Sleep Disorders in Geriatrics. Beth A. Malow, M.D., M.S. Associate Professor of Neurology Director, Vanderbilt Sleep Disorders Center
|
|
|
- Peter Strickland
- 7 years ago
- Views:
Transcription
1 Sleep Disorders in Geriatrics Beth A. Malow, M.D., M.S. Associate Professor of Neurology Director, Vanderbilt Sleep Disorders Center
2 Presentation Goals To recognize the prevalence and impact of treating sleep disorders in the geriatric population To become aware of the causes and treatments of sleep disorders To understand when to refer for a sleep evaluation and what the results mean
3
4 NSF 2003 Annual Poll focused on Sleep in Older Adults
5 Sleep Problems in Older Adults
6 Sleep disorders Common concerns I can t fall asleep or stay asleep I m too sleepy during the day I m told I do unusual things in my sleep
7 Case Example A 75-year-old woman complains of difficulty falling asleep. She goes to bed at 9:00 p.m., lies awake for several hours thinking about things, and watching the clock, and then feels that she only dozes lightly and intermittently all night. She experiences a creepy, crawly sensation in her legs. She wakes spontaneously at 5:00 a.m.
8
9 Sleep disorders Common concerns I can t fall asleep or stay asleep Psychophysiological Insomnia Inadequate Sleep Hygiene (poor sleep habits) Medications (corticosteroids) Neurologic Disorder (Parkinson s disease) Psychiatric Disorder (anxiety, depression) Sleep Apnea Restless Legs Syndrome ASK: about sleep time/wake time, habits (caffeine, alcohol), loud snoring, creeping/crawling sensations
10 Insomnia: Diagnosis Identify and treat underlying cause Medications can be useful for those with acute insomnia, anxiety disorders, and to accompany behavioral treatment Long term and sole use of medications not recommended for chronic insomnia Polysomnography not indicated unless there is concern of a sleep disorder causing insomnia (e.g., obstructive sleep apnea)
11 Insomnia: Drug Causes Caffeine Some antidepressants MAO inhibitors Bronchodilators Stimulants Corticosteroids
12 Psychophysiological Insomnia People with this disorder have a few nights of insomnia, perhaps due to some major stressor (death in family, new job, divorce) and then learn behaviors to prevent sleep. These behaviors include: Marked overconcern with the inability to sleep with focused absorption on sleep problem: vicious cycle develops! Associating bedroom with not sleeping (conditioned arousal) Psychophysiological insomnia may also lead to: Inadequate sleep hygiene Inappropriate use of stimulants or alcohol to promote sleep
13 Factors Affecting the Development of Insomnia (Spielman) Perpetuating Factors Conditioning Substance Abuse Abuse Poor Poor Sleep Sleep Hygiene Insomnia Predisposing Factors Personality Circadian Rhythm Age Age Precipitating Factors Situational Medical/Psychiatric Medication-related
14 Get out of bed and go into another room when you are Stimulus Control Stop associating bedroom with activities other than sleep Go to bed only when sleepy Use bed and bedroom only for sleep (no reading, TV watching, eating, etc.)
15 Sleep Restriction curtailing the amount of time spent in bed to the actual amount of sleep Many people are so worried about how long it takes them to fall asleep that they go to bed extra early (9 PM bedtime but don t fall asleep until 1 AM!) Using sleep restriction, these people would go to bed at 11 PM or midnight and fall asleep immediately, thereby breaking the cycle of lying awake in bed worrying about going to sleep. Once the cycle is broken, they can go to bed a few minutes earlier each night until they start feeling more rested.
