American College of Occupational and Environmental Medicine

View all recommendations from this society

Released February 24, 2014

Don’t routinely order sleep studies (polysomnogram) to screen for/diagnose sleep disorders in workers suffering from chronic fatigue/insomnia.

Workers who suffer from fatigue, but do not have other sleep apnea symptoms (e.g., waking with a very sore or dry throat, loud snoring) or risk factors (obesity, neck diameter, fullness of soft tissues in the oropharynx, etc.), may not need a polysomnogram (sleep study). While a polysomnogram is an essential tool in diagnosing many sleep disorders, it is not usually necessary in assessing insomnia. If lack of sufficient sleep or the job schedule is affecting the patient’s sleep patterns, then behavioral modification and attempts to modify the sleep schedule and improve sleep hygiene should be attempted first.

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 American College of Occupational and Environmental Medicine (ACOEM) routinely develops evidence-based clinical practice guidelines to assist physicians in improving or restoring the health of those workers who incur occupationally related illnesses or injuries. ACOEM’s Practice Guidelines, developed by expert panels, are the gold standard in effective treatment of occupational injuries and illnesses and are the only evidence-based guidelines that focus on returning employees to work within 90 days of an injury or illness. In addition, the College promotes the high-quality practice of occupational and environmental medicine (OEM) through the publication, via the scientific peer-reviewed Journal of Occupational and Environmental Medicine, of position statements and guidance documents relevant to the field. These documents are developed by ACOEM task forces made up of physician member volunteers and are approved by the Board of Directors.

After input from ACOEM leaders and approval from the Board of Directors, five topics were selected from the Practice Guidelines and the ACOEM position paper on fatigue risk management in the workplace for this campaign. The position paper and the methodology for the development of the Practice Guidelines are available at

ACOEM’s disclosure and conflict of interest policy can be found at


Lerman SE, Eskin E, Flower DJ, George EC, Gerson B, Hartenbaum N, Hursh SR, Moore-Ede M; American College of Occupational and Environmental Medicine Presidential Task Force on Fatigue Risk Management. Fatigue risk management in the workplace. J Occup Environ Med. 2012 Feb;54(2):231–58.