Principles and Practice of Sleep Medicine: Expert Consult - Online and Print, 5th Edition

Cover......Page 1
Front Matter......Page 2
ISBN:   9781416066453......Page 4
Copyright......Page 5
Dedication......Page 6
Poetry......Page 7
Contributors......Page 10
Foreword......Page 24
Preface......Page 28
Acknowledgments......Page 30
Abbreviations......Page 32
SLEEP AS A PASSIVE STATE......Page 37
THE ELECTRICAL ACTIVITY OF THE BRAIN......Page 38
EARLY OBSERVATIONS OF SLEEP PATHOLOGY......Page 39
THE DISCOVERY OF REM SLEEP......Page 40
ALL-NIGHT SLEEP RECORDINGS AND THE BASIC SLEEP CYCLE......Page 41
REM SLEEP IN ANIMALS......Page 42
EUROPEAN INTEREST......Page 43
BIRTH PANGS......Page 44
THE EARLY DEVELOPMENT OF SLEEP MEDICINE CLINICAL PRACTICE......Page 45
FURTHER DEVELOPMENT OF SLEEP MEDICINE......Page 46
THE TURN OF THE CENTURY AND BEYOND......Page 47
REFERENCES......Page 48
SLEEP DEFINITIONS......Page 50
Electromyogram......Page 51
Simple Behavioral Task......Page 52
Memory Near Sleep Onset......Page 53
First Sleep Cycle......Page 54
Generalizations about Sleep in the Normal Young Adult......Page 55
Prior Sleep History......Page 56
Drug Ingestion......Page 57
Sleep Fragmentation......Page 58
REFERENCES......Page 59
SLEEP ARCHITECTURE......Page 61
Percentage of Time Spent in Each Sleep Stage......Page 62
Slow-Wave Sleep......Page 63
CIRCADIAN RHYTHMS IN AGING......Page 64
Causes......Page 66
RESTLESS LEGS SYNDROME AND PERIODIC LIMB MOVEMENTS IN SLEEP......Page 67
Risk Factors......Page 68
Outcomes......Page 69
BASIC SCIENCE CONSIDERATIONS......Page 70
REFERENCES......Page 71
Sleepiness in Representative Populations......Page 76
Physiological Need State......Page 77
Neural Substrates of Sleepiness......Page 78
Quantifying Sleepiness......Page 79
Relation of Sleepiness to Behavioral Functioning......Page 80
Quantity of Sleep......Page 81
Circadian Rhythms......Page 82
Sedating Drug Effects......Page 83
CLINICAL AND PUBLIC HEALTH SIGNIFICANCE OF SLEEPINESS......Page 84
REFERENCES......Page 85
Sleep/Circadian Influences......Page 88
Temperature......Page 89
Motivation or Interest......Page 90
Personality and Psychopathology......Page 91
EEG Measures......Page 92
Autonomic Changes......Page 93
Pain......Page 94
Experimental Sleep Fragmentation......Page 95
Performance Effects......Page 96
EEG Effects......Page 97
REFERENCES......Page 98
Basal Sleep Need......Page 101
Two-Process Model Predictions of Sleep Restriction......Page 102
Sleep Propensity......Page 103
Cognitive Effects......Page 104
Individual Differences in Responses to Chronic Sleep Restriction......Page 106
REFERENCES......Page 107
Isolated Forebrain......Page 110
RETICULAR ACTIVATING SYSTEM AND DELINEATION OF AROUSAL SYSTEMS......Page 111
Serotonin......Page 112
SLEEP-PROMOTING MECHANISMS......Page 113
c-Fos Mapping......Page 114
THE ORCHESTRATION OF SLEEP BY THE POA HYPNOGENIC SYSTEM......Page 115
THALAMIC–CORTICAL INTERACTIONS AND THE GENERATION OF THE SLEEP EEG......Page 116
Slow Oscillations......Page 118
HIERARCHICAL CONTROL MODEL......Page 120
Adenosine......Page 121
Sleep as Detoxification or Protection from Oxidative Stress......Page 122
REFERENCES......Page 123
CHARACTERISTICS OF REM SLEEP......Page 126
Inactivation of Neurons by Lesions, Inhibition, Antisense Administration, or Genetic Manipulation......Page 127
Activation of Neurons by Electrical or Chemical Stimulation, Gene Activation, or Ion Channel Manipulation......Page 128
Observation of Neuronal Activity......Page 129
Transection Studies......Page 130
Localized Lesion Studies......Page 132
Medial Brainstem Reticular Formation......Page 133
Fos Labeling......Page 134
CONTROL OF MUSCLE TONE......Page 135
NARCOLEPSY AND HYPOCRETIN......Page 137
THE FUNCTIONS OF REM SLEEP......Page 139
REFERENCES......Page 142
The Origins and Definition of Sleep Homeostasis......Page 146
Sleep Duration and Sleep Intensity......Page 147
Daily Time Course of Slow-Wave Activity and Its Sleep-Wake Dependence......Page 149
Circadian versus Homeostatic Aspects of Sleep Regulation......Page 150
Sleep and Hibernation......Page 152
Birds......Page 153
SLEEP REGULATION IN INVERTEBRATES......Page 154
OUTLOOK......Page 156
REFERENCES......Page 157
ADAPTIVE INACTIVITY......Page 160
QUANTITATIVE ANALYSES OF THE CORRELATES OF SLEEP DURATION......Page 161
THE DIVERSITY OF SLEEP......Page 163
SLEEP IN MONOTREMES......Page 164
BIRDS......Page 166
SLEEP IN CETACEANS (DOLPHINS AND WHALES)......Page 167
SLEEP REBOUND......Page 169
REFERENCES......Page 170
Introduction......Page 173
REFERENCES......Page 174
CIRCADIAN CLOCK PROPERTIES AND CLOCK GENES......Page 175
Clock......Page 176
Period Genes......Page 177
Timeless......Page 178
Fbxl3......Page 179
Melanopsin......Page 180
REMAINING QUESTION: CLOCK GENES AS SLEEP GENES?......Page 181
REFERENCES......Page 182
DROSOPHILA AS A MODEL SYSTEM FOR GENETICS......Page 185
DROSOPHILA AS A MODEL FOR STUDIES OF SLEEP......Page 186
DROSOPHILA CIRCADIAN BEHAVIOR REVEALS CONSERVED MECHANISMS BETWEEN FLIES AND HUMANS......Page 187
SPECIFIC NEURAL CIRCUITS ARE IMPORTANT FOR SLEEP–WAKE REGULATION......Page 188
Circadian Clock Pathway......Page 189
Growth Factors and Signal Transduction......Page 190
Sleep Neurotransmitters: GABA and Adenosine Sleep Pathways......Page 191
REFERENCES......Page 192
GENE EXPRESSION, mRNAs, AND MICROARRAY STUDIES......Page 195
IDENTIFICATION OF ALLELES THAT INFLUENCE SLEEP OR SLEEP-RELATED TRAITS......Page 198
MUTAGENESIS AND KNOCKOUTS......Page 202
Targeted Gene Deletion......Page 203
Genetic Regulation of Circadian Rhythm......Page 204
REFERENCES......Page 205
Candidate Genes......Page 209
Slow-Wave Sleep and REM Sleep......Page 212
The Sleep EEG: Among the Most Heritable Traits in Humans......Page 213
GENES CONTRIBUTING TO THE SLEEP EEG......Page 214
Acknowledgements......Page 215
REFERENCES......Page 216
Abstract......Page 218
GENETIC STUDIES OF HUMAN SLEEP: METHODOLOGICAL LIMITATIONS......Page 219
GENETIC FACTORS UNDERLYING THE CIRCADIAN CLOCK AND CIRCADIAN RHYTHM DISORDERS......Page 221
Heritability......Page 222
Non-HLA, Non-Hypocretin Genes in Narcolepsy......Page 223
Genome-Wide Associations......Page 224
PTPRD and Nitric Oxide Synthase as Candidates in RLS......Page 225
AUTOSOMAL DOMINANT FRONTAL LOBE EPILEPSY......Page 226
CONGENITAL CENTRAL HYPOVENTILATION SYNDROME......Page 227
CONCLUSION......Page 228
REFERENCES......Page 229
Abstract......Page 233
REFERENCES......Page 234
NON–RAPID EYE MOVEMENT SLEEP......Page 235
PROCESSING OF EXTERNAL STIMULI DURING NREM SLEEP......Page 238
Reorganization of Regional Brain Function during REM Sleep: Relation with Dream Characteristics......Page 239
BRAIN IMAGING AND NEURAL CORRELATES OF SLEEP–WAKE CYCLE REGULATION......Page 240
BRAIN IMAGING AND NEURAL CORRELATES OF HUMAN SLEEP DEPRIVATION......Page 242
Insomnia and Brainstem and Hypothalamic Arousal Networks......Page 243
Insomnia, Disorders of Emotion, and Limbic and Paralimbic Arousal Networks......Page 244
Insomnia, Disorders of Emotion, and Neocortical Arousal Networks......Page 245
REFERENCES......Page 246
SLEEP-STATE CONTROL OF CARDIOVASCULAR FUNCTION......Page 249
Central Mechanisms......Page 250
Cardiorespiratory Homeostasis......Page 251
Heart Rate Surges......Page 252
Heart Rhythm Pauses......Page 253
Central Nervous System Sites Influencing Cardiac Electrical Stability......Page 254
Autonomic Factors in Arrhythmogenesis during Sleep......Page 256
REFERENCES......Page 257
THE CARDIOVASCULAR AUTONOMIC NERVOUS SYSTEM: DEFINITION AND FUNCTIONS......Page 260
Heart Rate, Arterial Blood Pressure, and Their Variability......Page 261
Microneurographic Recording of Sympathetic Nerve Activity......Page 263
Physiologic Responses to NREM and REM Sleep......Page 264
Periodic Leg Movements during Sleep......Page 265
IMPACT OF AGING ON NEURAL CIRCULATORY RESPONSE TO NORMAL SLEEP......Page 266
Loss of Diurnal Variation in Autonomic Function in Diabetes Mellitus: What Comes First?......Page 267
SYMPATHETIC ACTIVATION IN OBSTRUCTIVE SLEEP APNEA......Page 268
REFERENCES......Page 269
Pre-Bötzinger Complex......Page 271
Neuronal Connections......Page 272
Wakefulness......Page 273
CONTROL OF RESPIRATORY MOTONEURONS......Page 274
Tonic and Respiratory-Related Inputs to Respiratory Motoneurons......Page 275
Presynaptic Modulation......Page 276
NEUROMODULATION OF RESPIRATORY MOTONEURONS ACROSS SLEEP–WAKE STATES......Page 277
Excitatory Influences across Sleep–Wake States......Page 278
Inhibitory Influences across Sleep–Wake States......Page 279
Respiratory Neuron Activity in REM Sleep......Page 280
Neuromodulation of Respiratory Neurons across Sleep–Wake States......Page 281
REFERENCES......Page 282
PHYSIOLOGY OF VENTILATORY CONTROL DURING SLEEP......Page 284
Adult Human Beings......Page 285
Added Resistance......Page 286
Bronchial Irritation......Page 287
Decreased Basal Metabolic Rate......Page 288
CLINICAL SEQUELAE OF ABNORMAL VENTILATORY RESPONSES......Page 289
REFERENCES......Page 290
Elastic Forces and Lung Volumes......Page 293
Breathing Cycle and Minute Ventilation......Page 294
EFFECTS OF SLEEP ON LUNG VOLUME......Page 295
Upper Airway......Page 296
Collapsing Forces......Page 297
Dilating Forces......Page 298
CONCLUSION......Page 299
REFERENCES......Page 300
Sleep Disturbances......Page 303
PERIODIC BREATHING......Page 305
Roles of Hypoxia and Hypocapnia......Page 306
Role of Decreased PCO2 versus Increased pH in the Generation of Apnea......Page 307
Consequences of Periodic Breathing......Page 308
Living High, Training Low......Page 309
Carbonic Anhydrase Inhibitors......Page 310
SLEEP AT HIGH ALTITUDE AFTER LONG-TERM ADAPTATION......Page 311
REFERENCES......Page 312
THE ACUTE PHASE RESPONSE AND HOST DEFENSE......Page 315
Viral Challenge......Page 316
Bacterial Challenge......Page 318
SLEEP LOSS EFFECTS ON IMMUNE FUNCTION......Page 319
SLEEP AND IMMUNITY SHARE COMMON REGULATORY MOLECULES......Page 320
REFERENCES......Page 322
MODULATION OF ENDOCRINE FUNCTION BY SLEEP–WAKE HOMEOSTASIS AND CIRCADIAN RHYTHMICITY......Page 325
THE GROWTH HORMONE AXIS......Page 326
THE CORTICOTROPIC AXIS......Page 327
THE THYROID AXIS......Page 328
PROLACTIN SECRETION......Page 329
GLUCOSE REGULATION......Page 330
SLEEP AND APPETITE REGULATION......Page 331
Laboratory Studies......Page 332
Epidemiologic Studies......Page 334
Experimental Reduction of Sleep Quality......Page 335
Studies in Population and Clinic-Based Samples......Page 336
GH Axis......Page 337
Pituitary-Adrenal Axis......Page 338
Pituitary-Gonadal Axis......Page 339
Polycystic Ovary Syndrome......Page 340
REFERENCES......Page 341
HISTORICAL ASPECTS......Page 346
Acid Secretion......Page 347
GASTRIC MOTOR FUNCTION DURING SLEEP......Page 348
SWALLOWING AND ESOPHAGEAL FUNCTION......Page 349
INTESTINAL MOTILITY DURING SLEEP......Page 351
EFFECT OF INTESTINAL MOTILITY ON SLEEP......Page 352
COLONIC AND ANORECTAL FUNCTION DURING SLEEP......Page 353
REFERENCES......Page 354
CIRCADIAN REGULATION OF CORE BODY TEMPERATURE......Page 357
Baseline Conditions......Page 358
Changed Circadian Conditions......Page 360
Changing Temperatures......Page 361
Changing Sleep Pressure......Page 362
Brain Temperature, EEG, and Thermo- sensitive Neurons......Page 363
Thermoregulation and Metabolic Rate Reduction......Page 364
REFERENCES......Page 365
Abstract......Page 369
MEMORY SYSTEMS AND MEMORY CONSOLIDATION......Page 370
Posttraining Sleep Modifications......Page 371
Within-Sleep Stimulations......Page 372
Emotion in Episodic Memory......Page 373
Sleep and Motor Learning......Page 374
Sleep and Perceptual–Motor Learning......Page 375
Hippocampal Rhythms......Page 376
Conclusions......Page 377
REFERENCES......Page 378
Sensory Pathways and Mechanisms......Page 382
Modulation of Sensory Processes Including Those Related to Pain......Page 384
Clinical Correlates......Page 385
Processing of Somatic Reflexes during Sleep and Wakefulness......Page 386
PLMD and RLS......Page 387
Airway Negative-Pressure Reflex......Page 388
Laryngeal and Bronchopulmonary Reflexes......Page 389
Processing of Chemoreflexes during Sleep and Wakefulness......Page 390
REFERENCES......Page 392
INTEGRATION OF THE CIRCADIAN CLOCK AND SLEEP–WAKE SYSTEMS......Page 394
REGULATING SLEEP AMOUNT: A HOMEOSTATIC AND A CIRCADIAN INPUT......Page 395
REFERENCES......Page 396
THE NATURE OF CIRCADIAN RHYTHMS......Page 397
PARAMETERS AND MEASUREMENT OF CIRCADIAN RHYTHMS......Page 398
ADAPTIVE SIGNIFICANCE OF CIRCADIAN RHYTHMS......Page 399
Effects of Light on Circadian Phase......Page 400
Effects of Light on Circadian Period......Page 401
Masking and Entrainment......Page 402
Scheduled Feeding......Page 403
Temperature......Page 404
Activity and Arousal States......Page 405
CIRCADIAN RHYTHMS ACROSS THE LIFESPAN......Page 406
REFERENCES......Page 407
Cytoarchitecture......Page 410
Neurotransmitters Synthesized in the Suprachiasmatic Nucleus......Page 411
Gastrin-Releasing Peptide......Page 412
SUPRACHIASMATIC NUCLEUS INPUTS......Page 413
Retina......Page 414
Intergeniculate Leaflet......Page 415
Midbrain Raphe Nuclei......Page 416
Melatonin Rhythm......Page 417
Diffusible Suprachiasmatic Nucleus Output Signals......Page 418
CONCLUSION......Page 419
REFERENCES......Page 420
THE SUPRACHIASMATIC NUCLEUS: MASTER CIRCADIAN PACEMAKER......Page 424
Functional Neuroanatomy of the Suprachiasmatic Nucleus......Page 425
