What Tests Should Be Conducted For Severe Chronic Insomnia?
Posted on Sat, 29 Mar 2014
99504
Question: This is for a top notch sleep specialist. What tests, lab, possibly radiology would you order on a patient that c/o of approximately 20 yr Hx of severe chronic insomnia? Is thyroid the only hormone involved in the sleep process? Thanks, Jacki
Brief Answer:
Sleep Study, Flexible Scopy, Dynamic MRI
Detailed Answer:
Hi,
Thank you for your query.
1. I would divide the evaluation into:
Mandatory (Minimum)
Recommended (Ideal)
Mandatory:
a. Routine: (i) Routine Clinical Examination
(ii) Modified Friedman Staging
FNPL*: (i) Flexible Nasopharyngoscopy
(ii) Awake, Lying Down
PSG**: (i) Polysomnpography
(ii) Level III Screening
Recommended:
b. Routine: (i) Calculate the AHI (Mild:5–15/hr; Moderate:15–30/hr; Severe:>30/hr)
(ii) Determine whether Central / Obstructive or Mixed.
FNPL*: (i) Drug Induced Sleep Endoscopy (DISE)
(ii) Multichannel Pressure Recording
PSG**: (i) Polysomnography
(ii) Level I
*FNPL: Fibreoptic NasoPharyngoLaryngoscopy.
** PSG: Polysomnography
2. Dynamic MRI is an important tool.
3. Lifestyle Modifications (weight loss) , Oral appliance, PAP (Positive Airway Pressure) trials should be done.
4. Thyroid hormone is not the only hormone involved in the sleep process. For example, Melatonin is an important hormone which regulates the sleep-wake cycle.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
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What Tests Should Be Conducted For Severe Chronic Insomnia?
Brief Answer:
Sleep Study, Flexible Scopy, Dynamic MRI
Detailed Answer:
Hi,
Thank you for your query.
1. I would divide the evaluation into:
Mandatory (Minimum)
Recommended (Ideal)
Mandatory:
a. Routine: (i) Routine Clinical Examination
(ii) Modified Friedman Staging
FNPL*: (i) Flexible Nasopharyngoscopy
(ii) Awake, Lying Down
PSG**: (i) Polysomnpography
(ii) Level III Screening
Recommended:
b. Routine: (i) Calculate the AHI (Mild:5–15/hr; Moderate:15–30/hr; Severe:>30/hr)
(ii) Determine whether Central / Obstructive or Mixed.
FNPL*: (i) Drug Induced Sleep Endoscopy (DISE)
(ii) Multichannel Pressure Recording
PSG**: (i) Polysomnography
(ii) Level I
*FNPL: Fibreoptic NasoPharyngoLaryngoscopy.
** PSG: Polysomnography
2. Dynamic MRI is an important tool.
3. Lifestyle Modifications (weight loss) , Oral appliance, PAP (Positive Airway Pressure) trials should be done.
4. Thyroid hormone is not the only hormone involved in the sleep process. For example, Melatonin is an important hormone which regulates the sleep-wake cycle.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.