Relevant personal and societal factors (isolation, loneliness, bereavement, change in residence, security, or financial concerns) that may indicate a tempo- rary situational insomnia are key historical factors. Medical and psychiatric conditions that can impair sleep, including drug and alcohol history, also should be carefully investi- gated (Table 2).
A thorough but focused physical examination, including neurologic and mental status assessment, should seek con- firmation of conditions suggested in the history, including evidence of comorbid, insomnia-promoting conditions listed in Table 2.