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Care of the Patient with a Sleep Disorder

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Family Medicine

Abstract

Sleep is a periodically recurring physiologic state of lessened responsiveness from which one can be readily awakened. Quality and quantity of sleep vary with age. Newborns sleep an average of 16 hours each day in randomly fragmented fashion. As an individual matures, sleep usually coalesces into a single prolonged nighttime period, with an average length of 7 to 8 hours in adults. A few individuals function well with as little as 4 hours per day, whereas others require 10 hours or more. Transition into older adulthood produces a gradual increase in total daily sleep time. By age 90 the average is nearly 9 hours per day. In addition, older adults often take longer to fall asleep, take daytime naps, experience more frequent awakenings, and spend less time in the deep states of sleep.1 A wide variety of disorders can interfere with normal sleep patterns.

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References

  1. Roth T, Roehrs TA. Sleep disorders in the elderly. Clin Geriatr Med 1989;5:275–87.

    Google Scholar 

  2. Regestein QR, Monk TH. Delayed sleep phase syndrome: a review of its clinical aspects. Am J Psychiatry 1995;152:602–8.

    PubMed  CAS  Google Scholar 

  3. Bootzin RR, Perlis ML. Nonpharmacologic treatments of insomnia. J Clin Psychiatry 1992;53 Supp1:37–41.

    PubMed  Google Scholar 

  4. Morin CM, Culbert JP, Schwartz SM. Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. Am J Psychiatry 1994;151:1172–80.

    PubMed  CAS  Google Scholar 

  5. Friedman L, Bliwise DL, Yesavage JA, Salom SR. A preliminary study comparing sleep restriction and relaxation treatments for insomnia in older adults. J Gerontol 1991;46:1–8.

    Article  Google Scholar 

  6. Lichstein KL, Johnson RS. Relaxation for insomnia and hypnotic medication use in older women. Psychol Aging 1993; 8:103–11.

    Article  PubMed  CAS  Google Scholar 

  7. Guilleminault C, Clerk A, Black J, et al. Nondrug treatment trials in psychophysiologic insomnia. Arch Intern Med 1995; 155:838–44.

    Article  PubMed  CAS  Google Scholar 

  8. Walsh JK, Schweitzer PK, Anch AM, et al. Sleepiness/alertness on a simulated night shift following sleep at home with triazolam. Sleep 1991;14:140–6.

    PubMed  CAS  Google Scholar 

  9. Pagel JF. Treatment of insomnia. Am Fam Physician 1994;49: 1417–21.

    PubMed  CAS  Google Scholar 

  10. Hartmann PM. Drug treatment of insomnia: indications and newer agents. Am Fam Physician 1995;51:191–4.

    PubMed  CAS  Google Scholar 

  11. Langtry HD, Benfield P. Zolpidem, a review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential. Drugs 40:291–313.

    Google Scholar 

  12. Garfinkel D, Laudon M, Nof D, Zisapel N. Improvement of sleep quality in elderly people by controlled-release melatonin. Lancet 1995;346:541–4.

    Article  PubMed  CAS  Google Scholar 

  13. Haimov I, Lavie P, Laudon M, et al. Melatonin replacement therapy of elderly insomniacs. Sleep 1995;18:598–603.

    PubMed  CAS  Google Scholar 

  14. Grad RM. Benzodiazepines for insomnia in communitydwelling elderly: a review of benefit and risk. J Fam Pract 1995;41:473–81.

    PubMed  CAS  Google Scholar 

  15. Aldrich MS, Desforges JF. Narcolepsy. Curr Concepts 323: 389–93.

    Google Scholar 

  16. Chaudhary BA, Husain I. Narcolepsy. J Fam Pract 1993;36: 207–13.

    PubMed  CAS  Google Scholar 

  17. Garma L, Marchand F. Non-pharmacological approaches. Sleep 1994;17:S97–102.

    PubMed  CAS  Google Scholar 

  18. Miller MM, Aldrich MS, Koob GF, Zarcone VP. Narcolepsy and its treatment with stimulants. Sleep 1994;17:352–71.

    Google Scholar 

  19. Young T, Palta M, Dempsey J, et al. The occurrence of sleepdisordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5.

    Article  PubMed  CAS  Google Scholar 

  20. Partinen M, Guilleminault C. Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. Chest 1990;97:27–32.

    Article  PubMed  CAS  Google Scholar 

  21. He J, Kryger MR, Zorick FJ, et al. Mortality and apnea index in obstructive sleep apnea: experience in 385 male patients. Chest 1988;94:9–14.

    Article  PubMed  CAS  Google Scholar 

  22. Partinen M, Jamieson A, Guilleminault C. Long-term outcome for obstructive sleep apnea patients, mortality. Chest 1988;94:1200–4.

    Article  PubMed  CAS  Google Scholar 

  23. Strollo PJ Jr, Rogers RM. Obstructive sleep apnea. N Engl J Med 1996;334:99–104.

    Article  PubMed  Google Scholar 

  24. Reeves-Hoche MK, Hudger DW, Meck R, et al. Continuous versus bilevel positive airway pressure for obstructive sleep apnea. Am J Respir Crit Care Med 1995;151:443–9.

    Article  PubMed  CAS  Google Scholar 

  25. Hanzel DA, Proia NG, Hudger DW. Response of obstructive sleep apnea to fluoxetine and protriptyline. Chest 1991;100: 416–21.

    Article  PubMed  CAS  Google Scholar 

  26. Practice parameters for the use of laser-assisted uvulopalatoplasty. Sleep 1994;17:744–8.

    Google Scholar 

  27. Okeefe ST. Restless legs syndrome, a review. Arch Intern Med 1996;156:243–8.

    Article  Google Scholar 

  28. Walters AS, Hening W. Clinical presentation and neuropharmacology of restless legs syndrome. Clin Neuropharmacol 1987;10:225–37.

    Article  PubMed  CAS  Google Scholar 

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Johnson, T.A., Deckert, J.J. (1998). Care of the Patient with a Sleep Disorder. In: Taylor, R.B., David, A.K., Johnson, T.A., Phillips, D.M., Scherger, J.E. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2947-4_56

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  • DOI: https://doi.org/10.1007/978-1-4757-2947-4_56

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2949-8

  • Online ISBN: 978-1-4757-2947-4

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