How aggressively do you screen the menopausal patient presenting with new or worsening insomnia for OSA, and what is your threshold for in-lab PSG after a negative HSAT in this population?

I would treat the insomnia and do actigraphy or obtain data from an Apple Watch, or even repeat HST before doing an in-lab. At least once in a while, there is someone scheduled in the sleep lab who cannot sleep and leaves in the middle of the night.