Practice parameters for using polysomnography to evaluate insomnia: an update.
Insomnia is a common and clinically important problem. It may arise directly from a sleep-wake regulatory dysfunction and/or indirectly result from comorbid psychiatric, behavioral, medical, or neurological conditions. As an important public-health problem, insomnia requires accurate diagnosis and effective treatment. Insomnia is primarily diagnosed clinically with a detailed medical, psychiatric, and sleep history. Polysomnography is indicated when a sleep-related breathing disorder or periodic limb movement disorder is suspected, initial diagnosis is uncertain, treatment fails, or precipitous arousals occur with violent or injurious behavior. However, polysomnography is not indicated for the routine evaluation of transient insomnia, chronic insomnia, or insomnia associated with psychiatric disorders.
VA Greater Los Angeles Healthcare System, Sepulveda, CA, USA.
Michael
M
Littner
Max
M
Hirshkowitz
Milton
M
Kramer
Sheldon
S
Kapen
W McDowell
WM
Anderson
Dennis
D
Bailey
Richard B
RB
Berry
David
D
Davila
Stephen
S
Johnson
Clete
C
Kushida
Daniel I
DI
Loube
Merrill
M
Wise
B Tucker
BT
Woodson
D002908:Chronic Disease; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D006801:Humans; D017286:Polysomnography / Q000379:methods*; D010818:Practice Patterns, Physicians'; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis*