Course Outline
- Sleep I.Q.
- Answers to the Sleep I.Q.
- Sleep: A Dynamic Activity
- How Much Sleep Do We Need?
- What Does Sleep Do For Us?
- Dreaming and REM Sleep
- Sleep and Circadian Rhythms
- Sleep and Disease
- Sleep Disorders
- Insomnia
- Sleep Apnea
- Restless Legs Syndrome
- Narcolepsy
- Night Owls & Morning Larks
- Dementia-Related Sleep Disorders
- The Future
- Tips for a Good Night’s Sleep
- Introduction
- Definition and Prevalence
- Types of Insomnia
- Acute Insomnia
- Chronic Insomnia
- Selected Circadian Rhythm Sleep Disorders
- Consequences
- Recognition and Assessment
- Sleep/Wake Profile
- Suggested Questions Following a Complaint of Insomnia
- Signs of Sleepiness
- Management
- Introduction
- General Sleep Hygiene Measures
- Behavioral Treatment
- Pharmacological Treatment
- Conclusion
- References
- Members of the National Heart, Lung, and Blood Institute Working Group on Insomnia
- National Institutes of Health Staff
- Support Staff
- How Do I Cure Insomnia?
- Trouble Sleeping? Chill Out
- A Drop in Temperature May Help You Fall Asleep
- Using Light Therapy to Treat Insomnia
- Natural Treatments For Insomnia
- Bedroom Inventory
- Creating a Peaceful Place
- What’s Worrying You?
- Melatonin
- What is Melatonin?
- Why Isn’t Melatonin Considered a Drug?
- What Does This Mean to You?
- Why Do People Take Melatonin?
- Understanding Insomnia
- For More Information
- Stanford Group Therapy Program Aims to Put Insomniacs to Sleep
- Introduction
- What Behavioral and Relaxation Approaches Are Used for Conditions Such as Chronic Pain and Insomnia?
- Pain
- Insomnia
- Selection Criteria
- Relaxation Techniques
- Deep Methods
- Brief Methods
- Hypnotic Techniques
- Biofeedback Techniques
- Cognitive-Behavioral Therapy
- Relaxation and Behavioral Techniques for Insomnia
- How Successful Are These Approaches?
- Pain
- Insomnia
- Critique
- How Do These Approaches Work?
- Pain
- Insomnia
- Are There Barriers to the Appropriate Integration of These Approaches Into Health Care
- What Are the Significant Issues for Future Research and Applications
- Conclusions
- Technology Assessment Panel
- Bibliography
- Introduction
- Daytime Sleepiness Test
- The Epworth Sleepiness Scale Results
- Overview of Sleepiness
- Defining Sleepiness
- Magnitude of Problem Sleepiness
- Sleepiness Caused by Sleep Need
- Sleepiness Caused by the Biological Clock
- Effects of Problem Sleepiness
- Reversing Sleepiness
- Medications for Sleep and Sleepiness
- Shift Workers
- Introduction
- Magnitude of Problem Sleepiness Among Shift Workers
- Causes of Problem Sleepiness in Shift Workers
- Consequences of Problem Sleepiness for Shift Workers
- Countermeasures for Shift Worker Sleepiness
- Adolescents and Young Adults
- Introduction
- Magnitude of Problem Sleepiness Among Adolescents and Young Adults
- Causes of Problem Sleepiness in Adolescents and Young Adults
- Consequences of Problem Sleepiness for Adolescents and Young Adults
- Countermeasures for Problem Sleepiness in Adolescents and Young Adults
- Conclusion
- References
- Acknowledgments
- Introduction
- Consequences of Problem Sleepiness
- Automobile Crashes
- Adolescent Development and School Performance
- Work-Related Accidents
- Causes of Problem Sleepiness
- Primary Sleep Disorders
- Other Medical Conditions That Disrupt Sleep
- Effects of Drugs That Disrupt Sleep
- Inadequate Sleep Due to Lifestyle
- Identification of the Patient With Problem Sleepiness
- Table 1. Sleep/Wake Profile–Sample Questions
- Management of Problem Sleepiness
- Primary Sleep Disorders
- Where to Get More Information
- References
- Acknowledgments
- Executive Summary
- Biology of Human Sleep and Sleepiness
- Crash Characteristics
- Risks for Drowsy-Driving Crashes
- Population Groups at Highest Risk
- Countermeasures
- Focusing an Educational Campaign: Panel Recommendations
- Introduction
- Methods and Knowledge Base of This Report
- Research Needs
- Biology of Human Sleep and Sleepiness
- The Sleep-Wake Cycle
- Sleepiness Impairs Performance
- The Causes of Sleepiness/Drowsy Driving
- Evaluating Sleepiness
- Characteristics of Drowsy-Driving Crashes
- Risk for Drowsy-Driving Crashes
- Sleep Loss
- Driving Patterns
- The Use of Sedating Medications
- Untreated Sleep Disorders: Sleep Apnea Syndrome and Narcolepsy
- Consumption of Alcohol Interacts With Sleepiness to Increase Drowsiness and Impairment
- Interactions Among Factors Increase Overall Risk
- Population Groups at Highest Risk
- Young People, Especially Young Men
- Shift Workers
- People With Untreated Sleep Apnea Syndrome and Narcolepsy
- Countermeasures
- Behavioral Interventions
- Medical Interventions to Treat Narcolepsy and Sleep Apnea Syndrome
- Alerting Devices
- Shift Work Measures
- Employer Management of Work Schedules
- Employee Behavioral Steps
- Using Bright Light Treatments
- Focusing an Educational Campaign: Panel Recommendations
- Educate Young Males About Drowsy Driving and How to Reduce Lifestyle-Related Risks
- Promote Shoulder Rumble Strips as an Effective Countermeasure for Drowsy Driving; in this Context, Raise Public
- Awareness About Drowsy-Driving Risks and How to Reduce Them
- Educate Shift Workers About the Risks of Drowsy Driving and How to Reduce Them
- Other Organizations Can Provide Drowsy Driving Education
- References
- What Is Narcolepsy?
