutte-Rodin S et al. (AASM): Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults, J Clin Sleep Med 2008;4(5):487-504
• Carney CE et al.: The Consensus Sleep Diary: Standardizing Prospective Sleep Self-Monitoring, Sleep 2012;35(2):287-302
• Smith MT et al. (AASM): Use of Actigraphy for the Evaluation of Sleep Disorders and Circadian Rhythm Sleep-Wake Disorders, J Clin Sleep Med 2018;14(7):1231-1237
• Samaritans: samaritans.org
• 988 Suicide and Crisis Lifeline: 988lifeline.org