By Nancy Foldvary-Schaefer, Jyoti Krishna, Kumaraswamy Budur
Providing a realistic method of the advent of sleep medication, this easy-to-use, concise quantity makes use of real sufferer situations from the Cleveland hospital Sleep issues middle. a large spectrum of diagnoses are integrated to reveal the reader to the large variety of sleep-wake issues sufferer can event. Written in a concise layout designed to demonstrate the symptoms, diagnostic standards, workup and regimen remedy of sufferers providing to the sleep medical institution, this quantity serves as a realistic textual content ideal for the busy primary-care practitioner trying to increase her wisdom of sleep-wake issues. at any time when attainable, tracings from diagnostic checks, images, and videos are supplied to reinforce medical displays and to assist in attractiveness of abnormities pointed out within the sleep laboratory.
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Additional info for A Case a Week: Sleep Disorders from the Cleveland Clinic
Thus, many medications affect sleep architecture and may interfere with testing. It is optimal if the tests are run after discontinuation of as many medications as far in advance of testing as is safely possible after considering the time it may take to wash out their active metabolites. In the case of some SSRIs, this may mean weaning should begin weeks in advance. Normative data for various sleep related parameters must take into consideration the patient’s age. For instance, an apnea index greater than 1 may be abnormal in the younger child, but not in an adult.
Asp. The guidelines state there should be sufﬁcient sleep time and respiratory event frequency to convincingly diagnose sleep apnea. Further, there should be sufﬁcient time left in the remainder of the night (typically 3 hours) to allow for a reasonable attempt at PAP titration. If these criteria are not met but sleep apnea is diagnosed, the alternate choice is to subsequently run a full-night titration study on a different night. As a corollary, the decision to do a split-night study requires that the nighttime technologist is vigilant in scoring the respiratory events as they happen and make the decision once criteria are met.
Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307. Friedman M, Ibrahim H, Lee G, Joseph NJ. Combined uvulopalatopharyngoplasty and radiofrequency tongue base reduction for treatment of obstructive sleep apnea/ hypopnea syndrome. Otolaryngol Head Neck Surg. 2003;129(6):611–621. Horne JA, Ostberg O. A self-assessment questionnaire to determine morningnesseveningness in human circadian rhythms. Int J Chronobiol. 1976;4:97–110. Johns MW.
A Case a Week: Sleep Disorders from the Cleveland Clinic by Nancy Foldvary-Schaefer, Jyoti Krishna, Kumaraswamy Budur