Light Input to the Pacemaker: The Retinohypothalamic Tract......Page 426
Other Functional Inputs to the Circadian Clock......Page 427
MULTIPLE-OSCILLATOR NATURE OF THE CIRCADIAN SYSTEM......Page 428
REFERENCES......Page 432
INFLUENCE OF SLEEP AND CIRCADIAN RHYTHMS ON HUMAN PHYSIOLOGY......Page 436
Photic Suppression of Melatonin Secretion......Page 438
Human Dose-Response Curve to Circadian Phase-Resetting Effects of Light......Page 440
NONPHOTIC CIRCADIAN PHASE RESETTING AND REENTRAINMENT......Page 441
Separation from 24-Hour Environmental and Behavioral Cues......Page 442
Neurobehavioral Functions......Page 443
Sleep and Wake......Page 444
Internal Sleep Structure......Page 446
Intrinsic Period of the Human Circadian Pacemaker......Page 447
AGING AND CIRCADIAN SLEEP–WAKE REGULATION......Page 448
Acknowledgments......Page 449
REFERENCES......Page 450
Biosynthesis......Page 454
Melatonin Receptors......Page 455
PHYSIOLOGIC ROLE OF MELATONIN IN THE REST–ACTIVITY CYCLE: CONSEQUENCES FOR SLEEP......Page 456
Impairment of Attention......Page 457
Transmeridian Flights and Jet Lag Disorder......Page 458
Aging......Page 459
CONCLUSION......Page 460
REFERENCES......Page 461
Slow Waves and Sleep Intensity......Page 465
Effect of Sleep Deprivation......Page 466
Effect of NREM Sleep Pressure on REM Sleep Homeostasis......Page 467
Homeostatic Marker in the Waking Electroencephalogram......Page 468
Independence and Interactions of Homeostatic and Circadian Processes......Page 469
Two-Process Model and Related Models......Page 470
CONCLUSIONS AND PERSPECTIVES......Page 474
REFERENCES......Page 475
Objective Measures of Cognitive Performance......Page 479
The Practice Effect and Other Artifacts......Page 480
Morningness-Eveningness......Page 482
Forced Desynchrony......Page 483
Ultradian Days......Page 484
CONCLUSION......Page 485
REFERENCES......Page 486
DESTROYING THE MASTER CIRCADIAN CLOCK IN THE SCN: EFFECTS ON HEALTH AND WELL-BEING......Page 490
IMPORTANCE OF “RESONANCE” OF THE TIMING OF THE INTERNAL CIRCADIAN CLOCK WITH THAT OF THE ENTRAINING LD CYCLE......Page 491
HEALTH AND LONGEVITY IN ANIMAL MODELS OF SHIFT-WORK CONDITIONS......Page 492
CONCLUSIONS......Page 494
REFERENCES......Page 495
CLOCK REGULATION OF PHYSIOLOGY AND SLEEP......Page 497
THE CORE MOLECULAR CLOCK NETWORK......Page 498
Nuclear Hormone Receptors......Page 499
CHANGES IN METABOLISM LEAD TO BEHAVIORAL AND MOLECULAR DISRUPTION OF THE CLOCK......Page 500
REFERENCES......Page 501
INTRODUCTION......Page 504
Melatonin......Page 505
Pathogenesis......Page 506
Light......Page 507
Melatonin......Page 508
Epidemiology......Page 509
Epidemiology......Page 510
Treatment......Page 511
Pathogenesis......Page 512
REFERENCES......Page 513
GABAA Agonists: Benzodiazepines and the Newer Nonbenzodiazepines......Page 517
Neuroanatomic Considerations......Page 519
Other Neurotransmitters......Page 520
Benzodiazepines......Page 521
Zaleplon......Page 522
EFFECTS ON SLEEP......Page 523
REFERENCES......Page 524
A MODEL OF SLEEP–WAKE REGULATION RELEVANT TO SLEEP-PROMOTING DRUGS......Page 526
Overview......Page 528
Pharmacokinetics......Page 529
Effects on Human Sleep......Page 531
Effects on Human Sleep......Page 532
Side Effects......Page 533
Effects on Human Sleep......Page 534
Pharmacodynamics and Receptor Pharmacology......Page 535
Effects on Human Sleep......Page 536
GABOXADOL......Page 537
SEDATIVE ANTIPSYCHOTIC DRUGS......Page 538
REFERENCES......Page 539
Historical Perspective......Page 544
Structure-Activity Relationships and Major Chemical Entities......Page 545
Molecular Targets of Amphetamine Action......Page 546
Presynaptic Modulation of the Dopaminergic System Primarily Mediates the EEG Arousal Effects......Page 549
Anatomic Substrates Mediating Dopaminergic Effects on Wakefulness......Page 552
Abuse and Misuse of Amphetamine Stimulants......Page 553
Side Effects......Page 554
Mechanism of Action......Page 555
CAFFEINE......Page 556
Thyrotropin-Releasing Hormone......Page 557
REFERENCES......Page 558
THE HISTORY OF WAKE-PROMOTING MEDICATIONS......Page 561
Side Effects, Tolerance, and Withdrawal......Page 562
Alerting Effects......Page 564
Dependence, Abuse, and Tolerance......Page 565
Alerting Effects......Page 568
Alerting Effects......Page 569
IS ALL WAKEFULNESS THE SAME?......Page 570
CHANGING OR COMBINING MEDICATIONS......Page 571
RECOMMENDATIONS AND TREATMENT PLANNING......Page 572
REFERENCES......Page 573
Antidepressants......Page 576
Selective Serotonin Reuptake Inhibitors......Page 579
Miscellaneous Antidepressants......Page 580
Anxiolytic Drugs......Page 581
ANTIPARKINSONIAN DRUGS......Page 583
Beta Antagonists......Page 585
Other Cardiovascular Drugs......Page 586
PAIN MEDICATIONS......Page 587
Pseudoephedrine and Phenylpropanolamine......Page 588
REFERENCES......Page 589
Introduction:......Page 595
REFERENCES......Page 596
Cortical Connectivity in Sleep......Page 597
Dreaming and Phasic Activity in Sleep......Page 598
DREAMING AND “DEFAULT MODE” NETWORKS......Page 599
Acetylcholine......Page 600
Confabulation Shares Neural Substrate with Dreaming......Page 601
Ascending Arousal System......Page 603
Thalamocortical Relay Centers and Thalamic Subcortical Circuitry......Page 604
Motor Initiation and Control Centers......Page 605
CONCLUSION......Page 606
REFERENCES......Page 607
Quality of Dream Reports......Page 610
Dream Recall and Report Length Changes Across the Night......Page 612
Qualities of Dream Reports Change across the Night......Page 613
REFERENCES......Page 617
METHODS FOR COLLECTING DREAM REPORTS......Page 619
Questionnaires......Page 620
ANALYZING DREAM CONTENT: INSTRUMENTS AND ISSUES......Page 621
Dream Reports from Laboratory Awakenings......Page 622
Normative Dream Content in Home Dreams......Page 623
Dream Content and Well-Being......Page 624
Implications for Theories of Dreaming......Page 625
REFERENCES......Page 626
CONTENT ANALYSIS METHODS AS ASSESSMENTS OF REALITY SIMULATION......Page 629
Length-Corrected Measures......Page 630
DREAM BIZARRENESS AS REALITY SIMULATION ERROR......Page 632
Methods of Assessment......Page 633
THE PERCEPTUAL LIMITS OF REALITY SIMULATION......Page 635
REFERENCES......Page 636
WAKING EXPERIENCE AND DREAMING: THE CONTINUITY HYPOTHESIS......Page 638
Dream Content......Page 639
Nightmares and Negative Dream Emotions......Page 640
Dream Content......Page 641
Narcolepsy......Page 642
CONCLUSIONS......Page 643
REFERENCES......Page 644
REPLICATIVE-TRAUMA NIGHTMARES: HALLMARK OF A DISORDER?......Page 647
Dreams and Adaptation to Stress......Page 648
POLYSOMNOGRAPHIC CORRELATES OF NIGHTMARES IN PTSD......Page 649
TREATMENT OF POSTTRAUMATIC NIGHTMARES AND RELATED SLEEP DISTURBANCES......Page 650
