# Insomnia, RLS and circadian disorders

Apnea is only one variant. Free validated questionnaires exist for the rest.



## Takeaways

- Screen with ISI, Epworth, RLS, rMEQ.

- Bring flagged scores to your doctor.

- CBT-I before hypnotics.



Beyond apnea there are insomnia, restless legs syndrome, circadian rhythm disorders and chronotype mismatches. Galpin recommends starting with free, short, scientifically validated questionnaires — the Check tab has five of them.

Insomnia is often arousal at bedtime: cognitive load, novelty-seeking media, or unresolved stress. Melatonin doesn't fix mid-night waking — it's a circadian tool. First-line treatment in every major guideline is CBT-I, not pills.



## Sources

- Validation of the Insomnia Severity Index as an outcome measure for insomnia research (Bastien CH, Vallières A, Morin CM, 2001)

- A new method for measuring daytime sleepiness: the Epworth sleepiness scale (Johns MW, 1991)

- Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria (Allen RP, Picchietti DL, Garcia-Borreguero D, et al., 2014)

- Horne & Östberg morningness-eveningness questionnaire: a reduced scale (Adan A, Almirall H, 1991)

- European guideline for the diagnosis and treatment of insomnia (Riemann D, Baglioni C, Bassetti C, et al., 2017)

- Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians (Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD, 2016)

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Educational summary of published research, not medical advice. Screening scores are not diagnoses. If a score is elevated or you feel unwell, talk to a clinician.

SleepShred for iPhone: https://apps.apple.com/app/id6802040541