Utility of sleep studies in neurologic practice

Sleep disorders are frequent in patients with neurologic disease. This article provides an approach to the patient with sleep complaints that can be implemented during the course of a neurologic evaluation. Recognition of a sleep complaint is the key that leads to use of appropriate scales and sleep diaries to form a differential sleep diagnosis. Choosing the correct sleep test is essential to confirm diagnosis and plan therapy. We describe the important sleep tests for practicing neurologists: polysomnography, multiple sleep latency test, and maintenance of wakefulness test, as well as actigraphy and oximetry. The approved use of limited channel home tests (also known as "out of center testing," or "portable monitoring") is reviewed and an algorithm provided to guide the approach to the sleepy patient.