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Common pitfalls in sleep medicine : case-based learning / edited by Ronald D. Chervin, Professor of Neurology, Michael S. Aldrich Collegiate Professor of Sleep Medicine, Director, Sleep Disorders Center, University of Michigan, Ann Arbor, MI, USA.

Contributor(s): Material type: TextTextPublisher: Cambridge : Cambridge University Press, 2014Description: 1 online resource (xvii, 352 pages) : digital, PDF file(s)Content type:
  • text
Media type:
  • computer
Carrier type:
  • online resource
ISBN:
  • 9781139583848 (ebook)
Subject(s): Additional physical formats: Print version: : No titleDDC classification:
  • 616.8/498 23
LOC classification:
  • RC547 .C67 2014
Online resources:
Contents:
Machine generated contents note: 1.Introduction: the complexity, challenges, and rewards of effective sleep medicine / Ronald D. Chervin -- Section 1 Sleepiness versus fatigue, tiredness, and lack of energy -- 2.How to distinguish between sleepiness, fatigue, tiredness, and lack of energy / Anita Valanju Shelgikar -- 3.A patient with prominent fatigue, tiredness, or lack of energy rather than sleepiness may still have a sleep disorder / Sarah Nath Zallek -- 4.Fatigue, tiredness, and lack of energy, not just sleepiness, can improve considerably when a sleep disorder is treated / Wattanachai Chotinaiwattarakul -- 5.Patients with narcolepsy, in contrast to sleep apnea, more often choose to describe the problem as "sleepiness" rather than using other terms / Sarah Nath Zallek -- 6.Patients with fatigue and sleepiness: multiple sclerosis / Tiffany J. Braley -- Section 2 Assessment of daytime sleepiness --
Contents note continued: 50.Inadequate sleep hygiene is a common cause of sleepiness in adolescents / Dawn Dore-Stites -- 51.Sleep and attention-deficit/hyperactivity disorder in children / Lauren O'Connell -- 52.Obstructive sleep apnea can occur without prominent snoring among children with Trisomy 21 / Fauziya Hassan -- 53.Familiarity with infant sleep and normal variants can prevent extensive but unnecessary testing and intervention / Renee A. Shellhaas -- 54.Obstructive sleep apnea in patients with neuromuscular disorders / Fauziya Hassan -- Section 13 Sleep in older persons -- 55.Cognitive effects of untreated sleep apnea / Judith L. Heidebrink -- 56.Obstructive sleep apnea can present with symptoms and findings unique to older age / John J. Harrington -- 57.Delirium and sundowning in older persons: a sleep perspective / Mihai C. Teodorescu -- 58.Falls and hip fractures in the elderly: insomnia and hypnotics as unrecognized risk factors / Alon Y. Avidan.
Contents note continued: 42.Occult obstructive sleep apnea can contribute to chronic persistent asthma / Rahul K. Kakkar -- 43.Occult obstructive sleep apnea can exacerbate an uncontrolled seizure disorder / Beth A. Malow -- 44.Diagnosis and control of sleep apnea may improve the chances of successful treatment for atrial fibrillation / Johnathan Barkham -- 45.Sleep apnea in the acute stroke setting / Devin Brown -- 46.A missed diagnosis of obstructive sleep apnea can have a critical adverse impact in the postoperative setting / Satya Krishna Ramachandran -- Section 12 Sleep in children -- 47.Sleepiness in childhood obstructive sleep apnea may be subtle but significant / Timothy F. Hoban -- 48.Clinically significant upper airway obstruction may be present in children even when the polysomnogram is normal by adult standards / Timothy F. Hoban -- 49.Low socioeconomic conditions can create substantial challenges to adequate sleep for young children / Katherine Wilson --
Contents note continued: 36.Diagnosis and counseling for rapid eye movement sleep behavior disorder: a potential window into an uncertain neurologic future / Paul R. Carney -- 37.Obstructive sleep apnea must be ruled out as a potential underlying cause of sleepwalking in a child / Shalini Paruthi -- 38.An adult parasomnia can sometimes reflect effects of occult obstructive sleep apnea / Naricha Chirakalwasan -- Section 10 Circadian rhythm sleep disorders -- 39.Circadian rhythm sleep disorders can complicate or confuse mental health diagnoses in young persons / Fouad Reda -- 40.Advanced sleep phase can cause considerable morbidity in older persons until it is diagnosed and addressed / Cathy A. Goldstein -- 41.Shift work disorder is common, consequential, usually unaddressed, but readily treated / Cathy A. Goldstein -- Section 11 Missed diagnoses of obstructive sleep apnea can exacerbate medical and neurologic conditions --
Contents note continued: 30.The option of cognitive behavioral therapy should not be ignored simply because a patient has medical reasons for insomnia / J. Todd Arnedt -- Section 8 Restless legs syndrome and periodic leg movements -- 31.Misdiagnosis can delay appropriate and effective treatment for many years / Charles R. Davies -- 32.Periodic leg movements should not be overlooked as a possible cause of insomnia, and perhaps rarely, excessive daytime sleepiness / Lizabeth Binns -- 33.Oral iron supplementation can help ameliorate symptoms of restless legs syndrome but may not suffice to improve low iron stores / Shelley Hershner -- Section 9 Parasomnias -- 34.Diagnosis of a non-REM parasomnia without consideration of a patient's psychological makeup and its possible contribution can leave key issues unaddressed / Alan S. Eiser -- 35.History and polysomnographic findings are both critical to distinguish different parasomnias / Alon Y. Avidan --
