I am having difficulty sleeping!

Size: px
Start display at page:

Download "I am having difficulty sleeping!"

Transcription

1 I am having difficulty sleeping! a practical approach Bruce Arroll dept of general practice and primary health care school of population health

2 goodfellowunit.org short course: diagnosis and treatment of insomnia

3

4

5

6

7 what is insomnia what type of insomnia what can I/we do about it

8 what is insomnia do you have trouble with your sleeping (on at least 3 nights per week) such that it interferes with your activities the following day (eg unrefreshed in the morning, fatigued, poor concentration or irritabilitylasting for more than one month 41% in Auckland GP Study Arroll et al Br J Gen Pract 2102; Feb:e99-e103

9 range of definitions major current insomnia (taking at least two hours to fall asleep nearly every night 10% in Seattle Study Simon GE, et Am j Psychiatr 1997;154(10):

10

11 patient # 1 50 year old BMI 35 snores loudly at night not feeling rested the next day falls asleep at work

12

13 patient # 2 75 year old woman Bed at 2100 wakes for 2 hours gets up at 0600 does not feel rested when she wakes

14

15 patient # year old acoustic engineer 2.bed at 2 am 3.weekend wakes at 1000 hrs 4.during up at 6 am to go to work tired all day

16 return to patients later

17 dr tony fernando

18 dr karen falloon

19 an interest in insomnia tony fernando s story primary insomnia all better with bed time restriction BA skeptical need an RCT

20 an interest in insomnia primary insomnia insomnia with no other cause needed to know other causes?other causes in primary care

21 causes of insomnia depression 50% anxiety 48% sleep apnea 9% general health 43% parasomnias (Sleep walk 1%, restless legs bruxism 2% in reality about 5% Br J Gen Pract 2012; 62:e99-e103.

22 causes of insomnia alcohol problem 8% other substance 4% *delayed sleep phase disorder 2% *primary insomnia 12% * mutually exclusive of other conditions

23 weird conditions REM disorder sleep eating

24 interest in insomnia conducted RCT 1 0 insomnia * 75% intervention got a better sleep * 35% control group got better sleep sleep hygiene effective J Prim Health Care 2013;5(1):5-10.

25 time in bed restriction effective -?compression More on time in bed restriction later

26

27 patient # 1 50 year old BMI 35 very tired in in daytime-asleep at work!!!!!! wife notices that stops breathing for up to 15 seconds snores loudly at night wakes with dry mouth morning headache

28 patient # 1 meets criteria for sleep apnoea very tired during day stops breathing and gasping episodes minor criteria snores loudly at night wakes with dry mouth morning headache

29 patient # 1 needs assessment for CPAP pulse oximetry at night polysomnography (sleep lab) Treatment CPAP (continuous positive airways pressure) weight loss?? mandibular advancement splints (MAS) surgery???

30

31 patient # 2 75 year old woman goes to bed a 2100 wakes for 2 hours in middle of night gets up at 0600 does not feel rested when she wakes bored, cold lonely use screening tool

32 patient # 2 looking at the screening tool will tick yes to first 2 questions insomnia will tick no to all after bottom two questions i.e. no other cause for insomnia hence she has primary insomnia

33 patient # 2 what to do sleep hygiene check on naps ( 1200 to 1500) ~ 30 minutes max exercise time in bed restriction medication

34 sleep hygiene bed only for sleep or intimacy don t watch TV or computer screen in bed if not asleep within 20 minutes get up avoid caffeine before bed time avoid energetic activity before bed time avoid naps the during the day or before 3 pm make sure environment is comfortable quiet correct temperature comfortable bed

35 sleep advice slow down breathing make your eyes half closed eyes app- mysleepbutton- nonsense words listen to podcasts sleep routine

36 Exercise Cochrane review 2002 Sleep problems become more common with age, affect quality of life for individuals and their families, and can increase healthcare costs. Older people are often prescribed a range of drugs for their health problems (including with sleep) many of which have side effects. This review considered the effectiveness of a programme of physical exercise involving brisk walking and moderate resistance training tailored for the needs of the older adult. These reviewers report that evidence from one small trial is encouraging, and further research is needed.

37 treatment * bed time restriction * ask how long in bed ~ 9 hours * estimate time asleep approximately -or use sleep diary AASM

38 treatment * usually 5 to 6 hours * advise spend 5 to 6 hours in bed

39 treatment * if wake at 0600 hrs - go to bed 2400 * difficult to keep occupied -reading, light house work

40 treatment * if drowsy next day-increase by 15/30 * all changes need 1 week * may resist consider compression

41 treatment * notice that getting deeper sleep * professional drivers do in vacation

42 treatment other/meds 1. CBTi if you can find it 2. Melatonin 3. tricyclic in low doses?? -amitriptyline 10 mg - nortriptyline 10 mg

43 treatment other 4. mirtazapine 15mg 5. quetiapine 6.25 to 25 mg 6. all else fails low dose hypnotic -tolerance? fall

44 other conditions- meds 1. depression and anxiety 1. TCAs 2. Mirtazapine (weight issues) 3. Add benzodiazepines 2. stop SSRIS, SNRI, buproprion

45 treatment- supplements good evidence -acupressure, tai chi, yoga mixed evidence -L tryptophan, mindfulness Sleep Med Rev Dec;24C:1-12

46 treatment- supplements unsupportive -valerian, valerian, chamomile, kava, wuling -AEs more with valerian than placebo Sleep Med Rev Dec;24C:1-12

47 treatment- supplements good evidence mg magnesium in elderly J res med sci 2012 Dec;17(12): five mg melatonin, 225 mg magnesium, and mg zinc in elderly J am geriatr soc 2011 Jan;59(1):82-90.

