Am J Psychiatry 1988; 145:346-349
Copyright © 1988 by American Psychiatric Association
The role of polysomnography in the differential diagnosis of chronic insomnia
EA Jacobs, CF Reynolds 3d, DJ Kupfer, PA Lovin and AB Ehrenpreis
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213.
The authors examined the accuracy of the differential diagnosis of chronic
insomnia with and without sleep laboratory studies in a consecutive series
of 123 patients. All patients were evaluated by means of a sleep/wake log,
a sleep habits questionnaire, structured psychiatric and clinical
interviews, and a minimum of two consecutive nights of polysomnography.
Notwithstanding a high rate of Research Diagnostic Criteria (RDC)-diagnosed
psychopathology (63%) in this sample, the major finding was that in 49% of
the patients laboratory results added to, refuted, and/or failed to support
the clinical impression. This resulted in substantial modification of the
initial diagnostic formulation and therefore in increased specificity of
diagnosis.