Contents note continued: 24.Genioglossus advancement and hyoid suspension carries risks and may not obviate the need for subsequent use of continuous positive airway pressure / Joseph I. Helman -- 25.Maxillary and mandibular advancement offers an effective surgical approach to severe obstructive sleep apnea, but is not appropriate for all potential candidates / Joseph I. Helman -- Section 7 Diagnosis and treatment of chronic insomnia -- 26.A sleep study is often unnecessary in a patient with chronic insomnia / J. Todd Arnedt -- 27.Chronic use of hypnotics is unnecessary and can be counterproductive / Todd Favorite -- 28.Overlooking insomnia in a depressed patient can interfere with effective treatment for the mood disorder / J. Todd Arnedt -- 29.Overlooking insomnia in a patient with alcohol abuse or dependence can increase risk of relapse / Deirdre A. Conroy --
Contents note continued: 19.A daytime "PAP-Nap" can help new patients adjust to the use of continuous positive airway pressure / Q. Afifa Shamim-Uzzaman -- 20.Excessive positive airway pressure can create treatment-emergent central sleep apnea (complex sleep apnea) / Helena M. Schotland -- 21.Appropriate use of automatically adjusting positive airway pressure can enable a patient to use positive airway pressure therapy / Helena M. Schotland -- Section 6 Alternatives to positive airway pressure in the treatment of obstructive sleep apnea -- 22.Some patients with sleep apnea who are intolerant to continuous positive airway pressure can be treated most effectively with a mandibular advancement device / Emerson Robinson -- 23.Inadequate preoperative assessment risks ineffective surgical treatment of obstructive sleep apnea / Jeffrey J. Stanley --
Contents note continued: 13.A strict cut-off for the apnea/hypopnea index does more harm than good in clinical practice / Sheila C. Tsai -- 14.One night of polysomnography can occasionally miss obstructive sleep apnea / Raman K. Malhotra -- 15.Unattended, full polysomnography can be a good alternative to attended polysomnography, but technical limitations are common / Q. Afifa Shamim-Uzzaman -- 16.Home cardiopulmonary tests are a useful option, but only under appropriate circumstances / Daniel I. Rifkin -- Section 5 Positive airway pressure to treat obstructive sleep apnea -- 17.Repeated continuous positive airway pressure studies may raise the prescribed pressure above necessary treatment levels / Meredith D. Peters -- 18.Patient education and motivational enhancement can make the difference between adherence and non-use of positive airway pressure / Jennifer R. Goldschmied --
Contents note continued: 7.Patient complaints, subjective questionnaires, and objective measures of sleepiness may not coincide / Michael E. Yurcheshen -- 8.Daytime sleepiness and obstructive sleep apnea severity: where symptoms and metrics do not converge / Douglas Kirsch -- 9.Neither subjective nor objective measures allow confident prediction of future risk for motor vehicle crashes due to sleepiness / Anita Valanju Shelgikar -- 10.A sleep apnea patient with excessive daytime sleepiness and subtle respiratory events may be misdiagnosed with narcolepsy or idiopathic hypersomnia / Alp Sinan Baran -- Section 3 Diagnosis of narcolepsy -- 11.Narcolepsy with cataplexy can occur in the absence of a positive Multiple Sleep Latency Test / Daniel I. Rifkin -- 12.Narcolepsy is not the only cause of sleep-onset rapid eye movement periods / Shelley Hershner -- Section 4 Diagnosis of obstructive sleep apnea --
Summary: Unrecognized sleep disorders can shorten lives, promote hypertension, augment risk for diabetes, exacerbate metabolic syndrome, increase overall medical care costs, impair cognition, cause motor vehicle crashes, reduce workplace productivity, and greatly diminish quality of life. Sleep problems are among the most common complaints that patients bring to their clinicians, but little medical training is devoted to the field and so sleep disorders tend to remain undiagnosed for many years. The case-based chapters in this book highlight key points and pitfalls in a readable, easily assimilated, and memorable format that should improve a clinician's ability to address, investigate, and manage common sleep disorders. The cases illustrate how clinical skill and occasional wisdom can complement data obtained from laboratory testing. Common Pitfalls in Sleep Medicine will be of particular interest to clinicians and trainees in sleep medicine, neurology, internal medicine, family medicine, pulmonary medicine, otolaryngology, psychiatry, and psychology.
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Machine generated contents note: 1.Introduction: the complexity, challenges, and rewards of effective sleep medicine / Ronald D. Chervin -- Section 1 Sleepiness versus fatigue, tiredness, and lack of energy -- 2.How to distinguish between sleepiness, fatigue, tiredness, and lack of energy / Anita Valanju Shelgikar -- 3.A patient with prominent fatigue, tiredness, or lack of energy rather than sleepiness may still have a sleep disorder / Sarah Nath Zallek -- 4.Fatigue, tiredness, and lack of energy, not just sleepiness, can improve considerably when a sleep disorder is treated / Wattanachai Chotinaiwattarakul -- 5.Patients with narcolepsy, in contrast to sleep apnea, more often choose to describe the problem as "sleepiness" rather than using other terms / Sarah Nath Zallek -- 6.Patients with fatigue and sleepiness: multiple sclerosis / Tiffany J. Braley -- Section 2 Assessment of daytime sleepiness --

