Testing & Diagnosis
Diagnosis
Initially, a patient complaining of unusual sleep-related behaviors will be evaluated to determine whether further evaluation is necessary. A sleep specialist will inquire about the exact nature of the nocturnal events. Because many episodes are associated with partial or complete amnesia, additional descriptive information from a bed partner may be necessary. Additionally, home video tapes of the nocturnal disturbances may be useful and aide with diagnosis.
Indications for formal evaluation of parasomnias include actions that:
- are potentially violent or injurious
- are extremely disruptive to other household members
- result in the complaint of excessive daytime sleepiness
- are associated with medical, psychiatric, or neurological symptoms or findings
Testing & Evaluation
Specific attention should be paid to parasomnia complaints above. Formal polysomnographic studies can provide direct or indirect diagnostic information in most cases. Emphasis must be placed on the types of studies requested. In addition to the physiologic parameters monitored in the standard polysomnogram, there must be an expanded EEG mantage and continuous audiovisual monitoring. Observations by qualified technologist is invaluable. If nocturnal events are infrequent, multiple-night studies may be required to capture events. Patient may be asked to purposefully sleep deprive themselves prior to the polysomnographic study. This may increase the likelihood of capturing events in the sleep laboratory.
