Sleep Medicine Pearls E-Book

Mary H Wagner, Richard B. Berry

Description

Sleep Medicine is a rapidly growing and changing field. Experienced sleep medicine clinicians and educators Richard B. Berry, MD and Mary H. Wagner, MD present the completely revised, third edition of Sleep Medicine Pearls featuring 150 cases that review key elements in the evaluation and management of a wide variety of sleep disorders. The cases are preceded by short fundamentals chapters that present enough basic information so that a physician new to sleep medicine can start reading page 1 and quickly learn the essential information needed to care for patients with sleep disorders. A concise, practical format makes this an ideal resource for sleep medicine physicians in active practice, sleep fellows learning sleep medicine, and physicians studying for the sleep boards.

• Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
• Zero in on the practical, "case-based" information you need to effectively interpret sleep studies (polysomnography, home sleep testing, multiple sleep latency testing), sleep logs, and actigraphy.
• Get clear, visual guidance with numerous figures and sleep tracings illustrating important concepts that teach the reader how to recognize important patterns needed to diagnose sleep disorders.
• Confer on the go with short, templated chapters—ideal for use by busy physicians. A combination of brief didactic material followed by case-based examples illustrates major points.

• Stay current with knowledge about the latest developments in sleep medicine by reading updated chapters using the new diagnostic criteria of the recently published International Classification of Sleep Disorder, 3rd Edition and sleep staging and respiratory event scoring using updated versions of the scoring manual of the American Academy of Sleep Medicine Manual for the Scoring of Sleep and Associated Events.
• Benefit from Drs. Berry and Wagner’s 25+ years of clinical experience providing care for patients with sleep disorders and educational expertise from presenting lectures at local, regional and national sleep medicine courses. Dr Berry was awarded the AASM Excellence in Education Award in 2010.
• Access the full contents online at ExpertConsult.

Sujets

• Médecine
• Spécialités médicales
• Santé et bien-être
• Bien-être émotionnel
• Bien-être émotionnel
• Thoracic Medicine
• Pulmonary Medicine
• Medical

Informations

• Publié par: Saunders
• Date de parution: 15 septembre 2014
• Nombre de lectures: 0
• EAN13: 9780323319713
• Langue: English
• Poids de l'ouvrage: 10 Mo

Extrait

Sleep Medicine Pearls
Third Edition
Richard B. Berry, MD
Professor of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida College of Medicine
Medical Director, UF Health Sleep Disorder Center, Gainesville, Florida
Mary H. Wagner, MD
Associate Professor of Pediatrics, Division of Pediatric Pulmonary, University of Florida College of Medicine
Director, Pediatric Sleep Program, UF Health Sleep Disorder Center, Gainesville, Florida
Table of Contents
Cover image
Title page
Copyright
Dedication
Preface
Video Contents
Fundamentals 1: Sleep Stage Nomenclature and Basic Monitoring of Sleep
Fundamentals 1: Sleep Stage Nomenclature and Basic Monitoring of Sleep
Time Window for Staging Sleep
Electrooculography Monitoring of Sleep
Chin (Submental) Electromyography Monitoring
Patient 1: EEG Derivations and Eye Movements
Fundamentals 2: Electroencephalography and Electrooculography Patterns of Interest for Staging Sleep
Fundamentals 2: Electroencephalography and Electrooculography Patterns of Interest for Staging Sleep
Eye Movement Electrooculography Patterns
Patient 2: Alpha Rhythm and Sleep Spindles in a 20-Year-Old Man
Fundamentals 3: Sleep Staging in Adults I
Fundamentals 3: Sleep Staging in Adults I
Sleep Cycles
Overview of Sleep Stages
Scoring by Epochs
Stage W (Wakefulness) Rules
Stage N1
Stage N2
Stage N3
Patient 3: A 35-Year-Old Woman Who is Taking Fluoxetine and a Benzodiazepine
Patient 4: Scoring Stage N1 versus Stage W in Two Patients
Patient 5: Recognizing Stages N1 and N2
Patient 6: Recognizing Stage N3 in a Normal Individual and a Patient with Chronic Pain
Fundamentals 4: Scoring Stage R
Fundamentals 4: Scoring Stage R
Rules for Scoring Stage R
Definite Stage R
Start of Stage R
Continuation of Stage R
End of Stage R
Scoring Sleep with a Mixture of K-Complexes or Sleep Spindles and Rapid Eye Movements
Patient 7: An Arousal Interrupts Stage N2 and Stage R Sleep
Fundamentals 5: Arousals and Major Body Movements
Fundamentals 5: Arousals and Major Body Movements
Arousal Rules
Major Body Movements
Patient 8: Scoring Stage R
Patient 9: Identifying Stage R in a Woman with Violent Behavior During Sleep
Patient 10: A Patient with a Major Body Movement During Sleep
Fundamentals 6: Sleep Staging in Infants and Children
Fundamentals 6: Sleep Staging in Infants and Children
Sleep Staging in Infants and Children
Ages for Which AASM Pediatric Sleep Scoring Apply
Terminology of Sleep Stages
Posterior Dominant Rhythm
Additional Waveforms of Wakefulness
Pediatric Stage W Rules (Adapted from AASM Scoring Manual)1
Pediatric Stage N1
Pediatric Stage N1 Rules (Adapted from AASM Scoring Manual)
Pediatric Stage N2
Pediatric Stage N3
Pediatric Stage R
Pediatric Arousal Rules
Patient 11: A 3-Year-Old Male Undergoes a Sleep Study
Fundamentals 7: Sleep Architecture Terminology and Normal Patterns
Fundamentals 7: Sleep Architecture Terminology and Normal Patterns
Sleep Architecture Parameters
Normal Sleep in Adults
Sleep Architecture
Changes in Sleep Architecture with Age in Adults
Comparison of Normative Values Using the AASM Scoring Manual Versus the Manual of Rechtschaffen and Kales
Normal Sleep in Infants and Children
Patient 12: Sleep in a 20-Year-Old Man, a 2-Month-Old Infant, and a 6-Month-Old Child
Patient 13: Short REM Latency
Fundamentals 8: Effects of Sleep Disorders and Medications on Sleep Architecture
Fundamentals 8: Effects of Sleep Disorders and Medications on Sleep Architecture
Medications and Sleep
Sleep Latency and Insomnia
REM Latency
Amount of REM Sleep
Amount of Stage N3
Medications and Nightmares
Patient 14: Medications and Sleep
Fundamentals 9: Polysomnography I
Fundamentals 9: Polysomnography I
Referential and Bipolar Recording
PSG Channels
Impedance Checking, Calibration, and Biocalibrations
Information Flow During Digital PSG
Sampling Rate and Digital Resolution
Low-Frequency and High-Frequency Filters and Notch Filters
Video-Audio PSG
Patients 15: A Patient with Artifact in Many Channels
Fundamentals 10: Indications for Polysomnography, Portable Monitoring, and Actigraphy
Fundamentals 10: Indications for Polysomnography, Portable Monitoring, and Actigraphy
Diagnostic PSG
Patients at High Risk for OSA
PSG Titration
OCST (Unattended Limited Channel Sleep Testing)
Indications for OCST and Patient Selection
OCST Devices
Actigraphy
Patient 16: Out-of-Center Sleep Testing versus Portable Monitoring
Fundamentals 11: Artifacts
Fundamentals 11: Artifacts
ECG and Pulse Artifact
Pulse Artifact
Muscle Artifact
Snoring or Respiratory Chin EMG Artifact
Patient 17: Patients with Eye Movements of Interest
Patient 18: A Patient with Artifacts in the EEG and EOG Derivations
Fundamentals 12: Monitoring Respiration
Fundamentals 12: Monitoring Respiration
Air Flow
