ABSTRACT
This chapter provides guidance to the aeromedical practitioner in the initial stage of an investigation and in deciding whether it would be appropriate to refer the individual to a respiratory physician or a neurologist with experience in sleep disorders. In aviation medicine, sleep diaries are usually concerned with the analysis of the work and rest patterns of aircrew, but they are also helpful in dealing with a suspected disorder of sleep – particularly a disturbance of the circadian rhythm. The principle behind actigraphy is that increased movement occurs during wakefulness, whereas decreased movement, or even no movement at all, occurs during sleep – except movement due to changes in posture. Sleep electroencephalography involves recordings from the frontal, parietal and occipital areas, together with the electro-oculogram for the detection of conjugate eye movements and the submental electromyogram to indicate muscle tone. Additional physiological recordings are required where there is the possibility of a sleep disorder, and that constitutes a polysomnogram.
