Sleeping Disorders

 

Learning Objectives

After completing the course, you’ll be able to:

  1. Answer questions of your patient and dispel misconceptions about sleep.
  1. Describe various phases of sleep and our body's reaction during each phase.
  2. Explain the role played by circadian rhythms in our sleep.
  3. Make the connection between sleep and many diseases.
  1. Define insomnia and classify insomnia associated with various causes.
  2. Provide a differential diagnosis of primary insomnia.
  3. Frame and ask questions to assess insomnia.
  4. List 8 general sleep hygiene measures.
  5. Describe the behavioral and pharmaceutical interventions in the treatment of insomnia.
  6. Explain various therapeutic approaches in the treatment of insomnia, specifically relaxation therapy, sleep restriction therapy, stimuli control therapy and cognitive therapy.
  7. Compare the efficacy and side effects of various medications in the treatment of insomnia.
  8. Describe the effects of light, level of melatonin in the body and sleep problems.
  9. Explain the correlation between the nighttime drop in temperature and sleep.
  10. Explain how your bedroom environment can affect your sleep.
  1. State four relaxation and behavioral techniques for the management of insomnia.
  2. Identify barriers to the appropriate integration of behavioral and relaxation approaches into the treatment of pain and insomnia.
  3. Explain how the behavioral and relaxation approaches in the treatment of pain and insomnia work.
  1. Define sleepiness, distinguish it from fatigue and describe the magnitude of problem sleepiness.
  2. Describe the magnitude and causes of problem sleepiness among shift workers, adolescents and young adults.
  3. Identify strategies that may help counter problem sleepiness in adolescents and young adults.
  1. Describe the prevalence, symptoms and diagnoses of four primary sleep disorders.
  2. Describe the effects of various drugs and stimulants on sleep and sleepiness.
  3. Make an assessment of whether a patient is getting an adequate quantity of sleep and identify the patient with problem sleepiness
  4. Ask specific questions of a patient in the history-taking process to obtain a sleep/wake profile.
  1. List the risk factors for drowsy-driving crashes, identify population groups at highest risk and suggest countermeasures to prevent drowsy driving and its consequences.
  2. Identify elements of human performance that are impaired by sleepiness.
  3. Describe some tools for the assessment of chronic and situational (acute) sleepiness.
  4. 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.
  5. Identify three broad population groups at high risk for drowsy-driving crashes.
  6. Describe four categories of countermeasures and compare their effectiveness in reducing drowsy-driving crashes.
  7. Suggest behavioral interventions that reduce drowsy-driving crashes.
  8. Make three recommendations to reduce drowsy-driving crashes focusing on young males, promoting shoulder rumble strips and educating shift workers.
  9. Educate young males and shift workers about drowsy driving and how to reduce lifestyle-related risks.
  1. Define narcolepsy and list four classic symptoms of the disorder.
  2. Provide a diagnosis of narcolepsy and suggest effective courses of treatment.
  1. Describe restless legs syndrome and list some common symptoms.
  2. Identify five causes of restless legs syndrome.
  3. List three categories of drugs that are most commonly used to treat RLS.
  1. 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.
  2. Instruct clients concerning their children's obstructive sleep apnea, evaluation and possible treatment.
  3. Advise a patient about choosing a continuous positive airway pressure (CPAP) device with the desired features and applications.
  4. Help the patient with sleep apnea choose an appropriate mask and headgear.
  1. Brief a patient who is considering surgery for OSA about various options, efficacies of the treatments and possible outcomes.
  2. Caution a patient with sleep apnea about the dangers of general anesthesia in any surgery.
  1. 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).
  2. Describe the relation of neonatal and infant apnea to each other and to mortality (especially SIDS) and morbidity in infancy.
  3. Evaluate the circumstances and make recommendations to parents regarding the use of home apnea monitoring of infants.
  1. 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.
  1. 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.
  2. Provide indications for the treatment of sleep disorders, specifically obstructive sleep apnea and insomnia, in older individuals.
  3. Describe the common medical practices and lay treatment practices and their health implications for patients with insomnia and hypersomnia.
  4. Outline the issues that the medical profession and general public should know about good sleep hygiene and treatment of sleep disorders.
  5. Describe behavioral, mechanical and surgical approaches to the treatment of sleep apnea.
 

Contents Outline

Chapter 1.Test Your Sleep I.Q.

Chapter 2. Brain Basics: Understanding Sleep

Chapter 3. Insomnia: Assessment and Management in Primary Care

Chapter 4.Integration of Behavioral and Relaxation Approaches Into the Treatment of Chronic Pain and Insomnia

Chapter 5.Problem Sleepiness

Chapter 6.Problem Sleepiness in Your Patient

Chapter 7.Drowsy Driving and Automobile Crashes

Chapter 8.Narcolepsy

Chapter 9.Restless Legs Syndrome

Chapter 10.Sleep Apnea

Chapter 11. Sleep Apnea: Is Your Patient at Risk?

Chapter 12.Infantile Apnea and Home Monitoring

Chapter 13.Jet Lag

Chapter 14.The Treatment of Sleep Disorders of Older People

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