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Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

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Nội dung chi tiết: Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2nd Kelly Marie NewtonSleeplessness, restlessness at night, and insomnia are a common clinical complaint for the primary care patient. Patients may pre

sent with insomnia as the chief complaint. but insomnia will commonly be present as part of another illness or complaint. Insomnia has been reported a Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

nd is observed worldwide. In the adult population. 33-50 % will complain of insomnia in their lifetime, and 10-15 % will associate these symptoms with

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

distress or impairment. Identifiable risk factors include increasing age. female sex. comorbid disorders, shift work, and potentially lower socioecon

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2is often chronic: over the course of several years. 50-85 % of individuals will report persistence in symptoms [2].The International Classification of

Sleep Disorders. Third Edition, defines insomnia as repeated difficulty with sleep initiation, duration, consolidation, or quality that occurs despit Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

e adequate sleep opportunity, a persistent sleep difficulty, and associated daytime dysfunction [ 1 ]. Patients often complain of extended periods of

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

nocturnal wakefulness or insufficient sleep that are associated with daytime symptoms of fatigue, decreased mood, irritability, malaise, or some kind

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2omnia.J.Harrington. M.D., M.P.H. (E3)Division of Pulmonary/Critical Care/Sleep/Allergy.985990 Nebraska Medical Center. Omaha. NE 68198-5990, USAe-mail

: john.harrington@unmc.eduK.M. NewtonDivision of Critical Care and Hospital Medicine. Department of Medicine. National Jewish Health. 1400 Jackson Str Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

eet. Denver. CO 80206. USA e-mail: newtonk@NJHealth.org© Springer International Publishing Sw itzerland 2015D I/ X, 1.711...,\ <•/.........,„<■/...7.»

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

/..«» hAi IA 1AAT/ATO -J ÍIA 1OAC1 A Ừ101J. Harrington and K.M. Newton102Table 8.1 Consequences of insomniaFatigue or malaiseCognitive impairment (att

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2k of motivation or initiative reductionErrors or accidents at work or while driving Muscle tensionHeadachesGl upsetPatient HistoryThe evaluation of th

e patient complaining of sleeplessness begins with a careful history' and physical exam that addresses both sleep and waking behaviors. The history sh Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

ould include questions designed to evaluate the possibility of common medical, psychiatric and medication, or substance abuse-related issues [2|. Taki

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

ng a good history from a patient with sleeplessness or restless sleep can be lime consuming, but is critical to making a correct diagnosis and in guid

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2eep, early morning wakings, or nonrestorative sleep), severity, impact on daytime functioning, frequency (how many nights a week), duration (how long

has this been occurring), type of course (intermittent or progressive), aggravating or ameliorating symptoms, treatment attempts, and response to ther Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

apy [2]. Discussing the patient’s bedtime behaviors such as characterizing the sleeping environment, the patient's emotional state, and whether the pa

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

tient senses dread regarding sleep and sleep behaviors can provide insight [2]. Understanding the patients' sleep-wake cycle to include sleep latency

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2o-day variability should also be examined [2]. Patterns of sleep can be ascertained which may provide clues to circadian rhythm disorders, and assessi

ng the amount of sleep can provide clues that the patient has too much or too little sleep opportunity [2].In assessing insomnia, it is important to s Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

creen forcomorbid sleep disorders such as restless leg syndrome, obstructive sleep apnea, and parasomnias (sleep walking/ sleep talking) [2]. Comorbid

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

medical complaints such as chronic pain, untreated reflux, uncontrolled nocturnal asthma, headaches, and paroxsysmal nocturnal dyspnea may contribute

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2ional histories (Table 8.2). Not only are medical and psychiatric illnesses often comorbid or even causative for insomnia, but direct effects8 Key His

tory and Physical Examination Findings for the Sleepless or Restless Patient 103Table 8.2 Topics lo cover when taking a patient history for compliant Ebook Sleepy or sleepless - Clinical approach to the sleep patient: Part 2

of insomniaSleep patternsBedtimeTime the patient tries to go sleep

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

Part IIThe Sleepless or Restless PatientChapter 8Key History and Physical Examination Findings for the Sleepless or Restless PatientJohn Harrington an

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