Practice parameters for the use of polysomnography in the evaluation of insomnia

Abstract

These clinical guidelines, which have been reviewed and approved by the Board of Directors of the American Sleep Disorders Association, provide recommendations for the practice of sleep medicine in North America for the use of polysomnography in the evaluation of insomnia. The diagnosis of sleeplessness, or insomnia, is primarily based upon a careful, detailed medical and psychiatric history. Clinicians have sought an objective means to measure this symptom and have, therefore, turned to polysomnography. The American Sleep Disorders Association has assessed the available data and produced guidelines for the use of polysomnography in evaluating the symptoms of insomnia. Polysomnography is not required for the routine evaluation of transient or chronic insomnia. Polysomnography is, however, indicated in the evaluation of suspected sleep-related breathing disorders and periodic limb movement disorder, which may occasionally contribute to a complaint of insomnia, particularly in middle-aged or elderly patients. In addition, when the cause of insomnia is uncertain or when behavioral or pharmacologic therapy is unsuccessful, polysomnography may be helpful.