48

49 patient # year old acoustic engineer 2. goes to bed at 2 am and in weekend wakes at 1000 hrs 3. during the week gets up at 6 am to go to work tired all day 4. diagnosis??

50 patient # 3 1. Delayed sleep phase disorder (teenage pattern) 2. a dysregulation of a person's circadian rhythm (biological clock), compared to the general population and societal norms generally fall asleep some hours after midnight and have difficulty waking up in the morning. 3. Treat: melatonin at night and light box in am 4. Often get night jobs

51 take home message insomnia is common need to make a specific diagnosis primary insomnia when no other cause sleep hygiene first time in bed restriction for primary insomnia

Insomnia affects 1 in 3 adults every year in the U.S. and Canada.

Insomnia affects 1 in 3 adults every year in the U.S. and Canada. Insomnia What is insomnia? Having insomnia means you often have trouble falling or staying asleep or going back to sleep if you awaken. Insomnia can be either a short-term or a long-term problem. Insomnia

More information

SLEEP AND PARKINSON S DISEASE

SLEEP AND PARKINSON S DISEASE A Practical Guide on SLEEP AND PARKINSON S DISEASE MICHAELJFOX.ORG Introduction Many people with Parkinson s disease (PD) have trouble falling asleep or staying asleep at night. Some sleep problems are

More information

Coping with Shift Work & Fatigue. A good practice guide for drivers

Coping with Shift Work & Fatigue. A good practice guide for drivers Coping with Shift Work & Fatigue A good practice guide for drivers Working shifts can lead to fatigue. This may make you more likely to be involved in incidents and accidents. Managing your sleep at home

More information

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS

SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS E-Resource December, 2013 SLEEP DISTURBANCE AND PSYCHIATRIC DISORDERS Between 10-18% of adults in the general population and up to 50% of adults in the primary care setting have difficulty sleeping. Sleep

More information

Understanding. Sleep Disorders. Bob, diagnosed in 2005.

Understanding. Sleep Disorders. Bob, diagnosed in 2005. Understanding Sleep Disorders Bob, diagnosed in 2005. What Are Sleep Disorders? Many sleep disorders are brain disorders that cause interruptions in sleep patterns. They prevent people from getting enough

More information

Sleep and Brain Injury

Sleep and Brain Injury Patient Education Sleep and Brain Injury This handout describes how brain injury may affect sleep. A list of resources is included. Why is sleep important? During sleep, your brain and body recharge. Proper

More information

Primary Care Management of Sleep Complaints in Adults

Primary Care Management of Sleep Complaints in Adults Scope Primary Care Management of Sleep Complaints in Adults (Revised 2004) This guideline is for the primary care management of non-respiratory sleep disorders in adults and follows the DSM-IV-TR classification

More information

Sleep Disorders , The Patient Education Institute, Inc. [www.x-plain.com] nr Last reviewed: 03/06/2011 1

Sleep Disorders , The Patient Education Institute, Inc. [www.x-plain.com] nr Last reviewed: 03/06/2011 1 Sleep Disorders Introduction Sleep disorders are very common conditions that can be overcome. It is important to understand what affects sleep and the importance of sleep. This reference summary will help

More information

Keeping the night shift healthy (and happy ) Danielle Livelsberger RPSGT OSU Sleep Lab Manager

Keeping the night shift healthy (and happy ) Danielle Livelsberger RPSGT OSU Sleep Lab Manager Keeping the night shift healthy (and happy ) Danielle Livelsberger RPSGT OSU Sleep Lab Manager Objectives Identify good sleep practices Identify actions to help manage sleep when working night shift Sleep

More information

Many people with physical

Many people with physical Aging with Physical Disability FACT SHEET Sleep and Aging with a Disability Many people with physical disabilities suffer from sleep disturbances, and sleep tends to become more disrupted as we get older.

More information

SLEEP RIGHT SLEEP TIGHT

SLEEP RIGHT SLEEP TIGHT SLEEP RIGHT SLEEP TIGHT Natural sleep before medicines Sleep diary What is a sleep diary? A sleep diary is a daily log that can be used to record your sleep-wake pattern. It helps you monitor when you

More information

Quick Read Series. Information for people with seizure disorders

Quick Read Series. Information for people with seizure disorders Quick Read Series Information for people with seizure disorders 2003 Epilepsy Foundation of America, Inc. This pamphlet is designed to provide general information about epilepsy to the public. It does

More information

How To Avoid Drowsy Driving

How To Avoid Drowsy Driving How To Avoid Drowsy Driving AAA Foundation for Traffic Safety Sleepiness and Driving Don t Mix Feeling sleepy is especially dangerous when you are driving. Sleepiness slows your reaction time, decreases

More information

Is Obstructive Sleep Apnea Affecting Your Daily Life?

Is Obstructive Sleep Apnea Affecting Your Daily Life? Is Obstructive Sleep Apnea Affecting Your Daily Life? Is Obstructive Sleep Apnea Affecting Your Daily Life? Do you feel sleepy during the day no matter how much sleep you get? Can you fall asleep easily

More information

Memorial Hospital Sleep Center. Rock Springs, Wyoming 82901. Sleep lab Phone: 307-352- 8229 (Mon - Wed 5:00 pm 7:00 am)

Memorial Hospital Sleep Center. Rock Springs, Wyoming 82901. Sleep lab Phone: 307-352- 8229 (Mon - Wed 5:00 pm 7:00 am) Memorial Hospital Sleep Center Rock Springs, Wyoming 82901 Sleep lab Phone: 307-352- 8229 (Mon - Wed 5:00 pm 7:00 am) Office Phone: 307-352- 8390 (Mon Fri 8:00 am 4:00 pm ) Patient Name: Sex Age Date Occupation:

More information

Why are you being seen at Frontier Diagnostic Sleep Center?