16 Sleep Hygiene Sleep hygiene education: Exercising, but avoiding exercise too close to bedtime Regular bedtime and wake time Avoiding daytime naps Avoiding alcohol, caffeine, cigarettes Appropriate room temperature and noise level Light snack, rather than heavy meal at bedtime Avoid taking problems to bed
17 Restless Legs Syndrome A neurologic movement disorder of unknown cause Irresistible urge to move the legs, usually due to disagreeable leg sensations (creeping, crawling, termites) Worse with inactivity and at night Relieved by moving or rubbing legs Symptoms may involve arms and occur during the day Associated with periodic limb movements of sleep (PLMS) in 80% of cases although polysomnography not usually recommended for diagnosis Causes insomnia, disturbed sleep, and daytime sleepiness
18 Restless Legs Syndrome Hereditary RLS: Family studies suggest autosomal dominant inheritance, with variable penetrance. Earlier disease onset. Symptomatic RLS is associated with: Iron deficiency Chronic renal failure Pregnancy Neuropathy Spinal cord disease Peripheral vascular disease ASK about anemia, check ferritin (< 50 µg/l) even in absence of anemia is associated with RLS symptoms
19 Restless Legs Syndrome Etiology:??? No animal model, no pathologic lesion, normal cortical potentials and EEG Impaired central dopaminergic transmission demonstrated by PET studies (decreased caudate/putamen 18FDopa uptake) Treatment Dopamine agonists (e.g., pramipexole- Mirapex) Carbidopa-Levodopa (Sinemet) Opioids (e.g., codeine, oxycodone) Benzodiazepines (e.g., clonazepam) Antiepileptic drugs (e.g., gabapentin- Neurontin)
20 Sleep disorders- Common concerns I m too sleepy during the day Not enough sleep (sleep deprivation) Sleep is disrupted (sleep apnea, periodic limb movements of sleep, frequent awakenings from medical or neurological disorder) CNS pathology (narcolepsy, idiopathic hypersomnolence) Medications ASK: about sleep/wake time, awakenings, loud snoring, leg movements, medical conditions, and medications
21 Case Example A 70-year-old man with hypertension and diabetes complains of frequent awakenings and daytime sleepiness, which he attributes to the effects of a stroke he experienced 6 months ago. He is a loud snorer, and awakens with a dry mouth. His body mass index is 31, and he has a small jaw, and family history of loud snoring.
22 Risk Factors, Symptoms, Outcomes, and Comorbid Conditions of Obstructive Sleep Apnea (OSA) in Adults Young, JAMA, 2004
23 Epworth Sleepiness Scale Easy to administer in clinic setting, available as form on Vanderbilt s electronic medical record system Asks how likely you are to doze in specific situations, such as riding as a passenger in a car, watching TV, or sitting and talking to someone Scale of 0-24, with daytime sleepiness indicated by a score of 10 or greater
24 Fatigue vs. Sleepiness Individuals with daytime sleepiness function best when engaged in stimulating activities, when on their feet, not sedentary. Individuals with fatigue function best when resting, not exerting physical energy, in sedentary situations. However, sleepiness can make fatigue worse, and sleepiness and fatigue may coexist.
25 How is OSA treated? Continuous positive airway pressure (CPAP) Weight loss Positional therapy (to get person off back) Oral appliances: for mild to moderate OSA Surgery: Uvulopalatopharyngoplasty (UPPP), maxillofacial surgery, nasal somnoplasty
26 Continuous positive airway pressure (CPAP) works by using pressurized air to splint open the upper airway, preventing collapse during sleep A titration study in the sleep lab is followed by prescribing CPAP for home use
27 Only 40-60% of patients use CPAP every night when adherence is measured with usage meters
28 Why don t people use CPAP? Unattractive, feel old, sick, like ICU patient Claustrophobia Annoying and cumbersome to put on and wear Uncomfortable No clear benefit to using it Poor coping styles
29 Claustrophobia? Cumbersome?
30 What do we accomplish in sleep clinic? Assess for other sleep disorders which may coexist with sleep apnea (e.g., narcolepsy, insomnia). Treatment of sleep apnea in a vacuum without paying attention to these other factors is not as successful. Patient is still sleepy due to narcolepsy, insufficient sleep, poor sleep hygiene, etc. May not use CPAP due to lack of perceived benefit. Patient lies awake at night with CPAP on, unable to fall asleep due to restless legs, psychophysiological insomnia, etc. Provide intensive education PRIOR to sleep study and AFTER baseline, before CPAP. Education emphasizes importance of treatment and identifies motivators for patient to use CPAP.