Alternative Sensors for Apnea and Hypopnea
Respiratory Effort
Arterial Oxygen Saturation
Other Respiratory Sensors
Patient 19: Respiratory Monitoring Questions
Fundamentals 13: Respiratory Event Definitions in Adults
Fundamentals 13: Respiratory Event Definitions in Adults
Apnea
Hypopnea
Respiratory Effort–Related Arousal (RERA)
Hypoventilation
Cheyne-Stokes Breathing
AHI and RDI
Patient 20: Identifying Respiratory Events
Patient 21: Two Patients with Possible Central Apnea
Patient 22: Why is the Arterial Oxygen Desaturation Severe?
Fundamentals 14: Respiratory Events in Children
Fundamentals 14: Respiratory Events in Children
Ages for Which Pediatric Respiratory Scoring Rules Apply
Pediatric Apnea Rule2
Pediatric Hypopnea Rule2
Pediatric Rera Rule2
Pediatric Hypoventilation Rule2
Periodic Breathing Rule
Obstructive Hypoventilation
Respiratory Parameters Reported in Pediatric Polysomnography
Patient 23: Sickle Disease and an Unexplained Low Arterial Oxygen Saturation
Patient 24: Central Apnea and Obstructive Hypoventilation in Children
Fundamentals 15: Electrocardiography Monitoring During Sleep Studies
Fundamentals 15: Electrocardiography Monitoring During Sleep Studies
Sinus Rhythm During Sleep
Heart Rate Changes in Obstructive Sleep Apnea
Bradycardia and Sinus Pauses
Atrioventricular Block
Tachycardia During Sleep
Premature Beats
Pacemakers
Patient 25: A Patient with Slowing of Heart Rate During Sleep
Patient 26: Patients with a Sudden Increase in Heart Rate
Fundamentals 16: Monitoring Limb and Other Movements During Sleep
Fundamentals 16: Monitoring Limb and Other Movements During Sleep
Criteria for Leg Movements and Periodic Limb Movements in Sleep
Leg Movements Associated with Respiratory Events are Not Scored
Association of Arousals with Periodic Limb Movements
Periodic Limb Movements in Sleep
Periodic Limb Movements in Wakefulness
Other Leg Movement Activity
Excessive Fragmentary Myoclonus
Bruxism
Rhythmic Movements in Sleep and Rhythmic Movement Disorder
Rem Sleep Behavior Disorder
Patient 27: Identifying Movements During Sleep
Patient 28: A Child with Repeated Movements During Sleep
Fundamentals 17: Subjective and Objective Measures of Sleepiness
Fundamentals 17: Subjective and Objective Measures of Sleepiness
Subjective Measures
Objective Measures of Sleepiness or the Ability to Stay Awake
Patient 29: Two Patients with Questionable MSLT Results
Patient 30: Evaluating an MSLT
Patient 31: Scoring an MSLT and an MWT
Fundamentals 18: Sleepiness and Sleep Complaints in Children
Fundamentals 18: Sleepiness and Sleep Complaints in Children
Normal Sleep Duration
MSLT in Children and Adolescents
Patient 32: A Teenager with Sleep-Onset REM
Patient 33: Sleep in Children
Fundamentals 19: Diagnosis of Obstructive Sleep Apnea Syndromes in Adults
Fundamentals 19: Diagnosis of Obstructive Sleep Apnea Syndromes in Adults
Adult Obstructive Sleep Apnea: Diagnostic Criteria
Evaluation of Patients
OSA Symptoms and Key Historical Points
Physical Examination
Laboratory Testing in OSA
Prediction of the Presence of OSA
Diagnostic Testing for Suspected Sleep Apnea
Out-Of-Center Sleep Testing
Patient 34: A Patient with a Negative Out-of-Center Sleep Test
Patient 35: A 30-Year-Old Woman with Unexplained Daytime Sleepiness
Patient 36: Women with Loud Snoring
Fundamentals 20: Obstructive Sleep Apnea in Adults: Epidemiology and Variants
Fundamentals 20: Obstructive Sleep Apnea in Adults: Epidemiology and Variants
Epidemiology of Adult OSA
Risk Factors for OSA
Variants of Snoring and OSA
Patient 37: A 45-Year-Old Man with a Distinct Pattern of Desaturation
Patient 38: A Patient with Severe Obesity and Hypercapnia
Fundamentals 21: Pediatric Obstructive Sleep Apnea
Fundamentals 21: Pediatric Obstructive Sleep Apnea
Epidemiology
Consequences of Childhood OSA
Diagnosis
PSG in Pediatric OSA
Treatment of Pediatric OSA
Patient 39: A 5-Year-Old Child with Behavior Problems
Patient 40: A Snoring Patient Goes to Surgery
Patient 41: A 50-Year-Old Man with Severe Hypertension
Patient 42: A Patient with Insomnia and Snoring
Patient 43: A Patient with Snoring and Recent Cerebrovascular Accident
Patient 44: An Patient with Obstructive Sleep Apnea Gets Sleepy While Driving
Fundamentals 22: Obstructive Sleep Apnea: Treatment Overview and Medical Treatments
Fundamentals 22: Obstructive Sleep Apnea: Treatment Overview and Medical Treatments
Choosing Treatment
Patient Education Before Treatment
Follow-Up and Outcomes Assessment
Medical Treatment
Patient 45: Patient with OSA and Weight Loss
Patient 46: Postural OSA
Fundamentals 23: PAP Modes and Treatment
Fundamentals 23: PAP Modes and Treatment
Modes of PAP
Auto-BPAP
PAP and Supplemental Oxygen
Comfort Measures
Interfaces
Patient 47: Unable to Tolerate Nasal CPAP Because of “T