Sleep Medicine in Neurology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: NIP- Neurology in Practice
• Sprache: Englisch

Seitenzahl: 455

Veröffentlichungsjahr: 2013

Beschreibung

Recognize, understand, and manage sleep dysfunction in your patients

Sleep disorders can cause neurological problems. Neurological problems can cause sleep disorders. Whatever the cause or effect, neurologists need to be well versed in sleep medicine. This enables effective discussion of sleep problems and improved patient outcomes and satisfaction.

Sleep Medicine in Neurology introduces the practicing neurologist to sleep medicine, from examination of the patient to treatment of many sleep disorders. With a focused, practical approach throughout, the expert author team covers:

• History, examination and sleep testing of the patient
• Insomnia
• Excessive daytime sleepiness
• Narcolepsy
• Obstructive and central sleep apnea
• Movement disorders in sleep
• Parasomnias
• Sleep disorders in children

Clinical in approach, practical in execution, Sleep Medicine in Neurology helps you diagnose and treat your sleep-disordered patients more effectively.

Leseprobe

Contents

Contributors

Series Foreword

Preface

Acknowledgments

1 Introduction to Sleep Medicine

Introduction

A brief history of sleep and sleep medicine

Normal sleep

Sleep disorders: a brief review

Helpful resources

The future of sleep medicine

References

Further reading

2 The History and Physical Examination of the Sleep Patient

Introduction

The sleep history

Focusing the history

The physical examination

Conclusion

Further reading

3 Subjective and Objective Sleep Testing

Introduction

Subjective testing

Objective sleep testing

Conclusion

References

Appendix 1 Sleep diary (http://yoursleep.aasmnet.org/pdf/sleepdiary.pdf)

Appendix 2 Stanford Sleepiness Scale (www.stanford.edu/~dement/sss.html)

Appendix 3 Insomnia Severity Index (ISI) (www.myhealth.va.gov/mhv-portal-web/resources/jsp/help.jsp?helpDirectRequest=sleep_insomnia_indexprint.htm)

4 Approach to a Patient with Excessive Daytime Sleepiness

Introduction

History

Physical examination

Investigations and diagnostic tests

Conclusion

References

5 Approach to a Patient with Narcolepsy

Introduction

Epidemiology

Clinical symptoms

Pathophysiology

Differential diagnosis

Diagnosis

Management

Prognosis and complications

Future treatments and therapies

References

6 Evaluation and Medical Management of Sleep-Disordered Breathing

Introduction and epidemiology

Pathogenesis

Clinical presentation

Physical examination

Diagnosis

Management of obstructive sleep apnea

Management of central sleep apnea

Outcomes in neurological patients with sleep-disordered breathing

Conclusion

References

7 Surgical Management of Sleep-Disordered Breathing

Surgical evaluation

Pertinent history

Focused physical examination

Ancillary studies

Surgical treatment

Surgical procedures

Follow-up

Conclusion

References

8 Medical Co-morbidities Associated with Obstructive Sleep Apnea

Introduction

Mortality

Cardiovascular consequences and co-morbidities

Cerebrovascular disease/stroke

Endocrine consequences and co-morbidities

Neurocognitive consequences and co-morbidities

Psychological co-morbidity

Other sleep disorders

Conclusion

References

9 Non-Pharmacological Treatments of Insomnia and Circadian Rhythm Disorder: Special Focus on Neurology Patients

Introduction

Insomnia

Circadian rhythm disorder

Conclusion

References

10 Using Medications to Treat Insomnia

Introduction

Sleep requirements

Sleep architecture

Sleep disorders

Insomnia

Drugs used in treatment of insomnia

Conclusion

References

11 Parasomnias: Diagnosis, Evaluation, and Treatment

Types of parasomnias

Evaluation of the patient with a parasomnia

Parasomnia identification and initial testing

Polysomnography for parasomnias

The algorithm (Figure 11.1)