Why are you being seen at Frontier Diagnostic Sleep Center? 8425 South 84th Street Suite B Omaha, NE 68127 Phone: 402.339.7378 Fax: 402.339.9455 SLEEP QUESTIONNAIRE NAME: ADDRESS: Last First MI Street Address DATE City State Zip PHONE: ( ) BIRTHDATE: HEIGHT: WEIGHT:

More information

professionals for health Insomnia

professionals for health Insomnia for health professionals Insomnia Insomnia Healthy sleep Most people think that healthy sleep is one long 7-8 hour period of unconsciousness. However, sleep consists of different states of sleep that cycle

More information

GUIDELINES FOR THE INPATIENT TREATMENT OF INSOMNIA IN ADULTS version 4

GUIDELINES FOR THE INPATIENT TREATMENT OF INSOMNIA IN ADULTS version 4 GUIDELINES FOR THE INPATIENT TREATMENT OF INSOMNIA IN ADULTS version 4 GUIDELINE REPLACED Version 4 RATIFYING COMMITTEE Drugs and Therapeutics Group DATE RATIFIED 26 October 2015 NEXT REVIEW DATE October

More information

MELATONIN FOR SLEEP DISORDERS IN CHILDREN AND ADOLESCENTS WITH NEURODEVELOPMENTAL DISORDERS SHARED CARE GUIDELINES

MELATONIN FOR SLEEP DISORDERS IN CHILDREN AND ADOLESCENTS WITH NEURODEVELOPMENTAL DISORDERS SHARED CARE GUIDELINES MELATONIN FOR SLEEP DISORDERS IN CHILDREN AND ADOLESCENTS WITH NEURODEVELOPMENTAL DISORDERS SHARED CARE GUIDELINES Version control: Version Date Main changes/comments V1 4 June 2013 First draft circulated

More information

Obstructive Sleep Apnea Case Study

Obstructive Sleep Apnea Case Study Obstructive Sleep Apnea Case Study Shirin Shafazand, MD, MS Neomi Shah, MD for the Sleep Education for Pulmonary Fellows and Practitioners, SRN ATS Committee August 2014 Part 1: Case Presentation Mr. Simon

More information

Sleep Disorders Center 505-820-5363 455 St. Michael s Dr. 505-989-6409 fax Santa Fe, New Mexico 87505 QUESTIONNAIRE NAME: DOB: REFERRING PHYSICIAN:

Sleep Disorders Center 505-820-5363 455 St. Michael s Dr. 505-989-6409 fax Santa Fe, New Mexico 87505 QUESTIONNAIRE NAME: DOB: REFERRING PHYSICIAN: Sleep Disorders Center 505-820-5363 455 St. Michael s Dr. 505-989-6409 fax Santa Fe, New Mexico 87505 QUESTIONNAIRE NAME: DOB: REFERRING PHYSICIAN: PRIMARY CARE PHYSICIAN: Do you now have or have you had:

More information

BREATHE EASY WHY AM I USING CPAP?

BREATHE EASY WHY AM I USING CPAP? BREATHE EASY WHY AM I USING CPAP? Your doctor has prescribed Continuous Positive Airway Pressure or CPAP (pronounced See -pap) therapy for you. When used appropriately, CPAP therapy is nearly 100% effective

More information

Sleep Difficulties. Insomnia. By Thomas Freedom, MD and Johan Samanta, MD

Sleep Difficulties. Insomnia. By Thomas Freedom, MD and Johan Samanta, MD Sleep Difficulties By Thomas Freedom, MD and Johan Samanta, MD For most people, night is a time of rest and renewal; however, for many people with Parkinson s disease nighttime is a struggle to get the

More information

Dr Sarah Blunden s Adolescent Sleep Facts Sheet

Dr Sarah Blunden s Adolescent Sleep Facts Sheet Dr Sarah Blunden s Adolescent Sleep Facts Sheet I am Sleep Researcher and a Psychologist. As a Sleep Researcher, I investigate the effects of poor sleep on young children and adolescents. I also diagnose

More information

Supplementary Online Content

Supplementary Online Content Supplementary Online Content Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER

More information

Changes in the Evaluation and Treatment of Sleep Apnea

Changes in the Evaluation and Treatment of Sleep Apnea Changes in the Evaluation and Treatment of Sleep Apnea Joseph DellaValla, MD FACP Medical Director Center for Sleep Medicine At Androscoggin Valley Hospital Sleep Related Breathing Problems Obstructive

More information

Sleep Laboratory. Sleep Laboratory. Services

Sleep Laboratory. Sleep Laboratory. Services Sleep Laboratory Sleep Laboratory Services The Sleep Laboratory conducts sleep studies to help patients determine the cause of their sleep problems. This brochure shares with you what to expect before,

More information

Nursing Interventions for Sleep Disorders Following TBI

Nursing Interventions for Sleep Disorders Following TBI Nursing Interventions for Sleep Disorders Following TBI Kadesha Clark, RN BSN When you sleep, your body rests and restores its energy levels. A good night's sleep is often the best way to help you cope

