Clinical Sleep Disorders

Book Preface

It has been estimated that 20% of adults and children have sleep-disordered symptoms and signs; however, internists, pediatricians, family physicians, and house staff report considerable diffi culty in managing the most common sleep conditions and promptly refer patients to the sleep specialist. In the last decade, signifi cant diagnostic and therapeutic advances have been made for a number of conditions such as sleep-disordered breathing, insomnia, sleepiness, and associated cardiovascular and neurologic disorders. Since offi ce practice is demanding and fast-paced, practitioners must have access to current evaluations and treatment recommendations in a format that lends itself to speedy review and increases their confidence as principal care providers.

The goal of Clinical Sleep Disorders is to write a comprehensive and current text and provide sleep specialists and primary care providers with succinct authoritative reviews on the evaluation and treatment of sleep disorders. The second edition of this book is designed to meet the rigorous demands of a wide range of readers, including physicians from all specialties involved in sleep medicine, resident house staff, nurses, respiratory therapists, sleep technologists, and students. Whether the patient is managed independently by the primary care physician or referred to the sleep specialist, the book is intended to improve satisfaction of the patient, the sleep specialist, and the primary care physician.

The second section of the book, “Understanding Human Sleep”, reviews the neurobiology of human sleep, breathing during wakefulness and sleep, dreaming, and sleep ontogeny. In the third section, “Clinical Presentations of Sleep Medicine”, we include a review of the evaluation and treatment of conditions encountered in the outpatient setting, including the approach to the sleepy patient and sleep deprivation, approach to the patient with problems initiating sleep, approach to restless legs, and approach to nocturnal spells. The fourth section, “Sleep Disorders”, reviews specifi c sleep conditions, including obstructive sleep apnea, upper airway resistance syndrome, central sleep apnea, periodic legs syndrome, parasomnias, narcolepsy, idiopathic hypersomnia, chronobiologic sleep disorders, and pediatric sleep disorders. In the fifth and sixth sections, “Sleep and Psychiatric Disorders” and “Sleep Patients with Other Medical Disorders”, we review the evaluation and treatment of sleep disorders and dementia and related degenerative diseases, diencephalic and brainstem sleep disorders, sleep and epilepsy, and sleep and medical disorders. In the Appendices, we review methodology and technical problems and solutions related to polysomnography, the multiple sleep latency test, CPAP/BiPAP, airway pressure methodologies, specific sleep-related questionnaires, and how to develop a sleep laboratory/center. The book will have met its overall objective if practical state-of-the-art management advice is provided to a busy physician.

Paul R. Carney
James D. Geyer
Richard B. Berry