31 CPAP desensitization Done in our weekly CPAP clinic Instruct the patient to wear CPAP for incrementally increased periods of time, while awake and relaxed CPAP desensitization is ideally performed BEFORE in-lab CPAP titration, although patients may not declare themselves as CPAP intolerant until in-lab titration
32 Common remediable discomforts Mask problems: air leaks, skin irritation, removal of mask unintentionally Nasal congestion Mouth leaks Pressure intolerance Machine noise
33 No benefit, not worth the bother Work with patient to identify motivators: Daytime Alertness Improvement in Fatigue Sense of well-being Improvement in irritability Improvement in mood Improved health
34 Sleep disorders- Common concerns I m told I do unusual things in my sleep Parasomnias: disorders in which undesirable physical or mental phenomena occur during sleep NREM arousal disorders (sleepwalking, night terrors) REM sleep behavior disorder (dream-enacting behavior) Rhythmic movement disorder (head banging) Sleep Starts (hypnic jerks) Nocturnal seizures may mimic parasomnias
35 Case Example A 63-year-old accountant, who had been in the military, experienced combative sleep behaviors for ten years. A psychiatrist diagnosed post-traumatic stress disorder, but treatment was ineffective. He continued to have early morning spells of kicking, punching, screaming, sitting up and jumping out of bed to attack furniture. In the morning, he recalled dreaming of protecting his family from enemy soldiers.
36 REM Sleep Behavior Disorder Patients act out their dreams with punching, kicking, or diving from bed Prodrome of sleeptalking, yelling, and limb-twitching may precede symptoms Behavior discordant with dreamer s daytime personality Pathophysiology: lack of muscle atonia during REM sleep and disinhibition of brainstem centers
37 Parkinson s disease and Parkinsonian Syndromes Dementia, especially Diffuse Lewy Body Disease Narcolepsy Medications, including tricyclic antidepressants Alcohol withdrawal Etiology unknown in 50% of patients Parkinson s disease may occur more than 10 years after diagnosis REM Sleep Behavior Disorder- Associated Conditions
38 REM Sleep Behavior Disorder- Polysomnography Many sleep specialists recommend obtaining video-eeg polysomnography in suspected REM sleep behavior disorder. Diff dx includes sleep apnea, arousal disorder, and seizures. Can make diagnosis without capturing episode if REM sleep shows persistently elevated tonic chin EMG with excessive chin or limb twitching Videotaping important to document behavior Extended EEG montage important to exclude epileptic seizures
39
40 Vanderbilt Sleep Disorders Center
41
42 Vanderbilt Sleep Disorders Center
43 Vanderbilt Sleep Disorders Center
44 Vanderbilt Sleep Disorders Center
45 Vanderbilt Sleep Disorders Center
46 Summary Sleep disorders are important contributors to poor health in the geriatric population Sleep disorders are often treatable and can be diagnosed readily by a sleep evaluation and/or polysomnography Take home message: think about sleep disorders in your patients, especially in those with concerns about daytime functioning and overall health
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
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
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
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
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:
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
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
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
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
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
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:
building. 2. Enter Turn the on 5305 and begin Building testing and take the elevator/stairs to the third floor, turn right and go into
SLEEP DISORDERS CENTER St. Joseph Mercy Ann Arbor 5305 Elliott Drive, Ypsilanti, MI 48197 734-712-2276 / Fax 734-712-2967 Sleep Study Information Home Sleep Apnea Testing Dear,, Your are Sleep scheduled
Arlington Dental Associates Ira Stier DDS PC 876 Dutchess Tpk 2 Lafayette Ct. Poughkeepsie, NY 12603 Fishkill, NY 12524 845-454-7023 845-896-4977
Home Sleep Test Liability Form Study Equipment Due: @ I, accept responsibility for the sleep monitoring device while it is in rny possession. I understand that if I fail to return the device or I return
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
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
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
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,
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
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,
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:
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)
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
Sleep Medicine and Psychiatry. Roobal Sekhon, D.O.