Treatment of parasomnias

Conclusion

References

Further reading

12 Restless Legs Syndrome, Periodic Limb Movements, and Other Movement Disorders in Sleep

Introduction

Restless legs syndrome

Periodic limb movement disorder

Other movement disorders of sleep

Further reading

13 Sleep and Neurological Disorders

Introduction

Parkinson’s disease and other alpha-synucleinopathies

Alzheimer’s disease and other dementias

Epilepsy

Stroke

Multiple sclerosis

Neuromuscular disease

Conclusion

Further reading

14 Cognition, Driving, and Sleep

Introduction

Acute sleep deprivation

Chronic sleep deprivation

Accidents and safety

Conclusion

References

15 Pediatric Sleep Medicine

Introduction

Sleep onset insomnia

Sleep maintenance insomnia

Breathing disorders

Hypersomnias

Circadian rhythm disturbances

Parasomnias

Nocturnal epileptic events

Sleep-related movements

Conclusion

Further reading

Index

This edition first published 2014 © 2014 by John Wiley & Sons, Ltd

Registered OfficeJohn Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Offices9600 Garsington Road, Oxford, OX4 2DQ, UKThe Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK111 River Street, Hoboken, NJ 07030–5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or website may provide or recommendations it may make. Further, readers should be aware that internet websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

Sleep medicine in neurology / edited by Douglas B Kirsch.        p. ; cm. – (Neurology in practice)    Includes bibliographical references and index.

    ISBN 978-1-4443-3551-4 (cloth)I. Kirsch, Douglas B., editor of compilation. II. Series: Neurology in practice (Series)    [DNLM: 1. Sleep Disorders. 2. Nervous System Diseases. WL 108]    RC547    616.8′498–dc23

2013023366

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: ©iStockphoto.com. Inset image courtesy of Dr Douglas B. Kirsch.Cover design by Sarah Dickinson.

Contributors

Andreea Andrei, MD

Assistant Professor

Menninger Department of Psychiatry and Behavioral Sciences

Baylor College of Medicine

The Methodist Hospital

Houston

TX, USA

Mihaela H. Bazalakova, MD, PhD

Division of Sleep Medicine

Department of Medicine

Brigham and Women’s Hospital

and

Department of Neurology

Massachusetts General Hospital

Boston

MA, USA

Martha E. Billings, MD

Department of Medicine, Division of Pulmonary Critical Care

University of Washington

UW Medicine Sleep Center

Harborview Medical Center

Seattle

WA, USA

Robert Busch, DMD, MD

Oral and Maxillofacial Surgery Department

The Methodist Hospital Physician Organization

Houston

TX, USA

Melinda Davis-Malessevich, MD

The Bobby R Alford Department of Otolaryngology – Head and Neck Surgery

Baylor College of Medicine

Houston

TX, USA

Maryann C. Deak, MD

Clinical Instructor, Harvard Medical School

Medical Director, Sleep HealthCenters Beverly

Associate Physician, Brigham and Women’s Hospital

Boston, MA, USA

Lawrence J. Epstein, MD

Division of Sleep Medicine

Department of Medicine

Brigham and Women’s Hospital

and

Instructor in Medicine, Harvard Medical School

Boston

MA, USA

Jaime Gateno, DDS, MD

Weill Cornell Medical College

and

Oral and Maxillofacial Surgery Department

The Methodist Hospital

Houston

TX, USA

Aatif M. Husain, MD

Department of Medicine (Neurology)

