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Sleep-wake disorders based on a polysomnographic diagnosis. A national cooperative study
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1982
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Sleep DisordersParasomniasSleep HealthSleep-wake DisordersPolysomnographic DiagnosisBreathing DisordersDiagnosisSleep-related Breathing DisorderSleep MedicineClinical EpidemiologySleep PhysiologyAsdc Classification SystemSleepPsychiatryHypersomniaDiagnostic CriterionImpotency EvaluationsInsomniaSleep Disordered BreathingSleep DisorderPatient SafetySleep ApneaMedicineSleep QualityNational Cooperative StudySleep Psychology
The study discusses how its findings can be applied by practicing physicians. The study analyzed nearly 5,000 patient records from 11 sleep‑wake disorder clinics over two years, each patient undergoing polysomnographic study and diagnosis using the ASDC classification system. Among the 5,000 patients, hypersomnia was the most common category (42%, rising to 51% when excluding impotence evaluations), followed by insomnia (26%, 31% without impotence), parasomnias (3%, 15% without impotence), and sleep‑wake schedule disturbances (2%, 3% without impotence); within hypersomnia, sleep apnea (43%) and narcolepsy (25%) were most prevalent, and psychiatric disorders accounted for 35% of insomnia cases. JAMA 1982;247:997-1003.
Under the organizational aegis of Project Sleep and the Association of Sleep Disorders Centers (ASDC), nearly 5,000 patient records from 11 sleep-wake disorders clinics were analyzed in a cooperative study. These cases represented the diagnostic experience of each of these centers over a two-year period. Each patient underwent polysomnographic study, and his or her condition was diagnosed according to the ASDC classification system, a new, standardized nosology of sleep disorders medicine. The most common major diagnostic category was "disorders of excessive sleepiness (hypersomnia)," 42%; this was followed by "disorders of initiating and maintaining sleep (insomnia)," 26%; "penile tumescence evaluations for impotency," 17%; "parasomnias," 3%; and "disorders of the sleep-wake schedule," 2%. If the impotency evaluations performed in the sleep clinics are removed from the total, leaving only the population that was studied because of sleep complaints, the proportions of the diagnostic categories are hypersomnia, 51%; insomnia, 31%; parasomnias, 15%; and sleep-wake schedule disturbances, 3%. The most prevalent diagnoses in the hypersomnia category were sleep apnea (43%) and narcolepsy (25%). Psychiatric disorders (35%) comprised the most frequent group of insomnia diagnoses, though a variety of other disorders were common. The applications of these results for the practicing physician are discussed. (<i>JAMA</i>1982;247:997-1003)