Sleep Medicine and Psychiatry Roobal Sekhon, D.O. Common Diagnoses Mood Disorders: Depression Bipolar Disorder Anxiety Disorders PTSD and other traumatic disorders Schizophrenia Depression and Sleep: Overview
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
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.
Corporate Medical Policy
Corporate Medical Policy Polysomnography for Non Respiratory Sleep Disorders File Name: Origination: Last CAP Review: Next CAP Review: Last Review: polysomnography_for_non_respiratory_sleep_disorders 10/2015
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?
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
Patient Sleep Questionnaire
Patient Sleep Questionnaire Patient Name: _ Sex: Age: Date: Occupation: _ Usual Work Hours/Days: _ Referring Physician: Family Physician (PCP): Patient s email address: Please complete the following questionnaire
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
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
About Sleep Apnea ABOUT SLEEP APNEA
ABOUT SLEEP APNEA About Sleep Apnea What is Sleep Apnea? Sleep Apnea (from Greek, meaning "without breath") is one of the most common sleep disorders in which breathing stops and then restarts again recurrently
elf-awareness Toolkit
S Snoring & Sleep Apnea elf-awareness Toolkit Snoring: Your Dentist Can Test So You Can Rest 2009 Snoring Isn t Sexy, LLC S Snoring & Sleep Apnea elf-awareness Toolkit Snoring: Your Dentist Can Test So
Neurological causes of excessive daytime sleepiness. Professor Adam Zeman Royal Devon and Exeter Hospital University of Exeter Medical School
Neurological causes of excessive daytime sleepiness Professor Adam Zeman Royal Devon and Exeter Hospital University of Exeter Medical School Excessive daytime sleepiness Physiological sleep deprivation,
Please have your bed partner assist you with the enclosed questionnaire and bring it, completed, with you to your scheduled sleep appointment.
Welcome! Please read the following document carefully as it contains pertinent information regarding your sleep study, interpretation of your study, and billing information. On behalf of our staff here
SLEEP DISORDERS IN ASBESTOS-RELATED DISEASES
SLEEP DISORDERS IN ASBESTOS-RELATED DISEASES Asbestos pleural diseases ie benign asbestos pleural plaques, diffuse pleural thickening, benign asbestos pleurisy, benign asbestos pleural effusions and asbestosis
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
ROLE OF ORAL APPLIANCES TO TREAT OBSTRUCTIVE SLEEP APNEA
1 ROLE OF ORAL APPLIANCES TO TREAT OBSTRUCTIVE SLEEP APNEA There are three documented ways to treat obstructive sleep apnea: 1. CPAP device 2. Oral Appliances 3. Surgical correction of nasal and oral obstructions
Polysomnography in Patients with Obstructive Sleep Apnea. OHTAC Recommendation. Polysomnography in Patients with Obstructive Sleep Apnea
OHTAC Recommendation Polysomnography in Patients with Obstructive Sleep Apnea June 16, 2006 1 The Ontario Health Technology Advisory Committee (OHTAC) met on June 16, 2006 and reviewed a health technology
SUMMARY OF RECOMMENDATIONS
SUMMARY OF RECOMMENDATIONS FOR THE LONG- TERM TREATMENT OF RLS/WED from AN IRLSSG TASK FORCE Members of the Task Force Diego Garcia- Borreguero, MD, Madrid, Spain* Richard Allen, PhD, Baltimore, MD, USA*
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
MODULE. POSITIVE AIRWAY PRESSURE (PAP) Titrations
MODULE POSITIVE AIRWAY PRESSURE (PAP) Titrations POSITIVE AIRWAY PRESSURE (PAP) TITRATIONS OBJECTIVES At the end of this module the student must be able to: Identify the standards of practice for administering
Obstructive Sleep Apnoea
Obstructive Sleep Apnoea What is obstructive sleep apnoea? People who suffer from Obstructive Sleep Apnoea (OSA) reduce or stop their breathing for short periods while sleeping. This can happen many times
States of Consciousness Notes
States of Consciousness Notes There s been a lot in the news lately about the new Peace Palace they re building in West L.A., for people to come and meditate and not just Hollywood people! Psych 1 - States
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
Restless Legs Syndrome: Who are Willis and Ekbom?