More information

Full name: Male Female

Full name: Male Female 6700 W. Ninth Ave. Amarillo, TX 79106 Phone (806) 356-5522 www.adcsleepdisorders.com THE EPWORTH SLEEPINESS SCALE Full name: Male Female Date: Age: How likely are you to doze off or fall asleep in the

More information

Management of fatigue and sleep disorders Jean Arzbaecher RN MS APN The University of Chicago Medicine

Management of fatigue and sleep disorders Jean Arzbaecher RN MS APN The University of Chicago Medicine Management of fatigue and sleep disorders Jean Arzbaecher RN MS APN The University of Chicago Medicine 2014 Patient and Family Conference Providing and Pursuing Answers: Advances in Brain Tumor Research,

More information

SLEEP DISORDER ADULT QUESTIONNAIRE

SLEEP DISORDER ADULT QUESTIONNAIRE SLEEP DISORDER ADULT QUESTIONNAIRE Name: Date: Date of Birth (month/day/year): / / Gender: ο Male ο Female Marital Status: ο Never Married ο Married ο Divorced ο Widowed Home Address: City: Zip: Daytime

More information

Building a. With Your Doctor

Building a. With Your Doctor Building a With Your Doctor As a mental health consumer, there are many things you can do to improve your care and get more out of life. Learning more about your illness, current treatment options and

More information

SLEEP QUESTIONNAIRE. Name: Today s Date: Age (years): Your Sex (M or F): Height: Weight: Collar/Neck Size (inches) Medications you are taking:

SLEEP QUESTIONNAIRE. Name: Today s Date: Age (years): Your Sex (M or F): Height: Weight: Collar/Neck Size (inches) Medications you are taking: SLEEP QUESTIONNAIRE Name: Today s Date: Age (years): Your Sex (M or F): Height: Weight: Collar/Neck Size (inches) Medications you are taking: Medical conditions: High blood pressure Heart Disease Diabetes

More information

It doesn t matter how much you sleep, what is more important is how well you feel physically and mentally as a result of your sleep pattern.

It doesn t matter how much you sleep, what is more important is how well you feel physically and mentally as a result of your sleep pattern. Sleep problems i Sleep problems can be overcome Insomnia is the most common type of sleep problem. It is very distressing when others do not understand the difficulties that you are having with sleep and

More information

Tara Leigh Taylor, MD, FCCP Intensivist, Wyoming Medical Center

Tara Leigh Taylor, MD, FCCP Intensivist, Wyoming Medical Center Tara Leigh Taylor, MD, FCCP Intensivist, Wyoming Medical Center Objectives Define the magnitude of the problem Define diagnostic criteria of insomnia Understand the risk factors and consequences of insomnia

More information

SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P.

SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P. SLEEP DIFFICULTIES AND PARKINSON S DISEASE Julie H. Carter, R.N., M.S., A.N.P. Problems with sleep are common in Parkinson s disease. They can sometimes interfere with quality of life. It is helpful to

More information

SUMMARY OF FINDINGS. National Sleep Foundation 2005. National Sleep Foundation

SUMMARY OF FINDINGS. National Sleep Foundation 2005. National Sleep Foundation SUMMARY OF FINDINGS National Sleep Foundation 2005 National Sleep Foundation 1522 K Street NW, Suite 500 Washington, DC 20005 Ph: (202) 347-3471 Fax: (202) 347-3472 www.sleepfoundation.org Prepared by:

More information

Sleep. Drug and Alcohol Services South Australia. Progressive stages of the sleep cycle. Understanding the normal sleep pattern

Sleep. Drug and Alcohol Services South Australia. Progressive stages of the sleep cycle. Understanding the normal sleep pattern Drug and Alcohol Services South Australia INSOMNIA MANAGEMENT KIT Sleep: Facts and hygiene The Insomnia Management Kit is intended to be used in conjunction with your GP. To access further instructions

More information

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive Behavioral Therapy for Insomnia (CBT-I) Cognitive Behavioral Therapy for Insomnia (CBT-I) Virginia Runko, PhD, CBSM Behavioral Sleep Medicine Specialist Licensed Psychologist The Ross Center for Anxiety and Related Disorders, Washington DC Workshop

More information

Page 1 of 8. SLEEP DISORDERS CENTER QUESTIONNAIRE Swedish Medical Center. Name: Date: Height: Weight: Neck Size: Handedness: Right/Left.

Page 1 of 8. SLEEP DISORDERS CENTER QUESTIONNAIRE Swedish Medical Center. Name: Date: Height: Weight: Neck Size: Handedness: Right/Left. Page 1 of 8 SLEEP DISORDERS CENTER QUESTIONNAIRE Swedish Medical Center Name: Date: Date of Birth: Age: Sex: M F Height: Weight: Neck Size: Handedness: Right/Left Which physician evaluated you for your

More information

Name,, Last First MI DOB Age Current Occupation. Home Phone Work phone Cell Phone

Name,, Last First MI DOB Age Current Occupation. Home Phone Work phone Cell Phone Date / / Name,, Last First MI DOB Age Current Occupation Home Phone Work phone Cell Phone Ethnicity : White Hispanic Asian African American American Indian Pacific Islander Other What is your primary language?

