THE INDICATIONS FOR POLYSOMNOGRAPHY AND RELATED PROCEDURES

This paper is a review of the literature on the use of polysomnography in the diagnosis of sleep disorders in the adult. It is based on a se arch of MEDLINE from January 1966 through April 1996. It has been revi ewed and approved by the Board of Directors of the American Sleep Diso rders Association and provides the background for the accompanying ASD A Standards of Practice Committee's Parameters for the Practice of Sle ep Medicine in North America. The diagnostic categories reviewed are: sleep-related breathing disorders; other respiratory disorders; narcol epsy; parasomnias and sleep-related epilepsy; restless legs syndrome a nd periodic limb movement disorders; insomnia; and circadian rhythm sl eep disorders. Where appropriate, previously published practice parame ters papers are cited and discussed. The relevant published peer-revie wed literature used as the basis for critical decisions was compiled i nto accompanying evidence tables and is analyzed in the text. In the s ection on the assessment of sleep apnea syndrome, options for estimati ng pretest probability to select high risk patients are also reviewed. Sleep-testing procedures other than standard polysomnography are also addressed (daytime polysomnography, split-night studies, oximetry, li mited full respiratory recordings, and less-than-full respiratory reco rding) and treatment-related follow-up studies are discussed.