If a patient with claustrophobia asks to end a PSG, what is the next best step?

If a patient with claustrophobia asks to end a PSG, what is the next best step?

• A. Schedule re-titration study
• B. Refer to ENT for consultation
• C. Schedule dessensitization
• D. Start APAP therapy

Answer: (C)

When claustrophobia blocks completion of a PSG, the most effective next step is to address the anxiety itself through desensitization—gradual, controlled exposure to the sleep lab environment and equipment, often paired with relaxation or cognitive-behavioral strategies. This approach reduces fear so the patient can tolerate the full study, allowing accurate diagnostic data to be collected. Sedation is not used for PSG because it alters sleep architecture and confounds results, and the other options don’t address the fear preventing the study: reattempting the test without changing the environment, an ENT referral for a non-existent obstruction, or starting APAP therapy, which treats sleep-disordered breathing but doesn’t resolve the phobic reaction.

When claustrophobia blocks completion of a PSG, the most effective next step is to address the anxiety itself through desensitization—gradual, controlled exposure to the sleep lab environment and equipment, often paired with relaxation or cognitive-behavioral strategies. This approach reduces fear so the patient can tolerate the full study, allowing accurate diagnostic data to be collected. Sedation is not used for PSG because it alters sleep architecture and confounds results, and the other options don’t address the fear preventing the study: reattempting the test without changing the environment, an ENT referral for a non-existent obstruction, or starting APAP therapy, which treats sleep-disordered breathing but doesn’t resolve the phobic reaction.