Abstract
Each of us spend one-third of our lives asleep. Dysfunctions in this basic state lead to declines in quality of life, diminished waking performance, more frequent illness, and increases in both morbidity and mortality. Recent epidemiological data have emphasized the significant contribution of obstructive sleep apnea (OSA), one of the most physiological disruptive and dangerous sleep-related diagnosis, to pulmonary, cardiac, endocrine, and cognitive diseases (1–4). Yet sleep medicine is not just a pulmonary subspecialty. The spectrum of sleep disorders mirrors the clinical population of patients in a broad-based practice of primary care (5) (Table 1). Almost all chronic diseases result in physical or mental discomfort for the patient and consistently induce disturbances in the state of sleep.
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References
Gami AS, Caples SM, Somers VK (2003) Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am 32(4):869–894.
Kenchaiah S, Narula J, Vasan RS (2004) Risk factors for heart failure. Med Clin North Am 88(5):1145–1172.
Richert A, Ansarin K, Baran AS (2002) Sleep apnea and hypertension: pathophysiologic mechanisms. Semin Nephrol 22(l):71–77.
Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165(9): 1217–1239.
American Academy of Sleep Medicine, the International Classification of Sleep Disorders: Diagnostic and Coding Manual — 2nd edition, American Academy of Sleep Medicine, Westchester,IL, 2006.
Ancoli-Israel S, Roth T (1999) Characteristics of insomnia in the United States: Results of the 1991 National Sleep Foundation Survey. Sleep 22(Suppl 2):S347–S353.
Shochat T, Umphress J, Israel AG, Ancoli-Israel S (1999) Insomnia in primary care patients. Sleep 22(Suppl 2):S359–S365.
Chervin R, Archbold K, Panachi P, Pituch K (2001) Sleep problems seldom addressed at two general pediatric clinics. Pediatrics 107(6): 1375–1380.
NIH State of the Science conference Statement, Bethesda, MD 2005.
Walsh JK, Engelhardt CL (1999) The direct economic costs of insomnia in the United States for 1995. Sleep 22(Suppl 2):S386–S393.
National Center on Sleep Disorders Research, National Heart Lung and Blood Institute, and National Institutes of Health (1999) Insomnia: assessment and management in primary care. Sleep 22(Suppl 2): S402–S408.
Roth T, Roehers TA (2000) Treating Insomnia in the Primary Care Setting: National Sleep Foundation Monograph, Washington, DC.
Benca RM (2001) Consequences of insomnia and its therapies. J Clin Psychiatry 62(Suppl 10): 33–38.
Breslau N, Roth T, Rosenthal L, Andreski P (1996) Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry 39(Suppl 6):411–418.
Hasler G, Buysse DJ, Klaghofer R, et al. (2004) The association between short sleep duration and obesity in young adults: a 13-year prospective study. Sleep 27:661–666.
Roehrs TA, Blaisdell B, Greenwald MK, Roth T (2003) Pain threshold and sleep loss. Sleep 26(Suppl): A196.
Balter MB, Uhlenhuth EH (1992) New epidemiologic findings about insomnia and its treatment. J Clin Psychiatry 53(Suppl):34–39.
Chesson AL Jr, Anderson WM, Littner M, et al. (1999) Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 22:1128–1133.
Chesson AL Jr, Hartse K, Anderson WM, et al. (2000) Practice parameters for the evaluation of chronic insomnia. An American Academy of Sleep Medicine Report. Standards of Practice Committee of American Academy of Sleep Medicine. Sleep 23:237–241.
Thorpy M, Chesson A, Kader G, et al. (1995) Practice parameters for the use of polysomnography in the evaluation of insomnia. Standards of Practice Committee of the American Sleep Disorders Association. Sleep 18(1):55–57.
Stoller MK (1994) Economic effects of insomnia. Clin Ther 16:873–997.
Ebell MH, Siwek J, Weiss BD, et al. (2004) Strength of Recommendation Taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician 69:549–557.
Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. Cooperative Group Burgos-Santander. N Engl J Med 340(Suppl 11):847–851.
Smith R, Ronald J, Delaive K, Walld R, Manfreda J, Kryger M (2002) What are obstructive sleep apnea patients being treated for Prior to this diagnosis? Chest 121:164–172.
