Orr W C
Med Clin North Am. 1985 Nov;69(6):1153-67. doi: 10.1016/s0025-7125(16)30980-4.
Polysomnography is an indispensable tool in dealing with sleep disorders, but because of its inherent logistical complexity and expense, it must be used with discretion. Many sleep disorders can be diagnosed clinically by the astute physician and treated empirically with good results. On the other hand, there are numerous circumstances in which the best clinical judgment indicates a polysomnographic evaluation. The ubiquity of sleep complaints in medical practice, and the knowledge that they may in some instances be associated with life-threatening medical complications, compel the modern clinician to obtain a basic knowledge of the appropriate utilization of the sleep laboratory. Polysomnography is a useful adjunct to the clinician because it provides objective information to be integrated into the overall clinical picture in the evaluation of the patient's complaint. Polysomnography should be utilized in cases where the results will clearly make a difference in the differential diagnosis or in the treatment plan. If a clinician's basic approach to the evaluation of the patient or his treatment will not be substantially altered by polysomnography, it should not be undertaken. The results of polysomnography should give the referring physician critical information concerning the type of disorder, its severity, appropriate treatment and necessary follow-up. Unfortunately, few, if any, hard and fast rules exist concerning the appropriate utilization of polysomnography. As always in medicine, the physician must take a careful history, and integrate it with other basic laboratory tests and the physical examination, and then decide whether polysomnography will provide useful additional information. The ability to assess physiological phenomena during sleep objectively has clearly advanced the study of sleep disorders to the point that it is now considered an integral part of internal medicine. Polysomnography has made available the objective study and documentation of sleep disorders which, coupled with increasing sophistication concerning the natural history of sleep disorders, have created a new and exciting discipline in clinical medicine.
多导睡眠图是诊断睡眠障碍必不可少的工具，但因其本身在后勤安排上的复杂性和费用问题，必须谨慎使用。许多睡眠障碍可由经验丰富的医生通过临床诊断，并凭经验进行治疗，且效果良好。另一方面，在许多情况下，最佳的临床判断表明需要进行多导睡眠图评估。睡眠问题在医疗实践中很常见，而且人们知道在某些情况下，它们可能与危及生命的医疗并发症相关，这就迫使现代临床医生掌握睡眠实验室合理使用方面的基本知识。多导睡眠图对临床医生来说是一种有用的辅助手段，因为它能提供客观信息，以便在评估患者的病情时融入整体临床情况。在多导睡眠图结果会对鉴别诊断或治疗方案产生明显影响的情况下，应使用该技术。如果临床医生对患者评估或治疗的基本方法不会因多导睡眠图而发生实质性改变，就不应进行此项检查。多导睡眠图的结果应能为转诊医生提供有关疾病类型、严重程度、适当治疗方法和必要随访的关键信息，但不幸的是，关于多导睡眠图的合理使用，几乎没有什么严格的规则。与医学中一贯的做法一样，医生必须仔细询问病史，并将其与其他基本实验室检查和体格检查相结合，然后再决定多导睡眠图是否能提供有用的额外信息。客观评估睡眠期间生理现象的能力，显然推动了睡眠障碍研究的发展，使其达到了现在被视为内科不可或缺一部分的程度。多导睡眠图使睡眠障碍的客观研究和记录成为可能，再加上对睡眠障碍自然史的认识日益深入，在临床医学中创造了一个全新且令人兴奋的学科。