Restless Legs Syndrome: Who are Willis and Ekbom? Rochelle Goldberg, MD, FAASM, FCCP Associate Professor, Sidney Kimmel Medical Center, Thomas Jefferson University Director, Sleep Medicine Services Main
Raising Sleep Apnea Awareness:
Raising Sleep Apnea Awareness: Among People with Diabetes in North Carolina, 2012 People with diabetes have more sleep problems than people without diabetes in the same age, sex, and race/ethnicity group.
What is Obstructive Sleep Apnoea?
Patient Information Leaflet: Obstructive Sleep Apnoea Greenlane Respiratory Services, Auckland City Hospital & Greenlane Clinical Centre Auckland District Health Board What is Obstructive Sleep Apnoea?
Diabetes - - people with diabetes often wake up with night sweats, frequent need to urinate, diarrhea or symptoms of hypoglycemia.
Medical Illnesses that May Disturb Sleep More than 70% of people with medical illnesses suffer from sleep problems. Their trouble sleeping may stem from the disease itself or from the medicines used to
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
SUMMA HEALTH SYSTEM. Sleep Medicine Services
SUMMA HEALTH SYSTEM Sleep Medicine Services Contents Why should I be concerned about a sleep disorder? 2 Evaluate Your Daytime Sleepiness 3 Common sleep disorders 5 About sleep studies 6 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
EXPECTATIONS OF PHYSICIANS INTENDING TO PRACTISE SLEEP MEDICINE CHANGING SCOPE OF PRACTICE PROCESS BACKGROUND
EXPECTATIONS OF PHYSICIANS INTENDING TO PRACTISE SLEEP MEDICINE CHANGING SCOPE OF PRACTICE PROCESS BACKGROUND The College is gradually moving toward a system of performance measurement by focusing on a
News on sleep apnea for the commercial trucking industry. Support system leads to CPAP success
PPD Protecting Professional Drivers SM Driver edition Summer 2011 Volume 4, Issue 3 News on sleep apnea for the commercial trucking industry Visit PPD s new driver blog for OSA support Support system leads
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
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
Benzodiazepine & Z drugs withdrawal protocol
Benzodiazepine & Z drugs withdrawal protocol Rationale The NSF for Older People has highlighted the issues of dependence, sedation and fall in the elderly when taking these types of medications. It has
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
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
1/25/2015. Idiopathic restless legs syndrome: clinical definition, pathophysiology and treatment. Five essential criteria (all must be met)
Idiopathic restless legs syndrome: clinical definition, pathophysiology and treatment Joan Santamaria, MD Neurology service, Multidisciplinary Sleep Disorders Unit Hospital Clínic de Barcelona University
Treatment of Obstructive Sleep Apnea (OSA)
MP9239 Covered Service: Prior Authorization Required: Additional Information: Yes when meets criteria below Yes as shown below None Prevea360 Health Plan Medical Policy: 1.0 A continuous positive airway
SLEEP, RECOVERY, AND HUMAN PERFORMANCE A Comprehensive Strategy for Long-Term Athlete Development
SLEEP, RECOVERY, AND HUMAN PERFORMANCE A Comprehensive Strategy for Long-Term Athlete Development Post-exercise recovery and regeneration (PERR) is as important as the training regimen to the complex adaptive
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
SLEEP QUESTIONNAIRE AND WAKEFULNESS
SLEEP QUESTIONNAIRE AND WAKEFULNESS (SQAW) PATIENT: DOCTOR: DATE COMPLETED: Must Be Completed by Appointment Date 7423-029-W-BKLT 11-1-09 For questions to be answered on a scale of 1 to 5, please circle