- When Should You Suspect Narcolepsy?
- How Common Is Narcolepsy?
- Who Gets Narcolepsy?
- What Happens in Narcolepsy?
- How Is Narcolepsy Diagnosed?
- How Is Narcolepsy Treated?
- What Is Being Done To Better Understand Narcolepsy?
- How Can Individuals and Their Families and Friends Cope With Narcolepsy?
- References
- Resources
- Organizations
- What Is Restless Legs Syndrome?
- Common Characteristics of Restless Legs Syndrome
- What Causes It?
- Who Gets RLS?
- How Is It Diagnosed?
- How Is It Treated?
- Where Can I Get More Information?
- Sleep Apnea Defined
- Sleep Apnea Fact Sheet
- Symptoms of Sleep Apnea
- Risk Factors for Sleep Apnea
- Treatments for Sleep Apnea
- Personal Experiences
- Sleep Apnea and Driving
- Having Your Child Evaluated for Obstructive Sleep Apnea
- Choosing a CPAP
- Choosing a Mask and Headgear
- Considering Surgery for OSA?
- Sleep Apnea and Same-Day Surgery
- Considering Surgery for Snoring?
- Definition and Prevalence
- Consequences and Comorbidity
- Identification of Patients at Risk for Sleep Apnea
- Table 1. Patients at Risk for Sleep Apnea Diagnosis Treatment Options
- Table 2. Treatment of Sleep Apnea Behavioral Approaches
- Nasal Continuous Positive Airway Pressure
- Oral/Dental Appliances
- Surgical Procedures Pharmacological Treatment
- Oxygen
- Management Considerations
- Where to Get More Information
- References
- Introduction
- Definitions
- What Is Known About the Relation of Neonatal and Infant Apnea to Each Other and to Mortality (Especially SIDS) and
- Morbidity in Infancy?
- What Are the Efficacy and Safety of Currently Available Home Devices for Detecting Infant Apnea?
- Essential Features
- Desirable Features
- Other Considerations
- What Evidence Exists Regarding the Effectiveness of Home Monitoring in Reducing Infant Mortality (Especially SIDS) and
- Morbidity?
- Effectiveness of Home Monitoring
- Home Monitoring for ALTE
- Home Monitoring for Subsequent Siblings of SIDS Victims
- Home Monitoring for Premature Infants
- Home Monitoring for Other Pathologic Conditions
- SIDS Mortality Trends and Home Monitoring
- Home Monitoring and Morbidity
- Problems in Dealing With Studies of Effectiveness
- Based on the Above, What Recommendations Can Be Made at Present Regarding the Circumstances for Use of Home
- Apnea Monitoring in Infancy?
- What Further Research Is Needed on Home Apnea Monitoring for Infants?
- Apnea
- Monitoring: Technical
- Monitoring: Psychosocial
- Apnea Program: Health Services
- Sudden Death, Including SIDS
- Conclusion
- Consensus Development Panel
- Speakers
- Conference Sponsors
- What Is Jet Lag?
- What Causes Jet Lag?
- Who Gets Jet Lag?
- Techniques for Reducing Jet Lag
- Escaping Jet Lag
- Set Your Body Clock
- Abstract
- Introduction
- What Are the Changes in Sleep and Wakefulness as Functions of Aging and of Diseases of Older People?
- What Are the Diagnostic Criteria That Establish Clinical Abnormalities?
- Which Are Clinically and Epidemiologically Important?
- What Are the Indications for a Diagnostic Evaluation?
- What Sequence of Assessment Methods Should Be Used To Determine if the Diagnostic Criteria Are Met?
- What Are the Indications for the Treatment of Sleep Disorders?
- Indications for Treatment of Obstructive Sleep Apnea
- Indications for Treatment of Insomnia Complaints
- What Are the Common Medical Practices and Lay Treatment Practices and Their Health Implications?
