Skip Navigation LinksHome > February 2013 - Volume 19 - Issue 1, Sleep Disorders > Approach to and Evaluation of Sleep Disorders
CONTINUUM: Lifelong Learning in Neurology:
doi: 10.1212/01.CON.0000427214.00092.0f
Review Articles

Approach to and Evaluation of Sleep Disorders

Shelgikar, Anita Valanju MD; Chervin, Ronald MD, MS, FAASM, FAAN

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Abstract

Purpose of Review: This article provides a framework for the clinical assessment of patients with sleep-related complaints and outlines a systematic approach to a sleep-specific history and physical examination, subjective assessment tools, and diagnostic testing modalities.

Recent Findings: Physical examination findings may suggest the presence of a sleep disorder, and obstructive sleep apnea in particular, but the clinical history remains the most important element of the assessment for most sleep problems. While nocturnal polysomnography in a sleep laboratory remains the gold standard for diagnosis of sleep-disordered breathing, out-of-center testing may be considered when the clinician has a high pretest suspicion for obstructive sleep apnea and the patient has no significant cardiopulmonary, neuromuscular, or other sleep disorders.

Summary: Sleep-related symptoms are common in adult and pediatric patients. A comprehensive sleep history, physical examination with detailed evaluation of the head and neck, and judicious use of sleep-specific questionnaires guide the decision to pursue diagnostic testing. Understanding of the benefits and limitations of various diagnostic modalities is important as the spectrum of testing options increases.

© 2013 American Academy of Neurology

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