Referral criteria from primary care (parasomnias in an adult)

When to consider referral to a sleep specialist.

• all patients with adult onset parasomnias (NREM and REM) need to be referred to a sleep specialist for an evaluation
  • evaluation should include a nocturnal polysomnographic study, and the sleep specialist will determine whether the patient needs an MRI of the brain or a neurologic work up
  • when parasomnias lead to injury or psychological distress to the patient or the bed partner, result in law breaking, impair functioning due to excessive daytime sleepiness, cause weight gain, or complicate the treatment of a primary Axis I disorder, a referral should be made to a sleep specialist for evaluation and treatment.

Reference:

• Markov D et al. Update on Parasomnias. Psychiatry (Edgmont). 2006 Jul; 3(7): 69–76.