Choosing Wisely:

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

Rationale and Comments: 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), 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.
Sponsoring Organizations:
  • American College of Occupational and Environmental Medicine
  • Sources:
  • Expert consensus
  • Disciplines:
  • Pulmonary medicine
  • Neurologic
  • References: • 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.

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