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.