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
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
BCN e-referral Questionnaire Preview: Sleep study, outpatient facility or clinic-based setting
Sleep studies, outpatient facility or clinic-based setting Blue Care Network provides coverage for attended sleep studies in the outpatient treatment setting for pediatric members and for adult members
Ch 7 Altered States of Consciousness
Ch 7 Altered States of Consciousness Consciousness a state of awareness Altered State of Consciousness involves a change in mental processes in which one is not completely aware Sleep is a state of altered
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
CPAP Treats Muscle Cramps in Patients with Obstructive Sleep Apnea
CPAP Treats Muscle Cramps in Patients with Obstructive Sleep Apnea Andrew J Westwood, M.D., MRCP(UK) 1, Andrew R Spector, M.D., 2 Sanford H Auerbach, M.D. 3 1 Columbia University College of Physicians
INF159. Tiredness can kill. Advice for drivers. including drivers with Obstructive Sleep Apnoea Syndrome (OSAS) 2/16
INF159 Tiredness can kill Advice for drivers including drivers with Obstructive Sleep Apnoea Syndrome (OSAS) 2/16 What if I have a condition causing sleepiness/tiredness during the day? You need to tell
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
Snoring and Obstructive Sleep Apnea (updated 09/06)
Snoring and Obstructive Sleep Apnea (updated 09/06) 1. Define: apnea, hypopnea, RDI, obstructive sleep apnea, central sleep apnea and upper airway resistance syndrome. BG 2. What are the criteria for mild,
Non-epileptic seizures
Non-epileptic seizures a short guide for patients and families Information for patients Department of Neurology Royal Hallamshire Hospital What are non-epileptic seizures? In a seizure people lose control
DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource
E-Resource March, 2015 DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource Depression affects approximately 20% of the general population
Hitting the Mattress. Getting a good night s sleep is hard enough. Don t let multiple sclerosis turn your bed into the enemy.
Hitting the Mattress Getting a good night s sleep is hard enough. Don t let multiple sclerosis turn your bed into the enemy. 24 Neurology now January/February 2009 Even before Glenn Scott was diagnosed
Headache Types. Behavioral Treatments of. Tension Headache. Migraine Headache. Mixed Headaches. TMJ Disorder. Tension Migraine.
Headache Types Behavioral Treatments of Migraine Headaches Jonathan D. Cole, Ph.D. Clinical and Health Psychologist Bluegrass Health Psychology Lexington, KY Tension Migraine Mixed Cluster TMJ Tension
Care Manager Resources: Common Questions & Answers about Treatments for Depression
Care Manager Resources: Common Questions & Answers about Treatments for Depression Questions about Medications 1. How do antidepressants work? Antidepressants help restore the correct balance of certain
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
CONCORD INTERNAL MEDICINE TESTOSTERONE DEFICIENCY PROTOCOL
CONCORD INTERNAL MEDICINE TESTOSTERONE DEFICIENCY PROTOCOL Douglas G. Kelling, Jr., MD Carmella Gismondi-Eagan, MD, FACP George C. Monroe, III, MD Revised April 29, 2012 The information contained in this
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
Rapid Resolution of Intense Suicidal Ideation after Treatment of Severe. From the Department of Psychiatry and Psychology (L.E.K.
