Trouble Sleeping Can you tell me more about it? Rate severity from 1 to 10. Do you have trouble falling asleep or do you wake up multiple times at night? Time: Onset Offset How often do you wake up at night? how long do you stay awake for? How long do you sleep for? Can you think of what might have caused it? What is your bedtime routine like? Do you always sleep at around the same time? When do you usually sleep? What do you before you sleep? Do you eat a large meal before sleeping? Do you drink coffee or anything else before bed? Do you have a TV in your room? Screen time before bed. Early waking Do you feel tired after waking up? Did anything in your life change at that time? How has It been affecting your life? Does anything make it better? Does anything make it worse? Associated features: Inability to concentrate? Fatigue? Palpitations Tremors Hair loss Heat intolerance Weight changes Loss of appetite Breathing problems? Are you under any stress? Have you been getting more anxious? Mood changes Medications Prescription Non-prescription Medical history Surgery history Allergies Vaccinations Family history Social history Diet Smoking Alcohol Recreational drugs Diet Exercise Physical examinations to do for such patients” Cardiology Neurology Thyroid exam Extremity exams -> esp. hands. ENT exam. Differentials Generalised anxiety Insomnia Hyperthyroidism OSA depression