REFERENCES......Page 651
MOOD-REGULATION FUNCTION OF DREAMING IN NORMAL PERSONS......Page 654
Dreams in Subjects Undergoing Surgery......Page 655
Dreams in Divorcing Subjects......Page 656
Results......Page 657
Mood Regulation in Office Dreams in Psychotherapy......Page 658
CLINICAL APPLICATIONS......Page 659
REFERENCES......Page 660
SLEEP-DEPENDENT MEMORY CONSOLIDATION......Page 662
DREAMS AND MEMORY SYSTEMS......Page 663
ASSOCIATIVE NETWORKS IN SLEEP......Page 664
DREAMING AND DECLARATIVE MEMORY PROCESSING DURING SLEEP......Page 665
INCORPORATION OF WAKING EVENTS INTO DREAMS......Page 666
EMOTION IN THE SLEEPING BRAIN......Page 667
A NEUROCOGNITIVE MODEL OF DREAM CONSTRUCTION AND FUNCTION......Page 668
REFERENCES......Page 669
CHIEF COMPLAINT AND HISTORY......Page 675
Excessive Sleepiness......Page 677
SOCIAL HISTORY......Page 678
FORMULATION AND DIAGNOSTIC STUDIES......Page 679
REFERENCES......Page 680
INSOMNIA......Page 681
SNORING......Page 684
SLEEP APNEA......Page 685
HYPNAGOGIC AND HYPNOPOMPIC HALLUCINATIONS......Page 687
Sleep Terrors......Page 688
Bruxism......Page 689
PEDIATRIC CARDINAL MANIFESTATIONS......Page 690
REFERENCES......Page 691
Neck Circumference......Page 692
Examination of the Tonsils......Page 694
Neurologic Examination......Page 695
NARCOLEPSY......Page 696
Bruxism......Page 697
REFERENCES......Page 698
History and Questionnaires......Page 700
Physical Examination......Page 702
Nocturnal Polysomnography......Page 705
Portable Recording......Page 706
Studies of Airway Morphology......Page 707
Multiple Sleep Latency Test......Page 708
EVALUATION OF INSOMNIA......Page 709
BEYOND SENSITIVITY, SPECIFICITY, AND PREDICTIVE VALUE: DECISION AND COST-EFFECTIVENESS ANALYSES......Page 710
REFERENCES......Page 711
Primary Insomnia......Page 714
SLEEP-RELATED BREATHING DISORDERS......Page 717
HYPERSOMNIA OF CENTRAL ORIGIN......Page 718
PARASOMNIAS......Page 719
SLEEP-RELATED MOVEMENT DISORDERS......Page 720
Comorbid Insomnia and Insomnia Research Criteria......Page 721
Parasomnia......Page 723
REFERENCES......Page 724
SLEEP DURATION......Page 728
INSOMNIA AND USE OF HYPNOTIC AGENTS......Page 729
EXCESSIVE SLEEPINESS AND HYPERSOMNIA......Page 732
NARCOLEPSY AND NARCOLEPSY-LIKE SYMPTOMS......Page 735
Prevalence of Sleep Apnea......Page 736
Snoring, Sleep Apnea, and Heart Disease......Page 739
Evolution of Obstructive Sleep Apnea Syndrome......Page 740
PARASOMNIAS......Page 742
REFERENCES......Page 743
SLEEP IN MODERN SOCIETY......Page 750
Cardiovascular Disease......Page 751
Transportation Safety......Page 752
Health Care Workers......Page 754
MAKING SLEEP A MATTER OF PUBLIC HEALTH AND PUBLIC POLICY......Page 755
CONCLUSION......Page 756
REFERENCES......Page 757
Sleep......Page 759
Waking Consciousness......Page 760
Dreaming Consciousness......Page 761
Consciousness as a Continuum......Page 762
Fixed Action Patterns and Central Pattern Generators: A Neuroethologic Approach to Behavior......Page 763
CLINICAL GUIDELINES TO ASSIST IN DETERMINING PURPORTED VIOLENCE ARISING FROM SLEEP......Page 764
CONCLUSION......Page 765
REFERENCES......Page 766
FATIGUE AS A FUNCTION OF SLEEP–WAKE HISTORY, CIRCADIAN RHYTHM, AND WORK LOAD......Page 768
DROWSY DRIVING......Page 769
SLEEP, STRESS, AND BURNOUT......Page 770
REFERENCES......Page 771
THE NATURE OF SLEEPINESS-INDUCED PERFORMANCE DEFICITS......Page 772
FUNCTIONAL BRAIN IMAGING STUDIES OF SLEEPINESS AND PERFORMANCE......Page 773
TIME ON TASK (FATIGUE) EFFECTS......Page 774
PERFORMANCE PREDICTION MODELING......Page 776
REFERENCES......Page 777
Circadian Oscillators......Page 779
RECUPERATION DURING SLEEP......Page 780
PREDICTING PERFORMANCE......Page 782
FATIGUE MODELING APPLIED TO OPERATIONAL SETTINGS......Page 783
LIMITATIONS AND ENHANCEMENTS OF FATIGUE MODELS......Page 784
REFERENCES......Page 785
SLEEP, CIRCADIAN, AND TIME-ON-TASK FACTORS MODULATING RISK OF ERRORS AND ACCIDENTS......Page 787
FATIGUE, PERFORMANCE IMPAIRMENT, AND WAKE- STATE INSTABILITY......Page 788
PREDICTING ACCIDENTS......Page 789
MODELING SLEEP–WAKE–WORK AND ACCIDENT RISK......Page 790
REFERENCES......Page 792
A THEORETICAL FRAMEWORK......Page 794
Effects of Total Sleep Deprivation and Sleep Restriction......Page 795
Restorative Value of Sleep......Page 796
MANAGING FATIGUE RISK......Page 797
The Role of Regulation......Page 798
Changing Roles and Competing Interests......Page 799
REFERENCES......Page 800
Rest/Activity Patterns......Page 803
Sleep Disorders......Page 804
DRIVING LICENSE REGULATIONS......Page 805
FUTURE CONSIDERATIONS......Page 806
REFERENCES......Page 807
Sleep and Sleep Loss......Page 809
Workload and Operational Environment......Page 810
Added, Simulator-Derived, and Embedded Performance Metrics......Page 811
Studies of Physicians in Training......Page 812
A Series of Field Studies in Other Industries......Page 813
More Studies in Train Drivers......Page 814
REFERENCES......Page 815
Night-Shift Workers......Page 818
Circadian Misalignment and Effects of Light Exposure......Page 819
Work Productivity and Quality of Life......Page 820
Prevalence......Page 821
Clinical Evaluation......Page 822
Circadian Interventions......Page 823
Improving Diurnal (and Nocturnal) Sleep......Page 824
JET LAG......Page 825
Treatment......Page 826
Partial Preflight Circadian Adaptation......Page 827
CONCLUSIONS......Page 828
REFERENCES......Page 829
PREVALENCE OF SLEEP LOSS, MORTALITY, AND MORBIDITY......Page 833
Performance Challenges and Sleep Loss......Page 834
Shift Work: Interaction between the Organization and the Individual......Page 836
Shift Work: The Organization......Page 838
Exemplary Unified Approach......Page 840
REFERENCES......Page 841
Abstract......Page 843
Modafinil......Page 844
Prescription Sleep-Inducing Agents......Page 845
REFERENCES......Page 846
THE CROSS-SECTIONAL CONNECTION BETWEEN STRESS AND SLEEP......Page 848
THE PROSPECTIVE CONNECTION BETWEEN STRESS AND SLEEP......Page 849
SLEEP PHYSIOLOGY THAT SEEMS TO LINK SLEEP WITH STRESS......Page 850
BURNOUT AND SLEEP......Page 851
REFERENCES......Page 852
DIAGNOSIS AND ASSESSMENT......Page 856
PATHOPHYSIOLOGY AND BIOLOGICAL FINDINGS......Page 857
Pharmacologic Treatment......Page 858
REFERENCES......Page 859
Definition of Insomnia......Page 861
Prevalence......Page 862
Comorbidities......Page 863
Aging......Page 864
Gender......Page 865
Education and Socioeconomic Status......Page 866
Hyperarousal......Page 867
Evidence......Page 868
REFERENCES......Page 869
CLINICAL ASSESSMENT......Page 872
Theoretical Guide......Page 875
Current Sleep......Page 876
Sleep Diary......Page 877
Comorbid Psychiatric Disorders......Page 878
Comorbid Medical Disorders......Page 879
