A Case a Week: Sleep Disorders from the Cleveland Clinic by Nancy Foldvary-Schaefer, Jyoti Krishna, Kumaraswamy Budur

By Nancy Foldvary-Schaefer, Jyoti Krishna, Kumaraswamy Budur

Providing a realistic method of the advent of sleep drugs, this easy-to-use, concise quantity makes use of real sufferer situations from the Cleveland medical institution Sleep problems middle. a large spectrum of diagnoses are integrated to reveal the reader to the vast variety of sleep-wake issues sufferer can adventure. Written in a concise layout designed to demonstrate the symptoms, diagnostic standards, workup and regimen therapy of sufferers offering to the sleep hospital, this quantity serves as a realistic textual content excellent for the busy primary-care practitioner looking to enhance her wisdom of sleep-wake problems. each time attainable, tracings from diagnostic assessments, images, and videos are supplied to augment medical displays and to help in reputation of abnormities pointed out within the sleep laboratory.

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Example text

This was ruled out by Robert’s history and sleep log, which supported one another. Actigraphy can be a useful tool in subjects suspected to have paradoxical insomnia. Since Robert has some symptoms of anxiety, insomnia due to mental disorder is another differential diagnosis that should be considered. 1 ICSD-2 general criteria for Insomnia A. Difficulty initiating sleep, maintaining sleep, early awakening or sleep that is chronically non-restorative or poor in quality. B. The above sleep difficulty occurs despite adequate opportunity and circumstances for sleep C.

Normative data are available for interpretation. The tests will be briefly overviewed here to familiarize the reader. Pitfalls and drawbacks of these tests are not discussed. The MSLT and the MWT are daytime studies performed over several hours in the sleep laboratory with a trained technologist in attendance. 5 to 3 hours after the final morning awakening. It is usually preceded by an overnight PSG to ensure sufficient sleep time is documented and that no sleep related disorders such as sleep apnea syndromes are present to influence the daytime test results.

Many medications cause or exacerbate sleep disturbances. Drugs such as beta blockers, serotonin re-uptake inhibitors, dopamine re-uptake inhibitors, thyroid supplements, and corticosteroids can cause or worsen insomnia. Similarly, medications such as tricyclic antidepressants, serotonin re-uptake inhibitors, and diphenhydramine can trigger or worsen symptoms of restless legs syndrome. Some medications like sedating antidepressants, anti-epileptics, muscle relaxants, or antihistamines contribute to daytime sleepiness.

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