More information

F Be irritable F Have memory problems or be forgetful F Feel depressed F Have more falls or accidents F Feel very sleepy during the day

F Be irritable F Have memory problems or be forgetful F Feel depressed F Have more falls or accidents F Feel very sleepy during the day National Institute on Aging A Good Night s Sleep Ever since he retired, Edward dreads going to bed at night. He s afraid that when he turns off his light, he will just lie there with his eyes open and

More information

Oral Health Care Professionals, LLC Snoring & Sleep Apnea dental appliance patient testimonials

Oral Health Care Professionals, LLC Snoring & Sleep Apnea dental appliance patient testimonials Testimonial #1 Oral Health Care Professionals, LLC Snoring & Sleep Apnea dental appliance patient testimonials I just wanted to help you let others know how much the TAP device has helped our family. Now

More information

Sleep Deprivation and Fatigue. Effects on Performance in Residency Training. Adapted from the American Academy of Sleep Medicine

Sleep Deprivation and Fatigue. Effects on Performance in Residency Training. Adapted from the American Academy of Sleep Medicine Sleep Deprivation and Fatigue Effects on Performance in Residency Training Adapted from the American Academy of Sleep Medicine Learning Objectives 1. List factors that put you at risk for sleepiness and

More information

Diabetes and Sleep Problems. Sleep Study

Diabetes and Sleep Problems. Sleep Study Diabetes and Sleep Problems Sleep Study Diabetes and Sleep Problems Sanjay R. Patel, MD, MS Suzanne M. Bertisch MD, MPH Amy P. Campbell, MS, RD, CDE David Erani, MD This booklet was developed by Joslin

More information

A Good Night s. Department of Health

A Good Night s. Department of Health leep A Good Night s Department of Health Acknowledgments This resource is a collaborative project between the Eastern Perth Public and Community Health Unit, Royal Perth Hospital and the Alcohol and Other

More information

INSOMNIA SELF-CARE GUIDE

INSOMNIA SELF-CARE GUIDE INSOMNIA SELF-CARE GUIDE University of California, Berkeley 2222 Bancroft Way Berkeley, CA 94720 Appointments 510/642-2000 Online Appointment www.uhs.berkeley.edu All of us have trouble sleeping from time

More information

Eating Disorder Treatment Protocol

Eating Disorder Treatment Protocol Eating Disorder Treatment Protocol All Team Members: Patient Self-Management Education & Support Eating Disorders are incredibly debilitating and are associated with significant medical and psychosocial

More information

General Information about Sleep Studies and What to Expect

General Information about Sleep Studies and What to Expect General Information about Sleep Studies and What to Expect Why do I need a sleep study? Your doctor has ordered a sleep study because your doctor is concerned you may have a sleep disorder that is impacting

More information

Please describe any past professional evaluations or treatments for your sleep problems, including what was and was not helpful?

Please describe any past professional evaluations or treatments for your sleep problems, including what was and was not helpful? Name: Age: Gender: Male Female Date of Birth (month/day/year): / / Race: Marital Status: Never married Married Divorced Widowed Home Address: City: ZIP: Daytime Phone: ( ) Evening Phone: ( ) _ Cell Phone:

More information

Medical Information to Support the Decisions of TUECs INTRINSIC SLEEP DISORDERS

Medical Information to Support the Decisions of TUECs INTRINSIC SLEEP DISORDERS Introduction Excessive daytime sleepiness (EDS) is a common complaint. Causes of EDS are numerous and include: o Intrinsic sleep disorders (e.g. narcolepsy, obstructive sleep apnoea/hypopnea syndrome (OSAHS)

More information

Obesity Compared to other Diseases in US

Obesity Compared to other Diseases in US Fatima Cody Stanford, MD, MPH Obesity Medicine & Nutrition Massachusetts General Hospital Harvard Medical School Harvard Kennedy School of Government Obesity Compared to other Diseases in US 1 CDC.gov

More information

How to sleep better at night - sleep hygiene. Information for anyone having trouble sleeping

How to sleep better at night - sleep hygiene. Information for anyone having trouble sleeping How to sleep better at night - sleep hygiene Information for anyone having trouble sleeping www.leicspart.nhs.uk mail: feedback@leicspart.nhs.uk Aim for a good night s sleep A good night s sleep should

More information

Sleep Issues and Requirements

Sleep Issues and Requirements How Much Sleep Do I Need? Sleep Issues and Requirements http://kidshealth.org/pagemanager.jsp?dn=kidshealth&lic=1&ps=207&cat_id=20116&article_set=20280 TeensHealth.org: A safe, private place to get doctor-approved

More information

Sleep History Questionnaire

Sleep History Questionnaire Sleep History Questionnaire Name Address Daytime Phone Height Evening Phone Weight Weight 5yrs ago Describe your sleep problem: 1. What time do you go to bed? 2. What time do you wake up? 3. What time

More information

10pm. Melatonin. Without Serotonin 6am mid afternoon 6-8pm 6am

10pm. Melatonin. Without Serotonin 6am mid afternoon 6-8pm 6am In order to have efficient and normal functioning of all systems in the body adequate and restorative sleep must be obtained. Mental and physical health is directly affected by an individual s sleep patterns

More information

Preparation guidelines for your Child s Sleep Study

Preparation guidelines for your Child s Sleep Study Preparation guidelines for your Child s Sleep Study Patient Sticker here Maintain your child s regular night sleeping and nap schedule for several days before the study. On the day of the study, do not

More information

World Sleep Day Education Kit Ages 5-10 years. Teachers Notes

World Sleep Day Education Kit Ages 5-10 years. Teachers Notes INTRODUCTION 3 WHY DO WE SLEEP This material serves as a general introduction to sleep for young children. Recommended ages are guidelines only. It is designed to encourage discussion and increase awareness

More information

Sometimes insomnia is a perception. Some people need less sleep. Many need only seven hours and feel fine; but feel they have insomnia because they