Actigraphy......Page 880
REFERENCES......Page 881
Strengths and Weaknesses......Page 884
Basic Description......Page 885
Implications for Current and Future Research and Therapeutics......Page 886
Basic Description......Page 887
Strengths......Page 888
Basic Description......Page 889
Strengths......Page 890
Implications for Current and Future Research and Therapeutics......Page 891
Basic Description......Page 892
Strengths and Weaknesses......Page 893
Basic Description......Page 894
Strengths and Weaknesses......Page 895
CONCLUSION......Page 896
REFERENCES......Page 897
Rationale and Indications......Page 900
Stimulus Control Therapy......Page 901
Cognitive Therapy......Page 902
Evidence for Efficacy......Page 903
Generalizability of Treatment Effects to Comorbid Insomnia......Page 904
Initial Treatment Response versus Long-Term Outcome......Page 913
Combined Cognitive Behavior Therapy and Medication......Page 914
SUMMARY AND CONCLUSION......Page 915
REFERENCES......Page 916
Actigraphy......Page 918
Written Behavioral Prescriptions and Instruments for Home Use......Page 919
Sleep Restriction......Page 920
Sleep Hygiene......Page 922
Thought Records......Page 923
Group Treatment Protocols......Page 924
Delivering Treatment Outside of the Office......Page 926
TREATMENT DOSING......Page 927
TREATMENT ACCEPTABILITY AND ADHERENCE ISSUES......Page 928
Treatment Adherence......Page 929
APPLICATIONS TO PATIENTS WITH COMORBID PSYCHIATRIC CONDITIONS......Page 930
The Impact of Disease-Specific Symptoms on Insomnia......Page 931
Unhelpful Sleep-Related Beliefs......Page 932
Adolescents......Page 933
REFERENCES......Page 934
EFFICACY AND EFFECTIVENESS......Page 939
Primary Insomnia......Page 940
Comorbid Insomnia......Page 941
Effectiveness Studies......Page 942
Impact on Daytime Symptoms of Insomnia and Comorbid Conditions......Page 943
Discontinuation Effects......Page 944
Falls, Cognitive Effects, and Other Considerations for Older Adults......Page 945
CONSIDERATIONS FOR PHARMACOTHERAPY......Page 946
REFERENCES......Page 947
Overview......Page 950
Potential Clinical Utility......Page 954
Potential Clinical Utility......Page 955
Overview......Page 956
Potential Clinical Utility......Page 957
Overview......Page 958
Overview......Page 959
SUMMARY OF CLINICAL CIRCUMSTANCES WHERE OTHER AGENTS MIGHT BE PREFERRED......Page 960
SUMMARY AND CONCLUSIONS......Page 961
REFERENCES......Page 962
THE ROLE OF CLINICAL PRACTICE GUIDELINES......Page 965
DEVELOPMENT OF INSOMNIA CLINICAL GUIDELINES......Page 966
Evaluation......Page 967
Psychological and Behavioral Therapies......Page 968
Pharmacologic Therapies......Page 969
REFERENCES......Page 970
Abstract......Page 972
ANIMAL MODELS OF NARCOLEPSY......Page 973
Adrenergic Uptake Inhibition Mediates the Anticataplectic Effects of Antidepressants......Page 974
Increased Dopaminergic Transmission Mediates the Wake-Promoting Effects of Currently Prescribed Stimulant Compounds......Page 975
Anatomy and Physiology of the Hypocretin Neuropeptide System......Page 976
Hypocretin Transmission in Sleep Regulation......Page 977
Human Narcolepsy, Human Leukocyte Antigen, and the Immune System......Page 978
Genetic Factors other Than Human Leukocyte Antigen......Page 979
Testing in Narcolepsy......Page 980
Testing in Narcolepsy without Cataplexy or with Atypical or Dubious Cataplexy......Page 981
Hypocretin Studies......Page 983
Narcolepsy and Cataplexy in Syndromic Associations of Likely Genetic Origin......Page 984
HYPOCRETIN COMPOUNDS AS POTENTIAL THERAPEUTIC TARGETS......Page 985
REFERENCES......Page 986
Cataplexy......Page 991
Hallucinations......Page 992
Evaluating Sleepiness......Page 993
Diagnosing Narcolepsy......Page 994
Sodium Oxybate......Page 995
Modafinil......Page 997
Monoamine Nonspecific Uptake Inhibitors......Page 998
Medication Side Effects......Page 999
REFERENCES......Page 1000
Genetic and Environmental Factors......Page 1003
Nocturnal Sleep......Page 1004
Multiple Sleep Latency Test......Page 1005
Behaviorally Induced Insufficient Sleep Syndrome, Chronic Sleep Insufficiency, and Long Sleepers......Page 1008
Chronic Fatigue Syndrome......Page 1009
Circadian Disorders......Page 1010
TREATMENT......Page 1011
REFERENCES......Page 1012
Parkinsonism......Page 1014
Insomnia......Page 1015
Abnormal Movements during Sleep and REM Sleep Behavior Disorder......Page 1016
REM Sleep Behavior Disorder......Page 1018
REM Sleep Behavior Disorder......Page 1019
DIAGNOSIS......Page 1020
TREATMENT......Page 1022
Excessive Daytime Sleepiness......Page 1023
REFERENCES......Page 1024
Sleep-Disordered Breathing as Risk Factor for Stroke......Page 1027
Breathing Disturbances while Awake......Page 1028
Sleep-Disordered Breathing as a Consequence of Stroke......Page 1032
Diagnosis......Page 1033
Epidemiology......Page 1034
Hypersomnia and Excessive Daytime Sleepiness......Page 1036
Fatigue......Page 1037
Hallucinations and Altered Dreaming......Page 1038
Insomnia......Page 1040
Clinical Significance......Page 1041
Sleep Architecture Changes......Page 1042
Infratentorial Strokes......Page 1043
REFERENCES......Page 1044
EPIDEMIOLOGY AND GENETICS......Page 1050
Neurodegenerative Diseases......Page 1051
Myotonic Dystrophy......Page 1052
Other Myopathies......Page 1053
TREATMENT......Page 1054
REFERENCES......Page 1056
Sensory and Motor Manifestations......Page 1060
Sleep Laboratory Diagnosis......Page 1061
Severity Assessments......Page 1062
Relationship to Attention-Deficit/Hyperactivity Disorder......Page 1063
MEDICAL INVESTIGATION......Page 1064
Neurotransmitter Dysfunctions......Page 1065
Levodopa......Page 1066
Clinical Management......Page 1067
REFERENCES......Page 1068
Polysomnography Findings......Page 1072
PROGRESSIVE SUPRANUCLEAR PALSY......Page 1073
DEMENTIA WITH LEWY BODIES......Page 1074
HUNTINGTON’S DISEASE......Page 1075
Insomnia......Page 1076
Nocturnal Agitation and Wandering......Page 1078
REFERENCES......Page 1079
EPIDEMIOLOGY......Page 1082
PATHOGENESIS......Page 1083
Sleep Starts......Page 1084
Periodic Hypersomnia (Kleine-Levin Syndrome)......Page 1086
Insomnia......Page 1087
Rhythmic Movement Disorder......Page 1088
Classified Seizures......Page 1089
Unusual Behavioral Seizures......Page 1090
Psychogenic Dissociative States......Page 1091
DIAGNOSTIC EVALUATION......Page 1092
REFERENCES......Page 1093
Migraine Headaches......Page 1098
Headache on Awakening......Page 1099
Differential Diagnosis and Diagnostic Workup......Page 1100
Clinical Manifestations......Page 1101
Epidemiology......Page 1102
Machado-Joseph Disease......Page 1103
Encephalitis Lethargica......Page 1104
Pathophysiology......Page 1105
REFERENCES......Page 1106
Abstract......Page 1109