Contents note continued: 50.Inadequate sleep hygiene is a common cause of sleepiness in adolescents / Dawn Dore-Stites -- 51.Sleep and attention-deficit/hyperactivity disorder in children / Lauren O'Connell -- 52.Obstructive sleep apnea can occur without prominent snoring among children with Trisomy 21 / Fauziya Hassan -- 53.Familiarity with infant sleep and normal variants can prevent extensive but unnecessary testing and intervention / Renee A. Shellhaas -- 54.Obstructive sleep apnea in patients with neuromuscular disorders / Fauziya Hassan -- Section 13 Sleep in older persons -- 55.Cognitive effects of untreated sleep apnea / Judith L. Heidebrink -- 56.Obstructive sleep apnea can present with symptoms and findings unique to older age / John J. Harrington -- 57.Delirium and sundowning in older persons: a sleep perspective / Mihai C. Teodorescu -- 58.Falls and hip fractures in the elderly: insomnia and hypnotics as unrecognized risk factors / Alon Y. Avidan.

Contents note continued: 42.Occult obstructive sleep apnea can contribute to chronic persistent asthma / Rahul K. Kakkar -- 43.Occult obstructive sleep apnea can exacerbate an uncontrolled seizure disorder / Beth A. Malow -- 44.Diagnosis and control of sleep apnea may improve the chances of successful treatment for atrial fibrillation / Johnathan Barkham -- 45.Sleep apnea in the acute stroke setting / Devin Brown -- 46.A missed diagnosis of obstructive sleep apnea can have a critical adverse impact in the postoperative setting / Satya Krishna Ramachandran -- Section 12 Sleep in children -- 47.Sleepiness in childhood obstructive sleep apnea may be subtle but significant / Timothy F. Hoban -- 48.Clinically significant upper airway obstruction may be present in children even when the polysomnogram is normal by adult standards / Timothy F. Hoban -- 49.Low socioeconomic conditions can create substantial challenges to adequate sleep for young children / Katherine Wilson --

Contents note continued: 36.Diagnosis and counseling for rapid eye movement sleep behavior disorder: a potential window into an uncertain neurologic future / Paul R. Carney -- 37.Obstructive sleep apnea must be ruled out as a potential underlying cause of sleepwalking in a child / Shalini Paruthi -- 38.An adult parasomnia can sometimes reflect effects of occult obstructive sleep apnea / Naricha Chirakalwasan -- Section 10 Circadian rhythm sleep disorders -- 39.Circadian rhythm sleep disorders can complicate or confuse mental health diagnoses in young persons / Fouad Reda -- 40.Advanced sleep phase can cause considerable morbidity in older persons until it is diagnosed and addressed / Cathy A. Goldstein -- 41.Shift work disorder is common, consequential, usually unaddressed, but readily treated / Cathy A. Goldstein -- Section 11 Missed diagnoses of obstructive sleep apnea can exacerbate medical and neurologic conditions --

Contents note continued: 30.The option of cognitive behavioral therapy should not be ignored simply because a patient has medical reasons for insomnia / J. Todd Arnedt -- Section 8 Restless legs syndrome and periodic leg movements -- 31.Misdiagnosis can delay appropriate and effective treatment for many years / Charles R. Davies -- 32.Periodic leg movements should not be overlooked as a possible cause of insomnia, and perhaps rarely, excessive daytime sleepiness / Lizabeth Binns -- 33.Oral iron supplementation can help ameliorate symptoms of restless legs syndrome but may not suffice to improve low iron stores / Shelley Hershner -- Section 9 Parasomnias -- 34.Diagnosis of a non-REM parasomnia without consideration of a patient's psychological makeup and its possible contribution can leave key issues unaddressed / Alan S. Eiser -- 35.History and polysomnographic findings are both critical to distinguish different parasomnias / Alon Y. Avidan --

