Sleep, An Issue of Clinics in Chest Medicine , livre ebook

Clinics in Chest Medicine
Sleep

H. Klar Yaggi
Department of Medicine, Yale University, Clinical Epidemiology Research Center, 950 Campbell Avenue, Building 35a, West Haven, CT 06510, USA

Teofilo L. Lee Chiong, Jr.
Division of Sleep Medicine, Department of Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA

Vahid Mohsenin
Department of Medicine, Yale University School of Medicine, Yale Center for Sleep Medicine, New Haven, CT, USA
ISSN  0272-5231 Volume 31 • Number 2 • June 2010
Elsevier
Table of Contents
Cover image
Title page
Contributors
Forthcoming Issues
Preface
Dedication
Sleep-Disordered Breathing
Adult Obstructive Sleep Apnea/Hypopnea Syndrome: Definitions, Risk Factors, and Pathogenesis
Definitions
Prevalence
Pathogenesis
Treatment of Obstructive Sleep Apnea Syndrome
PAP in the treatment of OSAS
Determining the optimal CPAP setting
Benefits of CPAP therapy
Problems and compliance with CPAP therapy
CPAP summary
Technological advancements in the delivery of PAP therapy for OSAS: APAP and beyond
Bilevel positive pressure therapy
Expiratory-pressure relief systems
APAP
Oral appliance therapy
Upper-airway surgery
Conservative treatments and medical therapies
Summary
Cardiovascular Consequences of Sleep Apnea
Obstructive sleep apnea and arrhythmias
Obstructive sleep apnea and pulmonary hypertension
Pediatric Obstructive Sleep Apnea Syndrome
Sequelae of pediatric obstructive sleep apnea
Central Sleep Apnea
The mechanisms of genesis of central apnea during sleep: the apneic threshold and diminished Pco2 reserve
Causes of central sleep apnea
Hypoventilation Syndromes
Hypoventilation due to neuromuscular and chest wall disorders
Hypoventilation due to lower airways obstruction
Disorders of Glucose Metabolism in Sleep-disordered Breathing
Potential mechanistic links between OSA and adverse glucose metabolism
Testing
Polysomnography
Techniques
Staging sleep
Portable PSG
Summary and future
Ambulatory Management of Patients with Sleep Apnea: Is There a Place for Portable Monitor Testing?
A problem of patient access to diagnosis and treatment
PSG is a flawed reference standard
Types of portable monitors for diagnosis of OSA
Sensors used for portable diagnostic monitors
Scoring of portable diagnostic monitor studies
Attended versus unattended portable diagnostic monitor studies
Ambulatory management of OSA
APAP devices
Validating home, unattended, portable monitor testing
Selecting patients for ambulatory management of OSA
Current guidelines for using portable monitors in ambulatory management of patients with OSA
Costs of portal monitor testing
Predicting the future
Summary
Non Pulmonary Sleep Medicine
Neurobiology of Sleep
Wake-promoting systems
NREM sleep systems
The sleep-wake transition (flip-flop switch)
REM sleep systems
Homeostatic regulation of sleep
Circadian regulation of sleep
Summary
Circadian Rhythm Sleep Disorders
The circadian neurobiome
Circadian rhythm sleep disorders
Summary
The Evaluation and Management of Insomnia
Selected comorbid insomnias
Excessive Sleepiness
Public health implications
Patient safety implications
Normal sleep
Causes of excessive sleepiness
Assessment of sleepiness
Management of sleepiness
Summary
The Parasomnias: Epidemiology, Clinical Features, and Diagnostic Approach
Classification of parasomnias
Clinical Features, Diagnosis and Treatment of Narcolepsy
Special consideration
All the Wrong Moves: A Clinical Review of Restless Legs Syndrome, Periodic Limb Movements of Sleep and Wake, and Periodic Limb Movement Disorder
RLS
PLMS
PLMW
PLMD
Summary
Medication Effects on Sleep
Neuropharmacology of wakefulness and sleep
Index
Contributors

