Unmet need for a holistic approach to insomnia diagnosis – a review of current tools in practice

Background: Insomnia is a very common and yet challenging condition encountered in clinical practice. Clinical evaluation, often with the help of questionnaires is used to diagnose and quantify this condition. However, the questionnaires are highly heterogeneous in their scope and outlook and give varying information on different aspects of insomnia. Research questionnaires on insomnia abound in clinical literature but are not useful in the clinical setting to help in therapeutic decision-making. This paper is a review of the scope and limitations of some of the commonly used questionnaires in the diagnosis and evaluation of insomnia in the clinical setting. Methods: A thorough literature search of studies evaluating diagnosis and evaluation of insomnia were included. The studies were selected on basis of their utility in clinical settings and the quality of the research reporting the results of their use. The usefulness and scope of the questionnaire and voids in their utility were discussed. Out of a total of 3872 articles, a final of 11 studies were taken up for final study as per the guidelines of reporting of systematic reviews PRISMA statement, 2020. Results: The included articles showed great heterogeneity in their scope as well as outcome measures. The older studies were of low methodological quality and limited clinical utility. Administration in a clinical setting was difficult for many while scoring questionnaires was complex and cumbersome. Conclusion: There is an unmet need for a holistic and easily administrable assessment measure of insomnia remains.