Contents note continued: 24.Genioglossus advancement and hyoid suspension carries risks and may not obviate the need for subsequent use of continuous positive airway pressure / Joseph I. Helman -- 25.Maxillary and mandibular advancement offers an effective surgical approach to severe obstructive sleep apnea, but is not appropriate for all potential candidates / Joseph I. Helman -- Section 7 Diagnosis and treatment of chronic insomnia -- 26.A sleep study is often unnecessary in a patient with chronic insomnia / J. Todd Arnedt -- 27.Chronic use of hypnotics is unnecessary and can be counterproductive / Todd Favorite -- 28.Overlooking insomnia in a depressed patient can interfere with effective treatment for the mood disorder / J. Todd Arnedt -- 29.Overlooking insomnia in a patient with alcohol abuse or dependence can increase risk of relapse / Deirdre A. Conroy --

Contents note continued: 19.A daytime "PAP-Nap" can help new patients adjust to the use of continuous positive airway pressure / Q. Afifa Shamim-Uzzaman -- 20.Excessive positive airway pressure can create treatment-emergent central sleep apnea (complex sleep apnea) / Helena M. Schotland -- 21.Appropriate use of automatically adjusting positive airway pressure can enable a patient to use positive airway pressure therapy / Helena M. Schotland -- Section 6 Alternatives to positive airway pressure in the treatment of obstructive sleep apnea -- 22.Some patients with sleep apnea who are intolerant to continuous positive airway pressure can be treated most effectively with a mandibular advancement device / Emerson Robinson -- 23.Inadequate preoperative assessment risks ineffective surgical treatment of obstructive sleep apnea / Jeffrey J. Stanley --

Contents note continued: 13.A strict cut-off for the apnea/hypopnea index does more harm than good in clinical practice / Sheila C. Tsai -- 14.One night of polysomnography can occasionally miss obstructive sleep apnea / Raman K. Malhotra -- 15.Unattended, full polysomnography can be a good alternative to attended polysomnography, but technical limitations are common / Q. Afifa Shamim-Uzzaman -- 16.Home cardiopulmonary tests are a useful option, but only under appropriate circumstances / Daniel I. Rifkin -- Section 5 Positive airway pressure to treat obstructive sleep apnea -- 17.Repeated continuous positive airway pressure studies may raise the prescribed pressure above necessary treatment levels / Meredith D. Peters -- 18.Patient education and motivational enhancement can make the difference between adherence and non-use of positive airway pressure / Jennifer R. Goldschmied --

Contents note continued: 7.Patient complaints, subjective questionnaires, and objective measures of sleepiness may not coincide / Michael E. Yurcheshen -- 8.Daytime sleepiness and obstructive sleep apnea severity: where symptoms and metrics do not converge / Douglas Kirsch -- 9.Neither subjective nor objective measures allow confident prediction of future risk for motor vehicle crashes due to sleepiness / Anita Valanju Shelgikar -- 10.A sleep apnea patient with excessive daytime sleepiness and subtle respiratory events may be misdiagnosed with narcolepsy or idiopathic hypersomnia / Alp Sinan Baran -- Section 3 Diagnosis of narcolepsy -- 11.Narcolepsy with cataplexy can occur in the absence of a positive Multiple Sleep Latency Test / Daniel I. Rifkin -- 12.Narcolepsy is not the only cause of sleep-onset rapid eye movement periods / Shelley Hershner -- Section 4 Diagnosis of obstructive sleep apnea --

Unrecognized sleep disorders can shorten lives, promote hypertension, augment risk for diabetes, exacerbate metabolic syndrome, increase overall medical care costs, impair cognition, cause motor vehicle crashes, reduce workplace productivity, and greatly diminish quality of life. Sleep problems are among the most common complaints that patients bring to their clinicians, but little medical training is devoted to the field and so sleep disorders tend to remain undiagnosed for many years. The case-based chapters in this book highlight key points and pitfalls in a readable, easily assimilated, and memorable format that should improve a clinician's ability to address, investigate, and manage common sleep disorders. The cases illustrate how clinical skill and occasional wisdom can complement data obtained from laboratory testing. Common Pitfalls in Sleep Medicine will be of particular interest to clinicians and trainees in sleep medicine, neurology, internal medicine, family medicine, pulmonary medicine, otolaryngology, psychiatry, and psychology.

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