Focusing on the experience of insomnia.

Although insomnia is defined by sleep disturbances, patients also complain of daytime problems. To better define the range of experiences associated with insomnia, we conducted 3 focus groups comprising 16 patients with chronic insomnia. Participants were asked to describe their experience of insomnia and its effects, the changes that occurred with improved sleep, and what clinicians should ask about insomnia. Participants affirmed daytime consequences that are frequently cited in the literature: fatigue, irritability, and decreased performance. In addition, members of each group reported that they felt that the impact that insomnia had on their lives was pervasive and misunderstood by others who were significant to them or treating their sleep complaints. Daytime problems are salient descriptors of the insomnia experience. Assessing the patient's daytime experiences is valued by patients with insomnia and may be used as a benchmark for treatment response.