Sleep Inertia......Page 1110
Sleepsex......Page 1111
TREATMENT......Page 1113
REFERENCES......Page 1114
RBD and Extrapyramidal Disease......Page 1117
Pathogenesis......Page 1118
Case Studies......Page 1120
Dream Disorder and Behavior Disorder......Page 1121
Diagnostic Criteria......Page 1122
Differential Diagnosis......Page 1123
Parasomnia Overlap Syndrome......Page 1124
Treatment......Page 1125
REFERENCES......Page 1126
Sleep-Related Expiratory Groaning (Catathrenia)......Page 1132
Rhythmic Movement Disorder......Page 1133
Hypnic Headache......Page 1134
Night Sweats......Page 1135
REFERENCES......Page 1136
Historical Aspects......Page 1140
Prevalence and Frequency......Page 1141
Pathophysiology......Page 1142
Effects of Drugs and Alcohol......Page 1143
Treatment......Page 1144
Terrifying Hypnagogic Hallucinations......Page 1145
False Awakening......Page 1146
REFERENCES......Page 1147
Impoverished Dreaming in Brain Syndromes......Page 1150
Impoverished Dreaming in Alexithymia......Page 1151
Assault and Defense Dreams in REM Sleep Behavior Disorder and Parkinsonism......Page 1152
Re-experiencing Dreams in Posttraumatic Stress Disorder......Page 1156
Postpartum Infant Peril Dreams......Page 1157
TREATMENT......Page 1158
REFERENCES......Page 1159
EPIDEMIOLOGY AND RISK FACTORS......Page 1162
PATHOPHYSIOLOGY......Page 1163
Oromotor Excitability......Page 1164
Possible Role of Local Factors......Page 1165
CLINICAL FEATURES......Page 1166
Ambulatory Monitoring and Sleep Laboratory Recording......Page 1167
Other Diagnostic Features......Page 1168
Occlusal Appliances......Page 1169
Pharmacologic Management......Page 1170
REFERENCES......Page 1171
Abstract......Page 1174
Control of Breathing......Page 1175
Ventilatory Control Stability......Page 1176
Sleep-Onset Central Apneas......Page 1177
Idiopathic Central Sleep Apnea......Page 1178
Complex Sleep Apnea......Page 1179
Idiopathic Central Sleep Apnea......Page 1180
Complex Sleep Apnea......Page 1181
Medication......Page 1182
SUMMARY......Page 1183
REFERENCES......Page 1184
STATIC AND DYNAMIC PROPERTIES OF THE NORMAL PHARYNGEAL AIRWAY......Page 1187
Surface Adhesive Forces......Page 1188
Neck and Jaw Position......Page 1189
Dynamic Properties of the Normal Pharyngeal Airway......Page 1190
Activation of the Pharyngeal Muscles......Page 1191
Sensory Modulation of Pharyngeal Muscles......Page 1193
Edema......Page 1194
Fat Distribution and Body Weight......Page 1195
Upper Airway Myopathy......Page 1196
DYNAMIC PHYSIOLOGIC CHANGES IN UPPER AIRWAY STRUCTURES......Page 1198
Oral Appliances......Page 1199
INTERACTION OF ANATOMIC AND NEUROLOGIC FACTORS ON PHARYNGEAL AIRWAY CLOSURE DURING SLEEP: A SCHEMATIC MODEL......Page 1201
Anatomic Hypothesis......Page 1202
REFERENCES......Page 1203
PATHOPHYSIOLOGY AND MEASUREMENT OF SNORING......Page 1206
Snoring and Daytime Sleepiness......Page 1207
Physical Examination......Page 1208
Polysomnography......Page 1209
TREATMENT......Page 1210
Nasal Dilators......Page 1211
Pharyngeal Surgery......Page 1212
Radiofrequency Ablation......Page 1213
REFERENCES......Page 1214
INTERMEDIATE PHENOTYPES......Page 1217
CRANIOFACIAL MORPHOLOGY......Page 1218
VENTILATORY CONTROL PATTERNS......Page 1219
CONTROL OF SLEEP AND CIRCADIAN RHYTHM......Page 1220
FAMILIAL AGGREGATION OF OBSTRUCTIVE SLEEP APNEA–HYPOPNEA......Page 1221
Angiotensin II Converting Enzyme......Page 1222
Leptin Signaling......Page 1223
SUMMARY......Page 1224
REFERENCES......Page 1225
DEFINITION, ASSESSMENT, AND IMPACT......Page 1228
Memory......Page 1230
Executive Functions......Page 1231
QUALITY OF LIFE......Page 1232
ETIOLOGY AND MECHANISMS......Page 1233
MEDICAL AND LEGAL ASPECTS OF COGNITIVE AND PERFORMANCE DEFICITS......Page 1235
REFERENCES......Page 1237
EPIDEMIOLOGY......Page 1240
Nighttime Signs and Symptoms......Page 1241
Daytime Signs and Symptoms......Page 1244
UPPER AIRWAY RESISTANCE SYNDROME......Page 1246
CLINICAL EXAMINATION......Page 1247
Upper Airway......Page 1248
Gender......Page 1249
REFERENCES......Page 1250
Weight Loss......Page 1253
Sleep Hygiene and Sleep Deprivation......Page 1254
Alcohol......Page 1255
Barbiturates......Page 1256
Supplemental Oxygen......Page 1257
Protriptyline......Page 1258
Stimulants......Page 1259
Upper Airway Stimulation......Page 1260
Combination Therapy......Page 1261
Cardiac Resynchronization Therapy......Page 1262
REFERENCES......Page 1263
Mode of Action......Page 1267
PRACTICAL ASPECTS OF TREATMENT......Page 1268
The First Night......Page 1269
CPAP on the Night Sleep Apnea Is Diagnosed? The Split-Night Study......Page 1270
PROBLEMS AND SIDE EFFECTS......Page 1271
Pressure Level and Airflow......Page 1272
Adherence and CPAP......Page 1273
Baseline Indicators That Predict CPAP Use......Page 1274
MANAGEMENT OF CPAP FAILURE......Page 1275
Acknowledgments......Page 1279
REFERENCES......Page 1280
PRETREATMENT RECOMMENDATIONS AND CONCERNS......Page 1284
Fiberoptic Nasopharyngolaryngoscopy......Page 1285
ISSUES IN EVIDENCE- BASED MEDICINE......Page 1286
Surgical Expectations......Page 1287
Indications......Page 1288
Clinical Outcomes......Page 1289
Rationale......Page 1290
History and Clinical Outcomes......Page 1291
Rationale......Page 1292
Indications......Page 1293
Adverse Consequences of Phases I and II......Page 1294
AASM SURGICAL PRACTICE PARAMETERS......Page 1295
REFERENCES......Page 1297
MECHANISM OF ACTION......Page 1300
Polysomnographic Variables......Page 1302
Daytime Sleepiness......Page 1303
Comparison of Oral Appliance Designs......Page 1304
PREDICTORS OF TREATMENT OUTCOME......Page 1305
TREATMENT COMPLIANCE......Page 1306
Selecting the Appliance......Page 1307
FUTURE DIRECTIONS......Page 1308
REFERENCES......Page 1309
Prevalence and Incidence in the General Population......Page 1312
Snoring......Page 1313
Definitions......Page 1314
Upper Airway Resistance Syndrome......Page 1316
Ambulatory Multichannel Studies......Page 1317
Indications......Page 1318
Continuous Positive Airway Pressure......Page 1319
Radiofrequency Volumetric Tissue Reduction......Page 1320
Negative Sleep Studies......Page 1321
The Patient Who Remains Sleepy on CPAP Treatment......Page 1322
Treatment-Emergent Central Apneas or Complex Sleep Apnea......Page 1323
REFERENCES......Page 1324
Pathogenesis of Nocturnal Airway Narrowing......Page 1328
Bronchial Hyperreactivity......Page 1329
Conclusions......Page 1330
Sleep Disturbance......Page 1331
Treatment......Page 1332
Hypoventilation......Page 1333
Ventilation–Perfusion Mismatching......Page 1334
Prediction of Nocturnal Oxygenation......Page 1335
Clinical Value of Sleep Studies......Page 1336
Beta Agonists and Anticholinergic Bronchodilators......Page 1337
REFERENCES......Page 1338
Pathogenesis......Page 1342
Treatment......Page 1343
Control of Breathing......Page 1344
Weight Loss......Page 1345
Pathogenesis......Page 1346
Diagnosis......Page 1347
Definition, Epidemiology, and Risk Factors......Page 1348
Treatment......Page 1349
REFERENCES......Page 1350
Clinical Severity......Page 1352
Patients Needing Continuous NPPV......Page 1354
Nasal Interfaces......Page 1355
Oral Interfaces Used during Sleep......Page 1356
Assisted Coughing Techniques......Page 1357
Use of Alarms with NPPV Therapy......Page 1358
Effects of NPPV during Ventilatory Assistance......Page 1359
Effects of NPPV on Daytime Respiratory Function during Spontaneous Breathing......Page 1360
Effects on Hospitalization......Page 1361
REFERENCES......Page 1362
Diabetes Mellitus, Glucose Intolerance, and Insulin Resistance......Page 1365
OBSTRUCTIVE SLEEP APNEA AND ALTERED GLUCOSE METABOLISM......Page 1366
Sleep Fragmentation and Glucose Homeostasis......Page 1367
Hypoxemia and Glucose Homeostasis......Page 1368
OBSTRUCTIVE SLEEP APNEA AND THE METABOLIC SYNDROME......Page 1369
REFERENCES......Page 1370
Epidemiologic Association between Overweight/Obesity and OSA......Page 1373
Mechanism Linking Obesity to OSA Risk......Page 1374
Patient Assessment for OSA before Bariatric Surgery......Page 1375
Assessment of the Patient with Established OSA before Bariatric Surgery......Page 1376
Common Bariatric Surgical Procedures......Page 1377
Benefits of Bariatric Surgery......Page 1378
Risks and Complications of Bariatric Surgery......Page 1379
REFERENCES......Page 1380
SLEEP APNEA......Page 1383
IMPACT......Page 1385
REFERENCES......Page 1386
AUTONOMIC ACTIVITY AND CIRCULATORY FUNCTION DURING SLEEP......Page 1387
Nocturnal Myocardial Ischemia and Angina......Page 1389
Post-Myocardial Infarction Patients......Page 1391
Hypertension......Page 1392
Elderly Patients......Page 1393
REFERENCES......Page 1394
Therapy......Page 1397
ATRIAL FIBRILLATION......Page 1398
THE BRUGADA SYNDROME AND SUDDEN UNEXPLAINED NOCTURNAL DEATH......Page 1400
REFERENCES......Page 1401
Hypoxemia–Reoxygenation and Coronary Endothelial Dysfunction......Page 1404
Arousals, Shift to Light Sleep Stages, and the Autonomic Nervous System......Page 1405
ACUTE HEMODYNAMIC EFFECTS OF SLEEP APNEA......Page 1407
Obstructive Sleep Apnea and Systolic Heart Failure......Page 1408
Obstructive Sleep Apnea and Diastolic Heart Failure......Page 1409
Tachycardia–Bradycardia Oscillations......Page 1410
Atrial Fibrillation......Page 1411
REFERENCES......Page 1412
Epidemiologic Evidence for a Role of OSA in Systemic Hypertension......Page 1415
OSA and Diurnal Blood Pressure......Page 1418
Blood Pressure Changes in Patients with OSA after CPAP Treatment......Page 1419
Clinical Relevance of the Role of OSA in Hypertension......Page 1421
Obstructive Sleep Apnea as a Cause of Pulmonary Hypertension......Page 1422
Mechanisms of Pulmonary Hypertension in Patients with OSA......Page 1423
REFERENCES......Page 1424
Prevalence of OSA and CAD in the General Population......Page 1427
Prevalence of OSA in CAD......Page 1428
Impact of Elimination of OSA on CAD......Page 1429
PATHOGENESIS......Page 1430
REFERENCES......Page 1431
Heart Failure......Page 1434
Sleep Apnea in Systolic Heart Failure......Page 1435
Sex and Sleep-Related Breathing Disorders in Systolic Heart Failure......Page 1436
Mechanisms of Central Sleep Apnea......Page 1437
Effects of CSA on Cardiovascular Function and Mortality......Page 1438
Indications for Polysomnography in Heart Failure......Page 1440
Positive Airway Pressure Devices......Page 1441
Optimization of Cardiopulmonary Function......Page 1442
Positive Airway Pressure Devices......Page 1443
Cardiac Pacing......Page 1444
Inhaled CO2 and Addition of External Dead Space......Page 1445
REFERENCES......Page 1446
Sleep Disruption......Page 1450
Fatigue......Page 1451
Pathogenesis of Fatigue......Page 1452
Fatigue......Page 1453
REFERENCES......Page 1454
Abstract......Page 1456
PATHOGENESIS......Page 1457
CLINICAL FEATURES......Page 1458
Sleep–Wake Diary......Page 1459
Polysomnography......Page 1460
Sleep-Promoting Agents......Page 1461
Special Considerations in the Management of Patients with FMS and CFS......Page 1462
PITFALLS AND CONTROVERSIES......Page 1463
Periodic EEG Phenomena: Recording Techniques and Scoring Rules......Page 1464
REFERENCES......Page 1467
Pathogenesis......Page 1469
Morbidity and Mortality of Acromegaly and Sleep Apnea......Page 1470
Male Hormonal Disorders......Page 1471
DISORDERED CORTICOSTEROID SECRETION AND SLEEP......Page 1472
DIABETES AND CENTRAL OBESITY......Page 1473
REFERENCES......Page 1474
PAIN AND SLEEP......Page 1476
Epidemiology and Risk Factors......Page 1477
Cognitive Impairment, Sleep Deprivation, and Pain Perception......Page 1478
Neurochemistry, HPA Axis, and Genetics in the Interaction between Pain and Sleep......Page 1479
Clinical Evaluation......Page 1480
TREATMENT/MANAGEMENT......Page 1482
REFERENCES......Page 1483
NOCTURNAL ACID SECRETION IN DUODENAL ULCER DISEASE......Page 1486
GASTROESOPHAGEAL REFLUX DURING SLEEP......Page 1487
ESOPHAGEAL ACID CLEARANCE DURING SLEEP......Page 1488
Therapeutic Considerations......Page 1489
PULMONARY COMPLICATIONS OF SLEEP-RELATED GASTROESOPHAGEAL REFLUX......Page 1491
INTESTINAL MOTILITY DURING SLEEP AND IRRITABLE BOWEL SYNDROME......Page 1492
CONCLUSIONS......Page 1493
REFERENCES......Page 1494
Treatment......Page 1496
EPIDEMIOLOGY......Page 1497
INSOMNIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE......Page 1498
Morbidity and Mortality......Page 1499
SLEEP-RELATED BREATHING DISORDERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE......Page 1500
Influence of Breathing Disorders on Outcomes of Disease......Page 1501
Treatment......Page 1502
SUMMARY......Page 1503
REFERENCES......Page 1504
Abstract......Page 1507
Sleep Features......Page 1508
Treatment......Page 1510
Sleep Features......Page 1511
Epidemiology and Clinical Features......Page 1512
Treatment......Page 1513
Sleep Features......Page 1514
Sleep Features......Page 1515
PITFALLS AND CONTROVERSIES......Page 1517
REFERENCES......Page 1518
EPIDEMIOLOGY AND RISK FACTORS......Page 1522
Predictive Value of Sleep Complaints......Page 1524
Polysomnographic Findings......Page 1525
Neurotransmitter Imbalance......Page 1526
Primary Sleep Disorders and Mood Disorders......Page 1527
Bipolar Disorder......Page 1528
Sleep Loss and Bipolar Disorder......Page 1530
Clinical Application of Sleep Studies......Page 1531
REFERENCES......Page 1532
EPIDEMIOLOGY AND RISK FACTORS......Page 1535
DIAGNOSIS......Page 1536
Subjective Sleep Complaints......Page 1537
Sleep-Related Brain Wave Activity......Page 1538