Category [Case Report] Rapid Resolution of Intense Suicidal Ideation after Treatment of Severe Obstructive Sleep Apnea Lois E. Krahn, MD Bernard W. Miller, RPSGT Larry R. Bergstrom, MD From the Department
Treating Sleep Apnea A Review of the Research for Adults
Treating Sleep Apnea A Review of the Research for Adults Is This Information Right for Me? Yes, if: A doctor said you have mild, moderate, or severe obstructive sleep apnea, or OSA. People with OSA may
The Importance of Restful Sleep 4. Normal Breathing During Sleep 5. The Impact of Snoring on Sleep 6. Causes of Snoring 7
Contributing Authors THEODORE M. BERMAN, M.D. is a board certified medical specialist in sleep disorders medicine and pulmcnary medicine. Dr. Berman is a partner of the Minn sota Sleep Institute and practices
Maharashtra University of Health Sciences, Nashik. Syllabus. Fellowship Course in Sleep Medicine
Maharashtra University of Health Sciences, Nashik Syllabus Fellowship Course in Sleep Medicine Appendix A a) Title of the Fellowship Course: Fellowship Course in Sleep Medicine b) Duration of Course: 1
Pacific Sleep Program
Name: Date of Birth: / / Pacific Sleep Program Portland & Astoria Setting the standard in sleep medicine for over 30 years PATIENT QUESTIONNAIRE Hello, You have been referred to the Pacific Sleep Program
David W. Brandes, MS, MD, FAAN Hope MS Center, Knoxville, TN Director, Rest Analysis, Los Angeles, CA Asst. Clinical Professor, UCLA
David W. Brandes, MS, MD, FAAN Hope MS Center, Knoxville, TN Director, Rest Analysis, Los Angeles, CA Asst. Clinical Professor, UCLA Mrs. Smith: Doctor, I m tired all the time. Doctor: What do you mean
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
NeuroStar TMS Therapy Patient Guide for Treating Depression
NeuroStar TMS Therapy Patient Guide for Treating Depression This NeuroStar TMS Therapy Patient Guide for Treating Depression provides important safety and use information for you to consider about treating
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
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
Headaches and Kids. Jennifer Bickel, MD Assistant Professor of Neurology Co-Director of Headache Clinic Children s Mercy Hospital
Headaches and Kids Jennifer Bickel, MD Assistant Professor of Neurology Co-Director of Headache Clinic Children s Mercy Hospital Overview Headache classifications and diagnosis Address common headache
Parkinson s Disease Symptoms Guide
Parkinson s Disease Symptoms Guide Some symptoms of Parkinson s disease (PD) are hard for even specialists to detect. Others are obvious even to an untrained eye. Parkinson s symptoms are different for
SLEEP. Sleep Sleep disorders Lifestyle SCIENCE FAIR JUNE 11, 2010. Polysomnography (PSG) Polygraphy (PG) Neurophysiological parameters in PSG
Sleep Sleep disorders Lifestyle SLEEP SCIENCE FAIR JUNE 11, 2010 Dirk Pevernagie and Ronald M. Aarts 1 2 Polysomnography (PSG) Method:Simultaneous recording of neurophysiological signals (EEG, EOG, EMG)
Effective Treatment of Sleep Problems for Children with ASD
Effective Treatment of Sleep Problems for Children with ASD Dennis R Dixon, Ph.D. Center for Autism & Related Disorders, Inc. Normal Sleep What is Sleep? Sleep is a brain process Yet effected by environmental
Migraine The Problem: Common Symptoms:
Migraine The Problem: A combination of genetic and environmental factors alter pain mechanisms in your brain Transient changes in brain chemicals such as serotonin and neuropeptides affect the membranes
Excessive Daytime Sleepiness
Focus on CME at the xxx University of British Columbia On the Alert for Excessive Daytime Sleepiness Najib T. Ayas, MD, MPH; and Charlie S.K. Wang, MD Presented at UBC s 4th Annual Advances in Respiratory
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
Depression in Older Persons
Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression
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: