What are the limitations of single-night polysomnography (PSG)?

Updated: Apr 29, 2020
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Standard sleep studies usually use the overnight PSG (may be performed over several nights). If daytime sleepiness is an issue and cannot be fully explained by the overnight study results, an MSLT should be performed the next day. Limitations usually stem from the fact that recording conditions may not reflect what happens during a regular night in the patient's home.

Although diagnosing a sleep problem on the basis of a recording over a single night is common practice, some authorities caution that more than one night of recording may be necessary so the patient can become comfortable with unfamiliar surroundings and sleep more naturally. This effect is greatest on the first night in the sleep laboratory (ie, first-night effect).

Sporadic events may be missed with a single-night PSG. External factors that disturb the subject's sleep may be present in the home but absent from the controlled environment of the sleep laboratory.

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