By Paul R. Carney MD, Richard B. Berry MD, James D. Geyer MD
This clinically concentrated, useful reference is an entire consultant to diagnosing and treating sleep problems. the outlet sections clarify simple definitions, sleep tracking, and general human sleep. A medical displays part info tips to method analysis dependent upon sufferers' court cases, in addition to particular gains of the kid, adolescent, or older grownup with sleep difficulties. next sections tackle particular sleep issues and sleep problems in sufferers with different scientific and psychiatric stipulations. Chapters were seriously edited by way of specialists from a number of specialties, stick with a standardized template, and comprise bulleted lists, tables, and medical pearls. Appendices comprise details on polysomnography, sleep questionnaires, and beginning a snooze issues facility.
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Additional resources for Clinical Sleep Disorders
Hypopnea, a floating metric: Implications for prevalence, morbidity estimates, and case finding. Sleep. 1997;20:1209-1217. 32. Meoli AL, Casey KR, Clark RW. Clinical Practice Review Committee- AASM. Hypopnea in sleep disordered breathing in adults. Sleep. 2001;24:469-470. 33. Ayappa I, Norman RG, Krieger AC, et al. Non-invasive detection of respiratory effort related arousals (RERAs) by a nasal cannula/pressure transducer system. Sleep. 2000;23:763-771. 34. American Thoracic Society. Standards and indication for cardiopulmonary sleep studies in children.
POSTS usually appear in runs of bilaterally synchronous 4- to 5-Hz waves, but mild asymmetries are common. These waveforms first appear in drowsiness but may persist in deep stages of NREM sleep. On a 30-second epoch, POSTS may not be readily apparent. Stage 2 Sleep Stage 2 sleep is characterized by sleep spindles and K complexes superimposed on a background of mixed frequencies with less than 20% delta activity (Fig. 2-6). Stage 2 sleep constitutes 45% to 55% of total sleep time. Sleep spindles, or sigma activity, are rhythmic sinusoidal waves of 10 to 14 Hz seen in the central regions.
Sleep efficiency is reduced and there is more wake time in bed (8). Slow-wave sleep percentage declines and light NREM sleep (stages 1 and 2) constitutes a larger amount of the sleep period (8). 35 36 FIGURE 2-2. Sleep in the elderly. In older individuals, sleep latency is prolonged and sleep is fragmented by arousals and awakenings. The overall amount of SWS is decreased, with a relative preservation of REM sleep. Sleep architecture is commonly affected by environmental factors. The â first-night effectâ describes various alterations in sleep quality induced by a foreign environment, such as the sleep laboratory (Fig.