Sometimes insomnia is a perception. Some people need less sleep. Many need only seven hours and feel fine; but feel they have insomnia because they Insomnia Purpose: The purpose of this course is to provide an overview of insomnia including its definition, assessment and treatment options. Objectives 1. Differentiate between chronic and acute insomnia

More information

CAN'T SLEEP? YOU MAY HAVE INSOMNIA

CAN'T SLEEP? YOU MAY HAVE INSOMNIA David W. Kidder, Ph.D. Counseling Psychologist 893 Brownswitch Road, Suite 207 985-649-2011 Slidell, LA 70458 DrKidder.com CAN'T SLEEP? YOU MAY HAVE INSOMNIA WHAT IS INSOMNIA? Difficulty falling asleep

More information

Headache and Sleep Disorders 屏 東 基 督 教 醫 院 沈 秀 祝

Headache and Sleep Disorders 屏 東 基 督 教 醫 院 沈 秀 祝 Headache and Sleep Disorders 屏 東 基 督 教 醫 院 沈 秀 祝 Sleep Sleeping later Sleep deprivation Excessive Sleep Sleep Migraine Physiology of sleep Headache Clinical, Anatomical, and Physiologic Relationship Between

More information

Falling Asleep & Staying Asleep Handout

Falling Asleep & Staying Asleep Handout Falling Asleep & Staying Asleep Handout This handout contains information that may help if you have difficulty falling asleep or staying asleep. In the pages that follow, you will learn about sleep disorders

More information

Sleep Apnea Dr. Douglas Tapper

Sleep Apnea Dr. Douglas Tapper Sleep Apnea Dr. Douglas Tapper Dr. Hendler: Hello and welcome to KP Healthcast. I m your host today, Dr. Peter Hendler, and our guest is Dr. Douglas Tapper who is the chief of Pulmonary Medicine at Kaiser

More information

What to Expect During Your Stay at a Sleep Disorders Lab

What to Expect During Your Stay at a Sleep Disorders Lab What to Expect During Your Stay at a Sleep Disorders Lab Information for patients and families Read this information to learn: what a sleep study is what a CPAP titration study is how to prepare what to

More information

Melatonin prolongedrelease. (Circadin) for insomnia

Melatonin prolongedrelease. (Circadin) for insomnia Melatonin prolongedrelease tablets (Circadin) for insomnia This Medicine Update is for people who are taking, or thinking about taking, prolongedrelease melatonin. Summary Melatonin prolonged-release tablets

More information

SAMPLE. edin-labovernight ev. eatment sensorsbr. Your In-lab. ingsovernighthabits. sevaluationovernig. sks relaxedsenso. dybreathing technolo

SAMPLE. edin-labovernight ev. eatment sensorsbr. Your In-lab. ingsovernighthabits. sevaluationovernig. sks relaxedsenso. dybreathing technolo Your In-lab sleep study sevaluationovernig rsleep recordingsh stsstudycomforta orsbrainwavesre nheartbeatspecialistslee dybreathing technolo sks relaxedsenso ingsovernighthabits eatment sensorsbr comfortablesleep

More information

A Healthy Life RETT SYNDROME AND SLEEP. Exercise. Sleep. Diet 1. WHY SLEEP? 4. ARE SLEEP PROBLEMS A COMMON PARENT COMPLAINT?

A Healthy Life RETT SYNDROME AND SLEEP. Exercise. Sleep. Diet 1. WHY SLEEP? 4. ARE SLEEP PROBLEMS A COMMON PARENT COMPLAINT? Diet Sleep Exercise RETT SYNDROME AND SLEEP DR. DANIEL GLAZE, MEDICAL DIRECTOR THE BLUE BIRD CIRCLE RETT CENTER A good night s sleep promotes learning, improved mood, general good health, and a better

More information

CPAP TREATMENT Patient information September 2007

CPAP TREATMENT Patient information September 2007 LUNG FUNCTION UNIT CASTLE HILL HOSPITAL MEDICAL DIVISION CPAP TREATMENT Patient information September 2007 Working in Partnership to Provide a Quality Healthcare Service INTRODUCTION This leaflet has been

More information

Marshall Sleep Disorders Center PATIENT INFORMATION FORM (PLEASE PRINT) DATE: Date of Birth: Age: Sex: M F. Home Phone: ( ) Work Phone: ( )

Marshall Sleep Disorders Center PATIENT INFORMATION FORM (PLEASE PRINT) DATE: Date of Birth: Age: Sex: M F. Home Phone: ( ) Work Phone: ( ) Marshall Sleep Disorders Center PATIENT INFORMATION FORM (PLEASE PRINT) DATE: Name: Last First MI SSN# Address: Street City State zipcode Date of Birth: Age: Sex: M F Height: Weight: Home Phone: ( ) Work

More information

What you Need to Know about Sleep Apnea and Surgery

What you Need to Know about Sleep Apnea and Surgery What you Need to Know about Sleep Apnea and Surgery UHN For patients with sleep apnea who are going to have surgery Read this brochure to learn: What sleep apnea is Risks of having sleep apnea when going

More information

Treatment of Anxiety in the Methadone Maintained Patient

Treatment of Anxiety in the Methadone Maintained Patient Treatment of Anxiety in the Methadone Maintained Patient Abigail Kay M.D., M.A. Medical Director Narcotic Addiction Rehabilitation Program Department of Psychiatry and Human Behavior Thomas Jefferson University

