Other investigations

Further laboratory investigations may be appropriate depending on the nature of the sleep problem and the purpose of the assessment.

• The multiple sleep latency test, involving the recording of basic polysomnography variables, quantifies the degree of daytime sleepiness by measuring the time a patient takes to fall asleep during five opportunities to do so during the day. In adults a mean sleep latency of 5 min or less indicates pathological sleepiness (usually of organic origin); 5 to 10 min is a grey area which usually includes excessive sleepiness associated with primary psychiatric disorder; while longer than 10 min is normal. These values do not apply to children, whose sleep tendency varies with age ( Chaptei^,^?).

• HLA typing for the investigation of narcolepsy, and nocturnal penile tumescence monitoring in the differential diagnosis of organic versus psychogenic impotence, are examples of other specific tests that may be appropriate depending on the clinical problem.

• Formal psychometric assessment or, in children, developmental assessment may be appropriate.

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