Duke University Medical Center

and

Neurodiagnostic Center

Veterans Affairs Medical Center

Durham

NC, USA

Makoto Kawai, MD

Department of Neurology

Methodist Neurological Institute

and

Assistant Professor

Weill Cornell Medical College

Houston

TX, USA

Douglas B. Kirsch, MD, FAASM

Harvard Medical School

and

Division of Sleep Neurology

Department of Neurology

Brigham and Women’s Hospital

Boston

MA, USA

Ravichand Madala, MD

Department of Neurology

Duke University Medical Center

Durham

NC, USA

Raman Malhotra, MD

SLUCare Sleep Disorders Center

and

Department of Neurology and Psychiatry

Saint Louis University School of Medicine

St Louis

MO, USA

Shalini Paruthi, MD

Saint Louis University School of Medicine

and

Pediatric Sleep and Research Center

SSM Cardinal Glennon Children’s Medical Center

St Louis

MO, USA

Rodney A. Radtke, MD

Department of Neurology

Duke University Medical Center

Durham

NC, USA

Mary Rose, PsyD, CBSM

Department of Medicine

Pulmonary, Critical Care and Sleep Medicine

Baylor College of Medicine

Houston

TX, USA

Rajdeep Singh, MD

Department of Neurology, Carolinas Medical Center

UNC Chapel Hill

Charlotte

NC, USA

Masayoshi Takashima, MD, FACS, FAAOA

Sleep Medicine Fellowship, Otolaryngology – Head and Neck Surgery Section

The Bobby R Alford Department of Otolaryngology – Head and Neck Surgery

Baylor College of Medicine

Houston

TX, USA

Sheila C. Tsai, MD

Department of Medicine

National Jewish Health

University of Colorado Denver School of Medicine

Denver

CO, USA

Nathaniel F. Watson, MD, MSc

Department of Neurology, University of Washington

UW Medicine Sleep Center

Harborview Medical Center

Seattle

WA, USA

Emerson M. Wickwire, PhD, ABPP, CBSM

Pulmonary Disease and Critical Care Associates

Columbia

MD, USA

and

Department of Psychiatry and Behavioral Sciences

Johns Hopkins School of Medicine

Baltimore

MD, USA

Scott G. Williams, MD

Department of Pulmonary, Critical Care and Sleep Medicine

Womack Army Medical Center

Fort Bragg

NC, USA

Series Foreword

The genesis for this book series started with the proposition that, increasingly, physicians want direct, useful information to help them in clinical care. Textbooks, while comprehensive, are useful primarily as detailed reference works but pose challenges for uses at the point of care. By contrast, more outline-type references often leave out the “hows and whys” – pathophysiology, pharmacology – that form the basis of management decisions. Our goal for this series is to present books, covering most areas of neurology, that provide enough background information to allow the reader to feel comfortable, but not so much as to be overwhelming; and to associate that with practical advice from experts about care, combining the growing evidence base with best practices.

Our series will encompass various aspects of neurology, with topics and the specific content chosen to be accessible and useful.

Chapters cover critical information that will inform the reader of the disease processes and mechanisms as a prelude to treatment planning. Algorithms and guidelines are presented, when appropriate. “Tips and Tricks” boxes provide expert suggestions, while other boxes present cautions and warnings to avoid pitfalls. Finally, we provide “Science Revisited” sections that review the most important and relevant science background material, and references and further reading sections that guide the reader to additional material.

We welcome feedback. As additional volumes are added to the series, we hope to refine the content and format so that our readers will be best served.

Our thanks, appreciation, and respect go out to our editors and their contributors, who conceived and refined the content for each volume, assuring a high-quality, practical approach to neurological conditions and their treatment.

Our thanks also go to our mentors and students (past, present, and future), who have challenged and delighted us; to our book editors and their contributors, who were willing to take on additional work for an educational goal; and to our publisher, Martin Sugden, for his ideas and support, for wonderful discussions and commiseration over baseball and soccer teams that might not quite have lived up to expectations. We would like to dedicate the series to Marsha, Jake and Dan; and to Janet, Laura and David. And also to Steven R. Schwid, MD, our friend and colleague, whose ideas helped to shape this project and whose humor brightened our lives, but he could not complete this goal with us.

Robert A. GrossJonathan W. MinkRochester, NY, USA

Preface

For centuries of scientific exploration, sleep was considered a “black box.” Though theories about what happens when humans and animals sleep have been observed in the writings of the ancient Greek philosophers through Rene Descartes and Thomas Willis and into the 19th century, little understanding of the biology of sleep occurred until the 20th century. Over the last 75 years, there has been an explosion of knowledge about the physiological processes in the brain that occur during sleep and the disorders that disrupt normal sleep.