Guest Editors
H. KLAR YAGGI, MD, MPH
Assistant Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Yale University School of Medicine, New Haven; Director, West Haven VA Medical Center Sleep Laboratory, VA CT Health Care System, Clinical Epidemiology Research Center, West Haven, Connecticut
TEOFILO L. LEE CHIONG Jr, MD
Professor of Medicine, Division of Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado
VAHID MOHSENIN, MD
Professor, Department of Medicine, Yale University School of Medicine; Director, Yale Center for Sleep Medicine, New Haven, Connecticut

AUTHORS
IMRAN AHMED, MD
Assistant Professor of Neurology, Montefiore Medical Center, Albert Einstein College of Medicine; Neurology Department, Sleep-Wake Disorders Center, Bronx, New York
ALON Y. AVIDAN, MD, MPH
Associate Professor of Neurology; Neurology Residency Program Director; Director, UCLA Neurology Clinic; and Associate Director, Sleep Disorders Center, Department of Neurology, University of California Los Angeles, Los Angeles, California
LEE K. BROWN, MD
Professor of Internal Medicine and Pediatrics and Vice Chair, Clinical Program Development, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine; Program in Sleep Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
CAROLYN M. D AMBROSIO, MD
Division of Pulmonary Diseases, Department of Medicine, Tufts-New England Medical Center; Division of Pulmonary Diseases, Department of Medicine, Tufts Medical School, Boston, Massachusetts
KARL DOGHRAMJI, MD
Professor of Psychiatry and Human Behavior, Professor of Medicine, Associate Professor of Neurology, Medical Director, Jefferson Sleep Disorders Center; Program Director, Fellowship in Sleep Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
NEIL FREEDMAN, MD, FCCP
Pulmonary Physicians of the North Shore, Bannockburn, Illinois; Sleep Institute Steering Committee Member of the American College of Chest Physicians, Chicago, Illinois
CHARLENE E. GAMALDO, MD
Assistant Professor of Neurology, Johns Hopkins Sleep Disorders Center at Johns Hopkins Hospital, Johns Hopkins School of Medicine, Baltimore, Maryland
JOHN HARRINGTON, MD
Assistant Professor, Division of Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado
MARY S.M. IP, MD
Chair Professor, Division of Respiratory Medicine, and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, People s Republic of China
BEHROUZ JAFARI, MD
Senior Fellow, Section of Pulmonary, Critical Care and Sleep Medicine, Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut
S. JAVAHERI, MD
Emeritus Professor, Department of Medicine, University of Cincinnati College of Medicine; Medical Director, Sleepcare Diagnostics, Mason, Ohio
NAVEEN KANATHUR, MD
Professor, Division of Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado
NEERAJ KAPLISH, MD
Clinical Lecturer, Department of Neurology, University of Michigan, Ann Arbor, Michigan
ELIOT S. KATZ, MD
Division of Respiratory Diseases, Department of Medicine, Children s Hospital, Boston; Division of Respiratory Diseases, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
MEIR H. KRYGER, MD
Clinical Professor of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut; Director of Research and Education, Gaylord Sleep Medicine, Wallingford, Connecticut
SAMUEL T. KUNA, MD
Chief, Pulmonary, Critical Care and Sleep Medicine Section, Department of Medicine, Philadelphia VA Medical Center; Associate Professor of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
TEOFILO LEE-CHIONG Jr, MD
Professor of Medicine, Division of Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado
BRANDON S. LU, MD, MS
Department of Medicine, California Pacific Medical Center, San Francisco, California
MACY M.S. Lui, MRCP
Medical Officer, Division of Respiratory Medicine, and Critical Care Medicine, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, People s Republic of China
VAHID MOHSENIN, MD
Professor of Medicine and Director, Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut
RUSSELL RASQUINHA, MSE
Research Coordinator, Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
FRANCOISE J. ROUX, MD, PhD
Assistant Professor of Medicine, Section of Pulmonary and Critical Care Medicine; Yale Center for Sleep Medicine, Yale University School of Medicine, New Haven, Connecticut
RACHEL E. SALAS, MD
Assistant Professor of Neurology, Division of Pulmonary and Critical Care, Johns Hopkins Sleep Disorders Center at Johns Hopkins Hospital, Johns Hopkins School of Medicine, Baltimore, Maryland
BERNARDO SELIM, MD
Post Doctoral Fellow, Division of Pulmonary an