Practice Guidelines and Clinical Assessment Tools

Sleep Disorders Practice Guidelines

American Academy of Sleep Medicine
Provides a number of clinical practice guidelines for many Sleep Disorders.

Practice Parameters for the Treatment of Narcolepsy: An Update for 2000

Evaluating Excessive Sleepiness in the Older Adult

Clinician-Administered Assessment Tools

Sleep Disorders are usually assessed using a clinical interview. In many cases it is important to gather information from someone who has witnessed sleep difficulties, such as a bed partner sleep terrors. ¹ It is important to rule out medical, neurological, and psychiatric disorders when assessing for Primary Sleep Disorders. Also, it is important rule out the affects of medications, as antidepressants, sedatives, and stimulants may impact sleep. A providers should obtain a medical and sleep history, including specific sleep complaints (i.e., difficulty falling asleep, difficulty staying asleep, premature awakenings, decreased total sleep time, poor quality sleep and/or daytime fatigue), causal factors, onset and duration of symptoms, sleep hygiene, collateral report from sleep partner, treatment history, and consequences of sleep problems.²

It may be useful have patients complete a sleep diary to track sleep patterns and habits. The National Sleep Foundation has both interactive and printable sleep diaries. Sleep laboratory studies involving polysomnography are not recommended as a first line assessment strategy. However, laboratory sleep studies may be indicated if a physiological sleep disorder, such as sleep apnea or narcolepsy, is suspected, or if a patient has not responded to first line treatment.

¹ Durand, V. M. (in press). Sleep terrors. In J. Fisher and W. O'Donohue (Eds.), Practice guidelines for evidence based psychotherapy. New York: Kluwer Academic Publications.

² McCrae, C. s., Sidney, D. N., Taylor, D. J., & Lichstein, K. L. (in press). Insomnia. In J. Fisher and W. O'Donohue (Eds.), Practice guidelines for evidence based psychotherapy. New York: Kluwer Academic Publications.

More Resources for Providers

The American Academy of Sleep offers several assessment guidelines including:

• Practice Parameters for the Evaluation of Chronic Insomnia
• Practice Parameters for the Indicatons of Polysomnography and Related Procedures: An Update for 2005

Problem Sleepiness in Your Patient
National Center on Sleep Disorders Research and Office of Prevention, Education and Control

Insomnia: Psychological Assessment and Management
C. M. Morin

Insomnia: A Clinical Guide to Assessment and Treatment
C.M.Morin & C. A. Espie

TRICARE policy for reimbursement requires that services must be medically necessary for a diagnosed psychological disorder. The disorder must be one referenced in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and must be of a severity not only to cause the patient distress but also to interfere with the patient's usual activities.