Practice parameters for the indications for polysomnography and related procedures: an update for 2005.
These practice parameters are an update of the previously-published recommendations regarding the indications for polysomnography and related procedures in the diagnosis of sleep disorders. Diagnostic categories include the following: sleep related breathing disorders, other respiratory disorders, narcolepsy, parasomnias, sleep related seizure disorders, restless legs syndrome, periodic limb movement sleep disorder, depression with insomnia, and circadian rhythm sleep disorders. Polysomnography is routinely indicated for the diagnosis of sleep related breathing disorders; for continuous positive airway pressure (CPAP) titration in patients with sleep related breathing disorders; for the assessment of treatment results in some cases; with a multiple sleep latency test in the evaluation of suspected narcolepsy; in evaluating sleep related behaviors that are violent or otherwise potentially injurious to the patient or others; and in certain atypical or unusual parasomnias. Polysomnography may be indicated in patients with neuromuscular disorders and sleep related symptoms; to assist in the diagnosis of paroxysmal arousals or other sleep disruptions thought to be seizure related; in a presumed parasomnia or sleep related seizure disorder that does not respond to conventional therapy; or when there is a strong clinical suspicion of periodic limb movement sleep disorder. Polysomnography is not routinely indicated to diagnose chronic lung disease; in cases of typical, uncomplicated, and noninjurious parasomnias when the diagnosis is clearly delineated; for patients with seizures who have no specific complaints consistent with a sleep disorder; to diagnose or treat restless legs syndrome; for the diagnosis of circadian rhythm sleep disorders; or to establish a diagnosis of depression.
Kushida
Clete A
CA
Stanford University Center of Excellence for Sleep Disorders, Stanford, CA, USA.
Littner
Michael R
MR
Morgenthaler
Timothy
T
Alessi
Cathy A
CA
Bailey
Dennis
D
Coleman
Jack
J
Friedman
Leah
L
Hirshkowitz
Max
M
Kapen
Sheldon
S
Kramer
Milton
M
Lee-Chiong
Teofilo
T
Loube
Daniel L
DL
Owens
Judith
J
Pancer
Jeffrey P
JP
Wise
Merrill
M
D021081:Chronobiology Disorders / Q000175:diagnosis / Q000503:physiopathology; D045422:Continuous Positive Airway Pressure / Q000379:methods; D006801:Humans; D009290:Narcolepsy / Q000175:diagnosis / Q000503:physiopathology; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis / Q000503:physiopathology; D017286:Polysomnography / Q000379:methods*; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000503:physiopathology; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D020921:Sleep Arousal Disorders / Q000175:diagnosis / Q000503:physiopathology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000503:physiopathology; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology