Key Practice Recommendations

These key learning points summarize the consensus- and evidence-based recommendations included in this edition. The sources listed here for each statement recommend that physicians perform or implement these actions directly in a clinical setting. A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/pubs/afp/issues/2004/0201/p548.html.

1. Consider polysomnography to evaluate for sleep disorders such as nocturnal seizures, narcolepsy, periodic limb movement disorder, and rapid eye movement sleep behavior disorder.
Evidence rating: SORT A
Source: Section One, reference 8

2. Obtain polysomnography to evaluate for sleep-related breathing disorders, including obstructive sleep apnea, central sleep apnea, and sleep-related hypoxia or hypoventilation.
Evidence rating: SORT A
Source: Section One, reference 8

3. Recommend that adults ages 18 to 64 years sleep for 7 to 9 hours per night.
Evidence rating: SORT A
Source: Section One, reference 17

4. Use cognitive behavior therapy for insomnia to treat chronic insomnia and chronic insomnia disorder in adults.
Evidence rating: SORT B
Source: Section Two, references 36 and 49

5. Use video polysomnography to diagnose patients with complex or violent parasomnias, especially if nocturnal seizures or sleep-related movement disorders are suspected.
Evidence rating: A
Source: Section Three, references 1 and 44

6. To improve sleep quality for hospitalized patients, use nonpharmacologic strategies such as providing eye masks and earplugs, minimizing noise, and adjusting ambient light.
Evidence rating: SORT A
Source: Section Four, reference 13

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