This is the current release of this guideline.

This guideline updates a previous version: American Sleep Disorders Association. Practice parameters for the use of polysomnography in the evaluation of insomnia. Sleep 1995 Jan;18(1):55-7.

The recommendation ratings (i.e., standard, guideline, option) are given in brackets after each recommendation. Definitions used in the rating schemes follow the recommendations.

1. Insomnia is an important public-health problem that requires accurate diagnosis and effective treatment. (Standard)
2. Insomnia is primarily diagnosed by clinical evaluation through a careful, detailed medical, psychiatric, and thorough sleep history (which includes assessment of sleep patterns and waking processes). (Standard)
3. Polysomnography is indicated when sleep-related breathing disorders or periodic limb movement disorder is suspected. (Standard)
4. Polysomnography is indicated when initial diagnosis is uncertain, treatment fails (behavioral or pharmacologic), or precipitous arousals occur with violent or injurious behavior. (Guideline)
5. Polysomnography is not indicated for the routine evaluation of transient or chronic insomnia. (Guideline)
6. Polysomnography is not indicated for the routine evaluation of insomnia due to psychiatric disorders. (Guideline)
7. Polysomnography is not clinically useful in differentiating the insomnia associated with dementia from other forms of insomnia, including insomnia associated with depression. (Guideline)
8. Polysomnography is not useful in establishing the diagnosis of insomnia associated with fibromyalgia or chronic fatigue syndrome because the alpha-delta sleep pattern described in fibromyalgia syndrome is a nonspecific finding. (Guideline)

Definitions:

Standard

A standard is a generally accepted patient care strategy reflecting a high degree of clinical certainty. The term standard generally implies a basis in either Level I evidence directly addressing the clinical issue or overwhelming Level II evidence.

Guideline

A guideline is a patent care strategy reflecting a moderate degree of clinical certainty. The term guideline implies a basis in Level II evidence or a consensus of Level III evidence.

Option

An option is a patient care strategy reflecting uncertain clinical use. The term option implies either inconclusive or conflicting evidence, or conflicting expert opinion.

None provided

Recommendations are rated as standards, guidelines, or options based on evidence from studies published in peer-reviewed journals that were evaluated and listed in the evidence tables (see Tables 3A, 3B, and 3C in the original guideline document). However, when scientific evidence is not available, insufficient, or inconclusive, the recommendations were based on consensus opinion of the committee.

Not applicable: The guideline was not adapted from another source.

1995 (revised 2003 Sep)

American Academy of Sleep Medicine - Professional Association

American Academy of Sleep Medicine

Standards of Practice Committee

Committee Members: Michael Littner, MD (VA Greater Los Angeles Healthcare System and UCLA School of Medicine, Sepulveda, CA); Max Hirshkowitz, PhD (Baylor College of Medicine and VA Medical Center, Houston, TX); Milton Kramer, MD (Maimoides Medical Center, Psychiatry Department, Brooklyn, NY, and New York University School of Medicine, New York, NY); Sheldon Kapen, MD (VA Medical Center and Wayne State University, Detroit, MI); W. McDowell Anderson, MD (College of Medicine, University of South Florida, Tampa, FL); Dennis Bailey, DDS (Englewood, CO); Richard B. Berry, MD (University of Florida Health Science Center, Gainesville, FL); David Davila, MD (Baptist Medical Center, Little Rock, AR); Stephen Johnson, MD (St. Patrick Hospital Sleep Center, Missoula, MT); Clete Kushida, MD, PhD (Stanford University Center of Excellence for Sleep Disorders, Stanford, CA); Daniel I. Loube, MD (Sleep Medicine Institute, Swedish Medical Center, Seattle, WA); Merrill Wise, MD (Departments of Pediatrics and Neurology, Baylor College of Medicine, Houston, TX); B. Tucker Woodson, MD (Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI)

All members of the American Academy of Sleep Medicine Standards of Practice Committee and Board of Directors completed detailed conflict-of-interest statements and were found to have no conflicts of interest with regard to this subject.

This is the current release of this guideline.

This guideline updates a previous version: American Sleep Disorders Association. Practice parameters for the use of polysomnography in the evaluation of insomnia. Sleep 1995 Jan;18(1):55-7.

None available

None available

This summary was completed by ECRI on April 25, 1999. The information was verified by the guideline developer on May 24, 1999. This summary was updated by ECRI on March 4, 2004. The information was verified by the guideline developer on March 25, 2004.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the American Academy of Sleep Medicine (AASM) for information regarding reproduction of AASM guidelines.