Treating Schizophrenia with Antipsychotic Agents......Page 1539
Sleep-Promoting Effects of Antipsychotics......Page 1540
Schizophrenia-Related Hyperarousal......Page 1541
CONTROVERSIES......Page 1542
REFERENCES......Page 1543
DRUG DEPENDENCE AND SLEEP MEDICINE......Page 1546
UNDERSTANDING SUBSTANCE ABUSE......Page 1547
Behavioral Mechanisms......Page 1548
Alcohol in Healthy Adults......Page 1549
Recovery and Long-term Abstinence......Page 1550
Caffeine......Page 1551
Amphetamine......Page 1552
Sedative-Hypnotics......Page 1553
DRUG SEEKING VERSUS THERAPY SEEKING......Page 1554
REFERENCES......Page 1555
Abstract......Page 1558
Depressive and Bipolar Disorders......Page 1559
Arthritis......Page 1560
Kidney and Urologic Diseases......Page 1561
EFFECT OF MEDICATIONS ON SLEEP......Page 1562
Medications That can Exacerbate Primary Sleep Disorders......Page 1563
Caregiving......Page 1564
Geriatric Syndromes......Page 1565
SUMMARY......Page 1566
REFERENCES......Page 1567
CLINICAL MANIFESTATIONS AND PRESENTATION......Page 1570
Nocturia......Page 1571
Impaired Cognition......Page 1572
Continuous Positive Airway Pressure......Page 1573
SUMMARY......Page 1574
REFERENCES......Page 1575
EPIDEMIOLOGY AND RISK FACTORS......Page 1578
Age-Related Changes in Sleep Regulation......Page 1579
Periodic Limb Movements in Sleep......Page 1580
Nonpharmacologic......Page 1581
Pharmacologic......Page 1582
REFERENCES......Page 1583
THE NURSING HOME ENVIRONMENT AS A CHALLENGE TO SLEEP INTEGRITY......Page 1585
Sedative-Hypnotics......Page 1586
Cholinesterase Inhibitors, Antipsychotics, and Stimulants......Page 1587
NOCTURNAL WANDERING AND RESTLESS LEGS SYNDROME......Page 1588
SLEEP APNEA AND ASSOCIATED MORBIDITIES IN DEMENTIA......Page 1589
SUMMARY......Page 1591
REFERENCES......Page 1592
INFANCY......Page 1596
Polysomnographic Data......Page 1597
Polysomnographic Data......Page 1598
THE MENSTRUAL CYCLE AND EFFECTS OF OVARIAN HORMONES ON SLEEP AND CIRCADIAN RHYTHMS......Page 1599
Shift Work and Menstrual Rhythms......Page 1600
Polycystic Ovary Syndrome......Page 1601
Premenstrual Syndrome......Page 1602
Oral Contraceptives, Body Temperature, and Sleep......Page 1603
REFERENCES......Page 1604
Cortisol......Page 1606
Second Trimester......Page 1607
CHANGES IN SLEEP ARCHITECTURE AND SLEEP QUALITY IN NORMAL PREGNANCY......Page 1608
Third Trimester......Page 1609
Sleep-Disordered Breathing......Page 1610
Summary......Page 1611
Sleep-Related Leg Cramps......Page 1612
Pregnancy-Related Secondary Restless Legs Syndrome......Page 1613
Pregnancy-Associated Insomnia......Page 1614
Maternal Complications......Page 1616
Psychosocial Consequences of Insufficient Sleep......Page 1617
REFERENCES......Page 1618
SLEEP DURING POSTPARTUM RECOVERY......Page 1621
Breast-Feeding and Formula Feeding......Page 1622
Postpartum Depression......Page 1623
REFERENCES......Page 1625
NORMAL SLEEP PATTERNS DURING MENOPAUSE......Page 1626
Hot Flushes and Night Sweats......Page 1628
Apnea, Obesity, and Hypertension......Page 1629
Metabolic Syndrome......Page 1630
Cancer......Page 1631
SUMMARY......Page 1632
REFERENCES......Page 1633
HISTORY......Page 1636
ELECTRODE PLACEMENT AND APPLICATION......Page 1637
Waveforms......Page 1638
Sleep Staging Rules......Page 1639
Central Nervous System Arousal Scoring......Page 1640
AMBIGUOUS SLEEP STAGES AND SLEEP QUALITY......Page 1642
REFERENCES......Page 1643
METHODS TO DETECT AIRFLOW......Page 1644
Thermistors and Thermocouples......Page 1645
Expired Carbon Dioxide Sensing......Page 1646
Rib Cage and Abdominal Motion......Page 1647
Static Charge–Sensitive Bed......Page 1649
Strain Gauges, Inductance Plethysmography, and Piezoelectric Transducers......Page 1650
Blood Gas Changes......Page 1651
Instrument Filtering and Sampling Rate......Page 1652
Blood Pressure Changes......Page 1653
HOME SLEEP TESTING......Page 1654
Attended Laboratory Polysomnography......Page 1655
Automatic Scoring......Page 1656
REFERENCES......Page 1657
OVERVIEW......Page 1658
Utility......Page 1659
Electroencephalography......Page 1660
Methodology......Page 1661
Epworth Sleepiness Scale......Page 1662
PRACTICAL ISSUES AND CONCLUSIONS......Page 1663
REFERENCES......Page 1664
Learned Insomnia and the Vicious Circle......Page 1666
Predisposing, Precipitating, and Perpetuating Factors......Page 1667
ASSESSMENT METHODS OF SLEEP DISORDERS CENTERS......Page 1668
PSYCHOPATHOLOGY AND PERSONALITY QUESTIONNAIRES......Page 1669
INVENTORIES OF COGNITIVE AND SOMATIC AROUSAL......Page 1670
PROSPECTIVE SLEEP DIARIES......Page 1671
Case Illustrations......Page 1672
Recommendations for a Standard Research Assessment of Insomnia......Page 1673
Duke Structured Interview for Sleep Disorders......Page 1675
Actigraphy......Page 1676
SUMMARY......Page 1677
REFERENCES......Page 1678
Technical Aspects of Electroencephalography......Page 1680
Daytime Electroencephalography......Page 1681
Video-Electroencephalography Polysomnography......Page 1683
Ambulatory Monitoring......Page 1684
Suspected Sleep-Related Epileptic Seizures......Page 1685
Suspected NREM Arousal Disorders......Page 1687
Suspected Dissociative Disorder......Page 1688
REFERENCES......Page 1689
METHODOLOGIC QUESTIONS IN THE FIELD OF CIRCADIAN RHYTHMS......Page 1691
Fixed Light-Dark Schedules, Double Plotted......Page 1692
Time-Isolation Protocols......Page 1693
Phase Shifting of Gene Expression Protocol......Page 1694
Salivary Melatonin and Cortisol Assay......Page 1695
ACTIGRAPHY......Page 1696
MEASURING CIRCADIAN RHYTHM PARAMETERS IN GENE EXPRESSION......Page 1697
DISCUSSION......Page 1699
REFERENCES......Page 1700
HISTORY OF WRIST ACTIGRAPHY......Page 1702
Sleep Apnea......Page 1704
Geriatrics......Page 1705
EDITING ACTIGRAPHY DATA......Page 1706
SUMMARY......Page 1707
REFERENCES......Page 1708
AMBULATORY pH MONITORING......Page 1710
POLYSOMNOGRAPHIC RECORDING......Page 1712
CLINICAL INTERPRETATION......Page 1713
REFERENCES......Page 1714
Light Boxes......Page 1716
Safety of Bright Light for the Eyes......Page 1717
Monitoring of Patients......Page 1718
Timing of Morning Light Exposure......Page 1719
Delayed Sleep Phase Disorder......Page 1720
Advanced Sleep Phase Disorder......Page 1722
Free-Running Sleep Disorder......Page 1723
Seasonal Affective Disorder......Page 1724
Nonseasonal Bipolar Depression......Page 1725
TOWARD AN INTEGRATED CHRONOTHERAPEUTICS......Page 1726
REFERENCES......Page 1727
A......Page 1731
C......Page 1734
D......Page 1737
E......Page 1739
F......Page 1740
G......Page 1741
H......Page 1742
I......Page 1743
M......Page 1745
N......Page 1747
O......Page 1748
P......Page 1749
R......Page 1751
S......Page 1753
T......Page 1755
V......Page 1756
Z......Page 1757