The goal for this book is to review the clinical disorders of sleep for neurologists, but the subject material is likely relevant for a clinical practitioner of any specialty with an interest in sleep medicine. In today’s medical community, assessment of sleeping problems continues to be a mystery for many clinicians, mostly related to a dearth of sleep-related education in medical school and training programs. However, much information is now available about the links between sleep disorders and other medical conditions, including factors relevant to many clinicians’ daily practice. For instance, as neurologists consider modifiable risk factors for stroke prevention, methods of helping patients minimize headache frequency, and improving quality of life for patients with dementia, they should be considering disorders of sleep and how to address them. Hopefully, upon reviewing the chapters of this text, the reader will feel more comfortable conversing with their patients about sleep disorders and discussing possible treatment options.

Certification for sleep medicine in the United States requires a year-long fellowship after completing one of several residency programs, including neurology, internal medicine, psychiatry, and pediatrics. We are unable to replicate that learning process in this (or any) book. However, our hope is that this text provides a readable, clinically relevant source of information about sleep and its disorders, useful for any stage of medical practice from resident to attending physician. Particular tips, tricks, and cautions are highlighted in boxes throughout each chapter to increase the reader’s yield. This book introduces the topic of sleep medicine in the first chapter, discussing some of the background history and growth of the field. The second and third chapters review the clinical approach to the patient with a sleep problem and the possible options for subjective and objective testing. The following chapters describe in detail each of the major sleep disorders, including insomnia, parasomnias, hypersomnia, sleep-disordered breathing, and limb symptoms. In addition, there are chapters devoted to the specific relationships between sleep and neurological disorders and the effects of sleep disorders on cognition and driving. The final chapter reviews aspects of pediatric sleep medicine, particularly highlighting those that differ from their adult counterparts.

As a neurologist who didn’t even know sleep medicine was a subspecialty of neurology until late in my residency, I can only hope that the readers of this book, from whatever specialty, end up finding sleep medicine as exciting as I do.

Douglas B. Kirsch, MDBoston, MA

Acknowledgments

Thanks go:To Julie Elliott, from Oxford for keeping us all running like Swiss clocks … on time.

To Drs. Gross and Mink, for resuscitating a project nearing asystole.

To My parents, who let me choose my own adventure, while providing guidance along the way.

To Ryan, who smiles at me when I wake him up in the morning and when I put him to bed at night.

And to Erin, who supports what I do and amazingly enough loves me for who I am.

1

Introduction to Sleep Medicine

Douglas B. Kirsch, MD, FAASM

Harvard Medical School and Division of Sleep Neurology, Department of Neurology, Brigham and Women’s Hospital, USA

Introduction

Sleep medicine is a field which has had exponential growth over the last 25 years. Interest has blossomed from both medical practitioners and the general public on the impact sleep has on human function and long-term health. Sleep clinics and laboratories have become more common and an enlarging market of consumer goods for home analysis of sleep has developed. This chapter will introduce you to the field of sleep medicine, describe normal sleep, and provide a basic outline of the sleep disorders.

The American Medical Association recognized sleep medicine as a specialty in 1995. The field of sleep medicine is currently composed of physicians from many specialties. In fact, physicians from six American Board of Medical Specialties (ABMS) primary boards are able to sit for the board examination in sleep medicine: the American Boards of Psychiatry and Neurology, Internal Medicine, Pediatrics, Anesthesiology, Family Medicine, and Otolaryngology. This blend of primary specialties leads to a vibrant subspecialty with a variety of interests ranging from airway anatomy to snoring surveys.

CAUTION

As of 2013, to qualify to sit for the ABMS examination, an Accreditation Council for Graduate Medical Education (ACGME)-certified Sleep Medicine Fellowship must be completed. Before 2013, entry could be obtained via a practice-based experimental pathway.

A brief history of sleep and sleep medicine