Outcome of patients with sleep complaints and normal polysomnograms.

STUDY OBJECTIVE To determine the outcome in patients with sleep complaints and normal polysomnograms (PSG). BACKGROUND PSG is used in the evaluation of persons with sleep complaints. There is a small amount of literature available on patients with sleep complaints and normal PSGs. METHODS PSGs interpreted as normal at the sleep laboratory at Wake Forest University Baptist Medical Center over a 3-year period were considered for inclusion. All PSG requests were screened for appropriateness. Follow-up data were obtained by structured telephone interview (within a period of 5 months of PSG) and chart review. This interview requested: (1) main sleep complaint, (2) diagnosis given by the ordering physician, (3) treatment for the sleep complaint, (4) further studies, and (5) overall satisfaction. RESULTS Forty-six patients were identified with a normal PSG, and 27 (58%) were successfully contacted for the telephone interview. Of these 27 patients, 8 were men and 19 were women. Fifty-two percent of patients were not given a diagnosis by the referring physician after their normal PSG to explain their sleep symptoms. Eight patients (29%) were offered treatment for their sleep complaints despite their normal PSGs. Twenty patients (74%) reported no change in their sleep quality since the PSG. Most patients (66%) did not find the PSG helpful. CONCLUSIONS The majority of patients with sleep complaints and normal PSG were not given a clear diagnosis by the referring physician, and sleep complaints persist after a normal PSG. Further evaluation by a sleep specialist may be appropriate.