Sleep Wake Disorders

Sleep as a vital sign

Rowan Hutchins — Sat, 06 May 2023 05:00:00 +0000

Date Added:

May 6, 2023

Journal/Publication:

Sleep Science & Practice

Publisher:

Biomed Central

Publication Date:

April 24, 2023

Issue:

Volume:

URL:

Sleep as a vital sign

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1186/s41606-023-00085-1

Keywords

MeSH

A well-reasoned argument in favor of routine screening of adults for sleep problems and suggestions regarding how to do it. James W. Mold, MD, MPH

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Sleep is causally linked to the maintenance of every major physiological body system and disturbed sleep contributes to myriad diseases. The problem is, however, is that patients do not consistently, nor spontaneously, report sleep problems to their clinicians. Compounding the problem, there is no standard-of-care approach to even the most rudimentary of sleep queries. As a result, sleep disturbances remain largely invisible to most clinicians, and consequentially, unaddressed for the patient themselves – thereby exacerbating physical and mental health challenges due to unaddressed sleep problems. In this review, we argue that all patients should be routinely screened with a short, readily available, and validated assessment for sleep disturbances in clinical encounters. If the initial assessment is positive for any subjective sleep-related problems, it should prompt a more thorough investigation for specific sleep disorders. We further describe how a program of short and simple sleep health screening is a viable, efficacious yet currently missing pathway through which clinicians can 1) screen for sleep-related problems, 2) identify patients with sleep disorders, 3) rapidly offer evidence-based treatment, and (if indicated) 4) refer patients with complex presentations to sleep medicine specialists.

Author/s:

Hirschtritt, M.E., Walker, M. P., Krystal, A.D.

Parkinson disease primer, part 2: management of motor and nonmotor symptoms

Aubrey Delammermore — Thu, 23 Feb 2023 06:00:00 +0000

Date Added:

February 23, 2023

Journal/Publication:

Canadian Family Physician

Publication Date:

February 1, 2023

Issue:

Volume:

Pages:

91-96

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.46747/cfp.690291

Keywords

PMID (1):

36813521

MeSH

Levodopa

depression

Hypotension, Orthostatic

Physical Therapy Modalities

Sleep Wake Disorders

The second of a series of articles on management of Parkinson's Disease. James W. Mold, MD, MPH

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Objective To provide family physicians with an approach to the management of
motor and nonmotor symptoms of Parkinson disease (PD).
Sources of information Published guidelines on the management of PD were
reviewed. Database searches were conducted to retrieve relevant research
articles published between 2011 and 2021. Evidence levels ranged from I to III.
Main message Family physicians can play an important role in identifying and
treating motor and nonmotor symptoms of PD. Family physicians should initiate
levodopa treatment for motor symptoms if they affect function and if specialist
wait times are long, and they should be aware of basic titration approaches
and possible side effects of dopaminergic therapies. Abrupt withdrawal of
dopaminergic agents should be avoided. Nonmotor symptoms are common and
underrecognized and are a major factor in disability, quality of life, and risk of
hospitalization and poor outcomes for patients. Family physicians can manage
common autonomic symptoms such as orthostatic hypotension and constipation.
Family physicians can treat common neuropsychiatric symptoms such as
depression and sleep disorders, and they can help recognize and treat psychosis
and PD dementia. Referrals to physiotherapy, occupational therapy, speech
language therapy, and exercise groups are recommended to help preserve function.
Conclusion Patients with PD present with complex combinations of motor
and nonmotor symptoms. Family physicians should have basic knowledge of
dopaminergic treatments and their side effects. Family physicians can play
important roles in management of motor symptoms and particularly nonmotor
symptoms and can have a positive impact on patients’ quality of life. An
interdisciplinary approach involving specialty clinics and allied health experts
is an important part of management.

Author/s:

Frank, C., Chiu, R., Lee, J.

Disorders of Arousal in adults: new diagnostic tools for clinical practice

John Bayhi — Fri, 01 Nov 2019 17:52:36 +0000

Date Added:

November 1, 2019

Journal/Publication:

Sleep Science Practice

Publisher:

Springer Nature

Publication Date:

October 2, 2019

Issue:

Volume:

URL:

Disorders of Arousal in adults: new diagnostic tools for clinical practice

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1186/s41606-019-0037-3

Keywords

Video-polysomnography

MeSH

REM Sleep Behavior Disorder

Homicide

Sleep Arousal Disorders

Electroencephalography

Epilepsy

This is a review of the diagnosis and management of patients with various arousal disorders. James W. Mold, MD, MPH

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Disorders of Arousal (DOA) are mental and motor behaviors arising from NREM sleep. They comprise a spectrum of manifestations of increasing intensity from confusional arousals to sleep terrors to sleepwalking.

Although DOA in childhood are usually harmless, in adulthood they are often associated with injurious or violent behaviors to the patient or others. Driving motor vehicles, suspected suicide, and even homicide or attempted homicide have been described during sleepwalking in adults. Furthermore, adult DOA need to be differentiated from other sleep disorders such as Sleep-related Hypermotor Epilepsy or REM Sleep Behavior Disorder.

Although many aspects of DOA have been clarified in the last two decades there is still a lack of objective and quantitative diagnostic criteria for DOA.

Recent advances in EEG analysis and in the semiological characterization of DOA motor patterns have provided a better definition of DOA diagnosis.

Our article focuses on the DOA diagnostic process describing accurately the newest DOA clinical, EEG and video-polysomnographic tools in order to aid clinicians in DOA assessment.

Author/s:

Loddo, G, Lopez, R, Cilea, R, Dauvillers, Y, Provini, F