Appropriate Referral Indications?

[prominence]

Besides ruling out obstructive sleep apnea, are there any other suspected sleep disorders that would constitute an appropriate PSG (polysomnography) referral?

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[Bobblehead]

There are plenty of other reasons such as parasomnias, RLS in children, other sleep apneas (central), narcolepsy/hypersomnia.

 

[danielmd06]

Besides ruling out obstructive sleep apnea, are there any other suspected sleep disorders that would constitute an appropriate PSG (polysomnography) referral?

If you suspect a PSG is needed for any sleeping issue, but the case isn't straightforward obstructive sleep apnea, I would suggest referring to a sleep specialist first and letting them decide what diagnostic testing (if any) needs to be done.

 

[michaelrack]

Reasons, in addition to suspected osa, for which a sleep specialist might do a psg:

1. narcolepsy (+ MSLT) and other CNS hypersomnias
2. parasomnias (sometimes)
3. other forms of sleep apnea besides osa
4. impotence (with the penile pressure gauges, I forgot the formal name of this type of study)- still covered by medicare, very rarely done anymore.
5. periodic limb movements (sometimes)

 

[Bobblehead]

4. impotence (with the penile pressure gauges, I forgot the formal name of this type of study)- still covered by medicare, very rarely done anymore.

I don't think our lab would perform nocturnal penile tumescence testing. I don't think we even have the right equipment/channels for it. I think the tech is also to manually check the rigidity of the erection and document it in the test record. I wonder how well that one would go over nowadays.

 

[Manicsleep]

This is where buying all those cheap stamps really comes in handy.

 

[medicienne]

This is where buying all those cheap stamps really comes in handy.