- Insomnia
- Hypersomnia
- What Should the Medical Profession and General Public Know About Good Sleep Hygiene and Treatment of Sleep
- Disorders, and What Should Be Done To Increase Awareness?
- What Are the Directions for Future Research?
- Conclusions and Recommendations
- Consensus Development Panel
- Speakers
- Self-Study Examination
Learning Objectives
After completing the course, you’ll be able to:
- Answer questions of your patient and dispel misconceptions about sleep.
- Describe various phases of sleep and our body’s reaction during each phase.
- Explain the role played by circadian rhythms in our sleep.
- Make the connection between sleep and many diseases.
- Define insomnia and classify insomnia associated with various causes.
- Provide a differential diagnosis of primary insomnia.
- Frame and ask questions to assess insomnia.
- List 8 general sleep hygiene measures.
- Describe the behavioral and pharmaceutical interventions in the treatment of insomnia.
- Explain various therapeutic approaches in the treatment of insomnia, specifically relaxation therapy, sleep restriction therapy, stimuli control therapy and cognitive therapy.
- Compare the efficacy and side effects of various medications in the treatment of insomnia.
- Describe the effects of light, level of melatonin in the body and sleep problems.
- Explain the correlation between the nighttime drop in temperature and sleep.
- Explain how your bedroom environment can affect your sleep.
- State four relaxation and behavioral techniques for the management of insomnia.
- Identify barriers to the appropriate integration of behavioral and relaxation approaches into the treatment of pain and insomnia.
- Explain how the behavioral and relaxation approaches in the treatment of pain and insomnia work.
- Define sleepiness, distinguish it from fatigue and describe the magnitude of problem sleepiness.
- Describe the magnitude and causes of problem sleepiness among shift workers, adolescents and young adults.
- Identify strategies that may help counter problem sleepiness in adolescents and young adults.
- Describe the prevalence, symptoms and diagnoses of four primary sleep disorders.
- Describe the effects of various drugs and stimulants on sleep and sleepiness.
- Make an assessment of whether a patient is getting an adequate quantity of sleep and identify the patient with problem sleepiness
- Ask specific questions of a patient in the history-taking process to obtain a sleep/wake profile.
- List the risk factors for drowsy-driving crashes, identify population groups at highest risk and suggest countermeasures to prevent drowsy driving and its consequences.
- Identify elements of human performance that are impaired by sleepiness.
- Describe some tools for the assessment of chronic and situational (acute) sleepiness.
- Assess the risk for drowsy-driving crashes based on factors that include sleep loss, driving patterns, the use of sedating medications, untreated sleep disorders and consumption of alcohol.
- Identify three broad population groups at high risk for drowsy-driving crashes.
- Describe four categories of countermeasures and compare their effectiveness in reducing drowsy-driving crashes.
- Suggest behavioral interventions that reduce drowsy-driving crashes.
- Make three recommendations to reduce drowsy-driving crashes focusing on young males, promoting shoulder rumble strips and educating shift workers.
- Educate young males and shift workers about drowsy driving and how to reduce lifestyle-related risks.
- Define narcolepsy and list four classic symptoms of the disorder.
- Provide a diagnosis of narcolepsy and suggest effective courses of treatment.
- Describe restless legs syndrome and list some common symptoms.
- Identify five causes of restless legs syndrome.
- List three categories of drugs that are most commonly used to treat RLS.
- Define sleep apnea, list several common symptoms, differentiate among the three types of sleep apnea and explain basic facts about sleep apnea to a patient.
- Instruct clients concerning their children’s obstructive sleep apnea, evaluation and possible treatment.
- Advise a patient about choosing a continuous positive airway pressure (CPAP) device with the desired features and applications.
- Help the patient with sleep apnea choose an appropriate mask and headgear.
- Brief a patient who is considering surgery for OSA about various options, efficacies of the treatments and possible outcomes.
- Caution a patient with sleep apnea about the dangers of general anesthesia in any surgery.
- Define terms related to infantile apnea, such as apnea of prematurity (AOP), asymptomatic premature infants, symptomatic premature infants, apparent life-threatening event (ALTE), apnea of infancy (AOI), and sudden infant death syndrome (SIDS).
- Describe the relation of neonatal and infant apnea to each other and to mortality (especially SIDS) and morbidity in infancy.
- Evaluate the circumstances and make recommendations to parents regarding the use of home apnea monitoring of infants.
- Describe the jet lag phenomenon, list the factors that cause jet lag, identify people who get jet lag and prescribe some of the techniques for reducing jet lag.
- Explain the changes in sleep and wakefulness as functions of aging and of diseases of older people and name the diagnostic criteria that establish clinical abnormalities.
- Provide indications for the treatment of sleep disorders, specifically obstructive sleep apnea and insomnia, in older individuals.
- Describe the common medical practices and lay treatment practices and their health implications for patients with insomnia and hypersomnia.
- Outline the issues that the medical profession and general public should know about good sleep hygiene and treatment of sleep disorders.
- Describe behavioral, mechanical and surgical approaches to the treatment of sleep apnea.