More information

Allergies to Medications: Yes ( ) No ( ) if yes, explain: Allergies to environmental agents: Yes ( ) No ( ) if yes, explain:

Allergies to Medications: Yes ( ) No ( ) if yes, explain: Allergies to environmental agents: Yes ( ) No ( ) if yes, explain: Accredited by the American Academy of Sleep Medicine Sleep History Questionnaire Name: Ht: Wt: Neck Size: Allergies to Medications: Yes ( ) No ( ) if yes, explain: Allergies to environmental agents: Yes

More information

Obstructive Sleep Apnea:

Obstructive Sleep Apnea: Obstructive Sleep Apnea: Review of Screening and Management JOHN REID MD, FRCP(C), D.ABSM CSIM CONFERENCE CALGARY OCTOBER 2014 Disclosure Slide No financial or intellectual conflicts of interest to declare

More information

NON-PHARMACOLOGICAL STRATEGIES TO ENSURE A GOOD NIGHT S SLEEP

NON-PHARMACOLOGICAL STRATEGIES TO ENSURE A GOOD NIGHT S SLEEP NON-PHARMACOLOGICAL STRATEGIES TO ENSURE A GOOD NIGHT S SLEEP A guide to treat sleep problems without medication Introduction This guide has been sponsored by the Michel Saucier Chair in Geriatric Health

More information

How To Help Your Child To Sleep Better Advice For Parents Of Children And Young People Who Have Learning Disabilities Or Autism

How To Help Your Child To Sleep Better Advice For Parents Of Children And Young People Who Have Learning Disabilities Or Autism Why does my child have a sleep difficulty? Research suggests that at least two thirds of children and young people with developmental difficulties have a sleep problem at some point. Your child developing

More information

SLEEP APNEA SCREENING AND SURVEILLANCE Low Cost Monitoring Device

SLEEP APNEA SCREENING AND SURVEILLANCE Low Cost Monitoring Device SLEEP APNEA SCREENING AND SURVEILLANCE Low Cost Monitoring Device Sammy Homsi and Mustafa Muhyi Team Number: 42 Teacher: Rebecca Galves Mentor: Noor Muhyi CONTENTS Figure and tables...2 Abstract 3 Introduction..

More information

Cardio Respiratory. Obstructive Sleep Apnoea (OSA) Department. We Care

Cardio Respiratory. Obstructive Sleep Apnoea (OSA) Department. We Care Cardio Respiratory Department Obstructive Sleep Apnoea (OSA) Obstructive sleep apnoea (OSA) is a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing. If

More information

Disordered sleep at night has long been

Disordered sleep at night has long been Neurology 59 Excessive daytime sleepiness in PD Excessive Daytime Sleepiness (EDS) in Parkinson s disease (PD) is an important issue that warrants serious attention because it can have adverse effects

More information

sleep handbook Keep this by your bedside to help you get straight to sleep.

sleep handbook Keep this by your bedside to help you get straight to sleep. sleep handbook Keep this by your bedside to help you get straight to sleep. BEDSIDE BUDDY Chiropractic how can it help me get straight to sleep? Chiropractic is based on the scientific fact that the human

More information

Diagnosis and Treatment

Diagnosis and Treatment Sleep Apnea: Diagnosis and Treatment Sleep Apnea Sleep Apnea is Common Dangerous Easily recognized Treatable Types of Sleep Disordered Breathing Apnea Cessation of airflow > 10 seconds Hypopnea Decreased

More information

TeachingEnglish Lesson plans

TeachingEnglish Lesson plans Topic: Sleep Aims: - To help students talk about sleep and how it affects our lives - To develop students reading and listening skills - To develop students communication skills - To develop students debating

More information

Instructions for In-Lab Sleep Study Procedures

Instructions for In-Lab Sleep Study Procedures Instructions for In-Lab Sleep Study Procedures Please refer to the font of this booklet or email for the test you have been scheduled for Description Procedure Code Standard PSG (Polysomnogram) 95810 Split

More information

SLEEP QUESTIONNAIRE THE EPWORTH SLEEPINESS SCALE

SLEEP QUESTIONNAIRE THE EPWORTH SLEEPINESS SCALE SLEEP QUESTIONNAIRE Patient Name: Height: Weight: Date : My Main Sleep Complaint(s) : Trouble sleeping at night.. yes no Falling asleep.. yes no Staying asleep.. yes no Snoring. yes no Stop breathing yes

More information

COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH OFFICE OF THE MEDICAL DIRECTOR. 3.4 PARAMETERS FOR THE USE OF ANXIOLYTIC MEDICATIONS October 2014

COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH OFFICE OF THE MEDICAL DIRECTOR. 3.4 PARAMETERS FOR THE USE OF ANXIOLYTIC MEDICATIONS October 2014 COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH OFFICE OF THE MEDICAL DIRECTOR 3.4 PARAMETERS FOR THE USE OF ANXIOLYTIC MEDICATIONS October 2014 I. GENERAL CONSIDERATIONS A. Definition: Anxiolytic

More information

Related KidsHealth Links

Related KidsHealth Links Grades 3 to 5 Human Body Series KidsHealth.org/classroom Teacher s Guide This guide includes: Standards Related Links Discussion Questions Activities for Students Reproducible Materials Standards This

More information

Sleepless After TBI. MEDICAL News. Page 1

Sleepless After TBI. MEDICAL News. Page 1 Sleepless After TBI Why is it important to treat sleep disorders in TBI? Over 5 million people in the United States are currently living with a disability associated with brain injury. Although the major

