By Nancy Foldvary-Schaefer, Jyoti Krishna, Kumaraswamy Budur
Delivering a realistic method of the creation of sleep drugs, this easy-to-use, concise quantity makes use of real sufferer instances from the Cleveland sanatorium Sleep problems heart. a large spectrum of diagnoses are integrated to show the reader to the broad variety of sleep-wake issues sufferer can adventure. Written in a concise structure designed to demonstrate the signs, diagnostic standards, workup and regimen therapy of sufferers providing to the sleep health facility, this quantity serves as a realistic textual content excellent for the busy primary-care practitioner trying to increase her wisdom of sleep-wake problems. at any time when attainable, tracings from diagnostic checks, images, and videos are supplied to augment scientific shows and to help in popularity of abnormities pointed out within the sleep laboratory.
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Extra info for A Case a Week: Sleep Disorders from the Cleveland Clinic
1 Sleep log shows difﬁculty falling and staying asleep and early morning awakenings. The black shaded area represents patients self-reported sleep period. 28 A CASE A WEEK: SLEEP DISORDERS FROM THE CLEVELAND CLINIC Physical Examination On examination, Robert was of normal weight with a body mass index of 24 kg/m2. His oropharyngeal exam showed Grade I tonsils and a Freidman tongue position Grade II. His general and neurological examinations were otherwise unremarkable. Diagnosis Psychophysiological insomnia.
The sleep history should address psychological factors such as tension, anxiety, racing thoughts, worries, and feelings of 4 A CASE A WEEK: SLEEP DISORDERS FROM THE CLEVELAND CLINIC depression that may interfere with sleep onset or continuity. It is useful to know if sleep is improved in alternative sleeping environments (say, on vacation), by use of relaxation techniques or other interventions. A survey of the sleep environment, including ambient light, temperature, electronic devices, and bedroom comfort, is important.
Sleep and psychiatric disorders in children and adolescents. New York: NYL Informa Healthcare, 2008:109–138. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999. Oct 5;131(7):485–491. Spitzer R, Kroenke K, Williams J. Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. JAMA. 1999; 282:1737–1744. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, Trenkwalder C; International Restless Legs Syndrome Study Group.
A Case a Week: Sleep Disorders from the Cleveland Clinic by Nancy Foldvary-Schaefer, Jyoti Krishna, Kumaraswamy Budur