Insomnia, Sleep Apnea, Narcolepsy

Learning Objectives 

Upon completing the course youíll be able to:

  1. Answer questions of your patient and dispel misconceptions about sleep.
  1. Describe various phases of sleep and our bodyís 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. 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. 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 childrenís 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.
Evaluation of Individual Objectives To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.

Table Of Contents

Chapter 1. Test Your Sleep I.Q.

Sleep I.Q.

Answers to the Sleep I.Q.

Chapter 2. Brain Basics: Understanding Sleep

Sleep: A Dynamic Activity

How Much Sleep Do We Need?

What Does Sleep Do For Us?

Dreaming and REM Sleep

Sleep and Circadian Rhythms

Sleep and Disease

Sleep Disorders

Insomnia

Sleep Apnea

Restless Legs Syndrome

Narcolepsy

Night Owls & Morning Larks

Dementia-Related Sleep Disorders

The Future

Tips for a Good Nightís Sleep

Chapter 3. Insomnia: Assessment and Management in Primary Care

Introduction

Definition and Prevalence

Types of Insomnia

Acute Insomnia

Chronic Insomnia

Selected Circadian Rhythm Sleep Disorders

Consequences

Recognition and Assessment

Sleep/Wake Profile

Suggested Questions Following a Complaint of Insomnia

Signs of Sleepiness

Management

Introduction

General Sleep Hygiene Measures

Behavioral Treatment

Pharmacological Treatment

Conclusion

References

Members of the National Heart, Lung, and Blood Institute Working Group on Insomnia

National Institutes of Health Staff

Support Staff

How Do I Cure Insomnia?

Trouble Sleeping? Chill Out

A Drop in Temperature May Help You Fall Asleep

Using Light Therapy to Treat Insomnia

Natural Treatments For Insomnia

Bedroom Inventory

Creating a Peaceful Place

Whatís Worrying You?

Melatonin

What is Melatonin?

Why Isnít Melatonin Considered a Drug?

What Does This Mean to You?

Why Do People Take Melatonin?

Understanding Insomnia

For More Information

Stanford Group Therapy Program Aims to Put Insomniacs to Sleep

 

Chapter 4. Problem Sleepiness

Introduction

Daytime Sleepiness Test

The Epworth Sleepiness Scale Results

Overview of Sleepiness

Defining Sleepiness

Magnitude of Problem Sleepiness

Sleepiness Caused by Sleep Need

Sleepiness Caused by the Biological Clock

Effects of Problem Sleepiness

Reversing Sleepiness

Medications for Sleep and Sleepiness

Shift Workers

Introduction

Magnitude of Problem Sleepiness Among Shift Workers

Causes of Problem Sleepiness in Shift Workers

Consequences of Problem Sleepiness for Shift Workers

Countermeasures for Shift Worker Sleepiness

Adolescents and Young Adults

Introduction

Magnitude of Problem Sleepiness Among Adolescents and Young Adults

Causes of Problem Sleepiness in Adolescents and Young Adults

Consequences of Problem Sleepiness for Adolescents and Young Adults

Countermeasures for Problem Sleepiness in Adolescents and Young Adults

Conclusion

References

Acknowledgments

Chapter 5. Narcolepsy

What Is Narcolepsy?

When Should You Suspect Narcolepsy?

How Common Is Narcolepsy?

Who Gets Narcolepsy? 

What Happens in Narcolepsy? 

How Is Narcolepsy Diagnosed? 

How Is Narcolepsy Treated? 

What Is Being Done To Better Understand Narcolepsy? 

How Can Individuals and Their Families and Friends Cope

With Narcolepsy? 

References

Resources 

Organizations 

Chapter 6. Restless Legs Syndrome

What Is Restless Legs Syndrome?

Common Characteristics of Restless Legs Syndrome  

What Causes It? 

Who Gets RLS?  

How Is It Diagnosed?  

How Is It Treated?  

Where Can I Get More Information?  

Chapter 7. Sleep Apnea 

Sleep Apnea Defined

Sleep Apnea Fact Sheet 

Symptoms of Sleep Apnea 

Risk Factors for Sleep Apnea 

Treatments for Sleep Apnea 

Personal Experiences 

Sleep Apnea and Driving 

Having Your Child Evaluated for Obstructive Sleep Apnea  

Choosing a CPAP  

Choosing a Mask and Headgear  

Considering Surgery for OSA?  

Sleep Apnea and Same-Day Surgery  

Considering Surgery for Snoring?  

Chapter 8. Women and Sleep 

Womenís Unique Sleep Experiences  

Understanding Your Monthly Cycle  

Tips That May Help Sleep 

Pregnancy: Sleeping for Two 

Snoring and Severe Daytime Sleepiness

Restless Legs and Poor Sleep 

Sleep Tips for Pregnant Women 

Understanding Menopause

Most Common Sleep Problems In Women  

Insomnia 

Sleep Apnea 

Narcolepsy

Nocturnal Sleep-Related Eating Disorder  

Pain and Sleep 

Shift Work  

Travel and Sleep  

When to See a Doctor  


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