More information

Understanding Sleep Apnea

Understanding Sleep Apnea Understanding Sleep Apnea www.sleepmangementsolutions.com What is Obstructive Sleep Apnea (OSA)? OSA afflicts 20 million adult men and women in the U.S. People who have OSA stop breathing repeatedly during

More information

Cognitive Behavioural Therapy for Insomnia: What It Is & What it Does

Cognitive Behavioural Therapy for Insomnia: What It Is & What it Does Cognitive Behavioural Therapy for Insomnia: What It Is & What it Does Colin A Espie Director: University of Glasgow Sleep Centre Sackler Institute of Psychobiological Research University of Glasgow Scotland

More information

IMPORTANCE OF SLEEP. Essential to your physical health and emotional wellbeing. Helps improve concentration and memory formation

IMPORTANCE OF SLEEP. Essential to your physical health and emotional wellbeing. Helps improve concentration and memory formation IMPORTANCE OF SLEEP Essential to your physical health and emotional wellbeing Helps improve concentration and memory formation Allows your body to repair any cell damage that occurred during the day Refreshes

More information

BENZODIAZEPINE CONSIDERATIONS IN WORKERS COMPENSATION: IMPLICATIONS FOR WORK DISABILITY AND CLAIM COSTS By: Michael Erdil MD, FACOEM

BENZODIAZEPINE CONSIDERATIONS IN WORKERS COMPENSATION: IMPLICATIONS FOR WORK DISABILITY AND CLAIM COSTS By: Michael Erdil MD, FACOEM 3 rd Quarter 2015 BENZODIAZEPINE CONSIDERATIONS IN WORKERS COMPENSATION: IMPLICATIONS FOR WORK DISABILITY AND CLAIM COSTS By: Michael Erdil MD, FACOEM Introduction Benzodiazepines, sometimes called "benzos",

More information

Poor sleep/sleepiness in teenagers

Poor sleep/sleepiness in teenagers Poor sleep/sleepiness in teenagers what causes it how to assess it what can be done to help Dorothy Bruck Professor of Psychology 1 My aim today. Help you know what to ask make differential assessments

More information

THE CENTER FOR SLEEP DISORDERS GW- MEDICAL FACULTY ASSOCIATES SLEEP DISORDERS INVENTORY

THE CENTER FOR SLEEP DISORDERS GW- MEDICAL FACULTY ASSOCIATES SLEEP DISORDERS INVENTORY THE CENTER FOR SLEEP DISORDERS GW- MEDICAL FACULTY ASSOCIATES SLEEP DISORDERS INVENTORY Vivek Jain, M.D. Director, The Center for Sleep Disorders GW-Medical Faculty Associates Samuel J. Potolicchio, M.

More information

Don t just dream of higher-quality sleep. How health care should be

Don t just dream of higher-quality sleep. How health care should be Don t just dream of higher-quality sleep. How health care should be Many of our patients with sleep disorders don t realize there s another way of life, a better way, until they are treated. Robert Israel,

More information

MODULE MULTIPLE SLEEP LATENCY TEST (MSLT) AND MAINTENANCE OF WAKEFULNESS TEST (MWT)

MODULE MULTIPLE SLEEP LATENCY TEST (MSLT) AND MAINTENANCE OF WAKEFULNESS TEST (MWT) MODULE MULTIPLE SLEEP LATENCY TEST AND MAINTENANCE OF WAKEFULNESS TEST (MWT) MULTIPLE SLEEP LATENCY TEST AND MAINTENANCE OF WAKEFULNESS TEST (MWT) OBJECTIVES: At the end of this module the student must

More information

Diseases and Health Conditions that can Lead to Daytime Sleepiness

Diseases and Health Conditions that can Lead to Daytime Sleepiness October 21, 2014 Diseases and Health Conditions that can Lead to Daytime Sleepiness Indira Gurubhagavatula, MD, MPH Associate Professor Director, Occupational Sleep Medicine University of Pennsylvania,

More information

Sleep Medicine. Maintenance of Certification Examination Blueprint. Purpose of the exam

Sleep Medicine. Maintenance of Certification Examination Blueprint. Purpose of the exam Sleep Medicine Maintenance of Certification Examination Blueprint Purpose of the exam The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment skills expected of the

More information

Underwriting Sleep Apnea

Underwriting Sleep Apnea Underwriting Sleep Apnea Joel Weiner, MD, FLMI April 29, 2014 WAHLU The Northwestern Mutual Life Insurance Company Milwaukee, WI A Brief Survey Before We Get Started The Weiner Sleepiness Scale How likely

More information

teenagers drowsy driving Staying safe behind the wheel a wellness booklet from the American Academy of Sleep Medicine

teenagers drowsy driving Staying safe behind the wheel a wellness booklet from the American Academy of Sleep Medicine teenagers drowsy driving Staying safe behind the wheel a wellness booklet from the American Academy of Sleep Medicine Dear Reader Sleep isn t just time out from daily life. It is an active state important

More information

Related KidsHealth Links

Related KidsHealth Links Grades 9 to 12 Human Body Series KidsHealth.org/classroom Teacher s Guide This guide includes: Standards Related Links Discussion Questions Activities for Students Reproducible Materials Standards This

More information

Snoring. As you breathe, air passes in and out of your lungs through your mouth, nose, and throat.

Snoring. As you breathe, air passes in and out of your lungs through your mouth, nose, and throat. Snoring Introduction Snoring is the harsh sound that is made when the flow of air through your mouth and nose is blocked while you are sleeping. Snoring can be an annoyance for your partner or other people

More information