Wolk R, Shamsuzzaman AS, Somers VK (2003) Obesity, sleep apnea, and hypertension. Hypertension 42(6): 1067–1074.
Vgontzas AN, Bixler EO (2003) Chrousos GP Metabolic disturbances in obesity versus sleep apnea: the importance of visceral obesity and insulin resistance. J Intern Med 254(l):32–44.
Verrier R, Josephson M Cardiac Arrhythmias and Sudden Death During Sleep, in Sleep: A Comprehensive Handbook (Lee-Chiong T, ed.) Wiley-Liss, Hoboken, NJ, 2006, pp. 727–732.
Gozal D (1998) Sleep-disordered breathing and school performance in children. Pediatrics 102:616–620.
Pagel JF, Snyder S, Dawson D (2004) Obstructive Sleep Apnea in Sleepy Pediatric Psychiatry Clinic Patients: Polysomnographic and Clinical Correlates. Sleep Breathing 8(3):125–131.
Kapur V, Blough DK, Sandblom RE, et al. (1999) The medical cost of undiagnosed sleep apnea. Sleep 22(Suppl 6):749–755.
Bahammam A, Delaive K, Ronald J, Manfreda J, Roos L, Kryger MH (1999) Health care utilization in males with obstructive sleep apnea syndrome two years after diagnosis and treatment. Sleep 22(Suppl 6):740–747.
Peker Y, Hedner J, Johansson A, Bende M (1997) Reduced hospitalization with cardiovascular and pulmonary disease in obstructive sleep apnea patients on nasal CPAP treatment. Sleep 20:645–653.
Tarasiuk A, Simon T, Tal A, Reuveni H (2002) Adenotonsillectomy in children with obstructive sleep apnea syndrome reduces health care utilization. Pediatrics 110:68–72.
Ronald J, Delaive K, Roos I, Manfreda J, Bahammam A, Kryger MH (1999) Health care utilization in the 10 years prior to diagnosis in obstructive sleep apnea syndrome patients. Sleep 22(2):225–229.
National Highway Traffic Safety Administration, http://www.nhtsa.dot.gov. Accessed October 2006.
Littner MR, Kushida C, Wise M, et al. (2005) Practice parameters for clinical use of the multiple sleep latency test and the maintenance of wakefulness test. Sleep 28(1): 113–121.
Mahowald M (2000) Parasomnias. in: Principles and Practice of Sleep Medicine 3rd editions (Kryger M, Roth T, Dement W, eds.) W. B. Saunders Company, Philadelphia, pp. 693–796.
Littner MR, Kushida C, Anderson WM, et al. (2004) Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 27(3):557–559.
Thorpy M, Ehrenberg BL, Hening WA, et al. (2000) Restless Legs Syndrome: Detection and Management in Primary Care. National Heart, Lung, and Blood Institute Working Group on Restless Legs Syndrome. Am Academy Fam Physician 62(Suppl l):108–114.
Chesson AL Jr, Wise M, Davila D, et al. (1999) Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 22(7):961–968.
Chesson AL, Ferber RA, Fry JM, et al. (1997) The indications for polysomnography and related procedures. Sleep 20:423–485.
Chesson A, Ferber R, Fry J, et al. (1997) Practice parameters for the indications for polysomnography and related procedures. Polysomnography Task Force, American Sleep Disorders Association Standards of Practice Committee. Sleep 20(6):406–422.
Kushida CA, Littner MR, Hirshkowitz M, et al. (2006) Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 29(3):375–380.
Ferber R, Millman R, Coppola M, et al. (1994) Portable recording in the assessment of obstructive sleep apnea. ASDA standards of practice. Sleep 17(4):378–379.
Thorpy M, Chesson A, Ferber R, et al. (1994) Practice parameters for the use of portable recording in the assessment of obstructive sleep apnea. Standards of Practice Committee of the American Sleep Disorders Association. Sleep 17(4):372–377.
Littner M, Hirshkowitz M, Davila D, et al. (2002) Practice parameters for the use of auto-titrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. An American Academy of Sleep Medicine report. Sleep 25(2): 143–147.
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Pagel, J.F. (2007). Sleep Disorders in Primary Care. In: Pagel, J.F., Pandi-Perumal, S.R. (eds) Primary Care Sleep Medicine. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-421-6_1
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DOI: https://doi.org/10.1007/978-1-59745-421-6_1
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