American Academy of Sleep Medicine

View all recommendations from this society

Released December 2, 2014

Avoid polysomnography in chronic insomnia patients unless symptoms suggest a comorbid sleep disorder.

Chronic insomnia is diagnosed by a clinical evaluation that includes a thorough sleep history along with a medical, substance and psychiatric history. Some instruments can be helpful at the clinical encounter: these include self-administered questionnaires, sleep logs completed at home and symptom checklists. Although polysomnography (PSG) may confirm self-reported symptoms of chronic insomnia, it does not provide additional information necessary for diagnosis of chronic insomnia. However, PSG is indicated in some specific circumstances, for example when sleep apnea or sleep-related movement disorders are suspected, the initial diagnosis is uncertain, behavioral or pharmacologic treatment fails, or sudden arousals occur with violent or injurious behavior.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Executive Committee of the American Academy of Sleep Medicine developed 21 candidate recommendations for ways in which medical waste could be minimized while care for patients with sleep disorders is improved. Members of the Executive Committee then voted to assign priorities to each, and the top five were selected. Final wording of the five statements were approved by the full Board of Directors of the American Academy of Sleep Medicine. The Secretary/Treasurer and research staff of the American Academy of Sleep Medicine developed rationale and references for each recommendation. The final statements, explanations and citations were approved by a final vote of the Board of Directors.

The AASM disclosure and conflict of interest policy can be found at aasmnet.org.

Sources

Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008 Oct 15;4(5):487-504.

Sateia M, Doghramji K, Hauri P, Morin CM. Evaluation of chronic insomnia. Sleep. 2000 Mar 15;23(2):243-308.

Chesson A Jr, Hartse K, Anderson WM, Davila D, Johnson S, Littner M, Wise M, Rafecas J. Practice parameters for the evaluation of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 2000 Mar 15;23(2):237-41.

Reite M, Buysse D, Reynolds C, Mendelson W. The use of polysomnography in the evaluation of insomnia. Sleep 1995;18(1):58-70.