Avoid polysomnography in chronic insomnia patients unless symptoms suggest a comorbid sleep disorder.
|Rationale and Comments:||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 may confirm self-reported symptoms of chronic insomnia, it does not provide additional information necessary for diagnosis of chronic insomnia. However, polysomnography 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.|
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