Insomnia or something else?

[sleepyt]

After an overnight sleep study my primary care doctor has left me a message indicating she thinks I have insomnia and wants me to make an appointment with the sleep center for behavioral therapy.  (I currently already practice good sleep hygiene and do many of the things suggested on your website and by a psychologist I have seen who does behavioral therapy. I've also tried taking prescription benzodiazepines on the nights I have trouble falling asleep, but these leave me feeling hung over and even more exhausted the next day.  I do not feel it is as clear-cut as insomnia, but would like to ask your opinion.  I haven't seen the polysomnogram report, so I don't know anything it says.
The night of the study it did take me approximately 45 minutes to fall asleep, and from what I remember I woke up about 2 or 3 times but was only awake for a minute or two.
At home I go back and forth between taking 15 minutes to an hour to fall asleep (occasionally longer), and I wake up often, sometimes 15 or 20 times, but usually only very briefly.  However some nights I don't remember waking up at all. No matter what, whether I appear to have slept 9 hours or 3 hours I am excessively tired all day.  

I am prescribed Adderall to help with the daytime sleepiness.  I recently experimented by not taking any medication during the day.  Without the aid of a stimulant I can stay awake approximately 4 hours before the overpowering urge to nap strikes. If I can fight this urge off I do, but I can never go any longer than 7 hours before I really do need to lie down and nap.  
With Adderall I can go through a day without a nap, but I still feel excessively tired.  

But, as I said, it's not every night that I have trouble sleeping, and more often than not it occurs just before or during my menstrual cycle and seems hormonally related.  The excessive daytime sleepiness however is every day without fail.  Does this sound like a case of insomnia?  

[sleepyt]

Thanks for responding.  Is a high spontaneous arousal index common in insomnia?  I got the results and it shows nothing clear cut, but my arousal index is 32.3/hour, which seems extremely high to me.  There's no indication of what caused these arousals.  
Sleep latency was almost 70 minutes, WASO 40 min and REM latency 215 minutes.
however it showed 10% Stage N1, 57% N2, 18% N3 and 16% Stage R, which all seem fairly normal.
I had only 29 hypopneas and 1 central apnea, and zero PLMs noted.

My sleep problems have been going on for over 5 years now.  I just want to get my energy back and stop falling asleep all day.  My doctor seems to feel these results don't warrant much discussion or follow up. The sleep medicine doctor who interpreted the report said it was a normal sleep study and did not indicate any diagnosis at all.  My primary thinks I have insomnia or stress (I don't; the only stress I have is from having to nap all day) and wants me to simply try following some sleep hygiene steps (which I already follow religiously), or she said I could try having a follow up study to see if anything else shows up (which I can't afford).  I know you can't diagnose anything or make any definitive statements, but based on the results I got does it sound like any sleep disorder you've come across?

[Gregg D Jacobs, Ph.D.]

Although daytime sleepiness is not typically associated with insomnia, it is hard to say much more without knowing the results of your sleep study. Therefore, you should meet with the Dr. who read your study to review the sleep study together and to ask him/her these same questions.