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Sleep Medicine

  • David Hillman
  • Olivier Vanderveken
  • Atul Malhotra
  • Peter EastwoodEmail author
Reference work entry

Abstract

Sleep has important impacts on upper airway function, and thus the nature of sleep, the physiological changes that accompany it, and the disorders associated with it are of concern to oral medicine specialists. These concerns relate to both their role in helping manage upper airway problems during sleep – snoring and obstructive sleep apnea – and to the fact that these problems often exist in patients presenting with other functional or cosmetic abnormalities involving the upper airway. Additionally, oral medicine specialists help manage insomnia related to chronic orofacial pain and sleep bruxism. The purpose of this chapter is to provide a general overview of sleep and its disorders, hence a context within which to consider specific sleep-relevant issues. It is particularly important that specialists focused on the upper airway have a good understanding of the impacts of sleep, as problems with airway patency may only manifest in this state. Furthermore, such problems, in turn, disrupt sleep itself, causing sleep loss and other physiological disturbances which have their own impacts on symptoms and on well-being.

Keywords

Sleep disorders Upper airway Pharyngeal muscles Inadequate sleep Sleep disorders Sleep apnea Snoring Sleep hypoventilation Periodic breathing Insomnia Restless legs Narcolepsy Parasomnia Bruxism 

References

  1. Adams RJ, Appleton SL, Taylor AW, et al. Sleep health of Australian adults in 2016: results of the 2016 Sleep Health Foundation national survey. Sleep Health. 2017;3(1):35–42.PubMedCrossRefGoogle Scholar
  2. Allen RP, Walters AS, Montplaisir J, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med. 2005;165(11):1286–92.PubMedCrossRefGoogle Scholar
  3. American Academy of Sleep Medicine. International classification of sleep disorders. Westchester: American Academy of Sleep Medicine; 2005.Google Scholar
  4. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation survey. I. Sleep. 1999;22:S347–53.PubMedGoogle Scholar
  5. Antic NA, Catcheside P, Buchan C, et al. The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep. 2011;34(1):111–9.PubMedPubMedCentralCrossRefGoogle Scholar
  6. Australian Bureau of Statistics. 1301.0 – year book Australia, 2008. Feature article 4: work related injuries. Canberra: Australian Bureau of Statistics. http://www.abs.gov.au/AUSSTATS/abs@.nsf/7d12b0f6763c78caca257061001cc588/9e37df09e753eff8ca2573d20010f43b!OpenDocument# (2008). Accessed 22 June 2015.
  7. Ayas NT, Patil SP, Stanchina M, Malhotra A. Treatment of central sleep apnea with adaptive servoventilation in chronic heart failure. Am J Respir Crit Care Med. 2015;192(2):132–3.PubMedCrossRefGoogle Scholar
  8. Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder: review article. Sleep Med Rev. 2000;4(1):27–43.PubMedCrossRefGoogle Scholar
  9. Berry RB, Kryger MH, Massie CAA. Novel nasal expiratory positive airway pressure (EPAP) device for the treatment of obstructive sleep apnea: a randomized controlled trial. Sleep. 2011;34(4):479–85.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Bloom JW, Kaltenborn WT, Quan SF. Risk factors in a general population for snoring. Importance of cigarette smoking and obesity. Chest. 1988;93(4):678–83.PubMedCrossRefGoogle Scholar
  11. Borbely AA, Achermann P. Sleep homeostasis and models of sleep regulation. J Biol Rhythm. 1999;14(6):559–70.CrossRefGoogle Scholar
  12. Camacho M, Song SA, Tolisano AM. Oral pressure therapy (winx) for obstructive sleep apnea: a meta-analysis updating the systematic review. Sleep Breath. 2016;20(3):1011–2.PubMedCrossRefGoogle Scholar
  13. Cappuccio FP, Cooper D, D’Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.PubMedCrossRefGoogle Scholar
  14. Center for Disease Control and Prevention. Perceived insufficient rest or sleep among adults – United States, 2005–2008. MMWR. 2011;60:239–42.Google Scholar
  15. Chikahisa S, Sei H. The role of ATP in sleep regulation. Front Neurol. 2011;2:87.PubMedPubMedCentralCrossRefGoogle Scholar
  16. Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812–21.PubMedCrossRefGoogle Scholar
  17. Chung F, Abdullah HR, Liao P. STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest. 2016;149(3):631–8.PubMedCrossRefGoogle Scholar
  18. Collop NA, Anderson WM, Boehlecke B, et al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. J Clin Sleep Med. 2007;3(7):737–47.PubMedGoogle Scholar
  19. Colrain IM, Brooks S, Black J. A pilot evaluation of a nasal expiratory resistance device for the treatment of obstructive sleep apnea. J Clin Sleep Med. 2008;4(5):426–33.PubMedPubMedCentralGoogle Scholar
  20. Colrain IM, Black J, Siegel LC, et al. A multicenter evaluation of oral pressure therapy for the treatment of obstructive sleep apnea. Sleep Med. 2013;14(9):830–7.PubMedPubMedCentralCrossRefGoogle Scholar
  21. Delaey P, Duisit J, Behets C, Duprez T, Gianello P, Lengele B. Specific branches of hypoglossal nerve to genioglossus muscle as a potential target of selective neurostimulation in obstructive sleep apnea: anatomical and morphometric study. Surg Radiol Anat. 2016;39:507–15.PubMedPubMedCentralCrossRefGoogle Scholar
  22. Eastwood PR, Barnes M, Walsh JH, et al. Treating obstructive sleep apnea with hypoglossal nerve stimulation. Sleep. 2011;34(11):1479–86.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest. 2007;131(2):595–607.PubMedPubMedCentralCrossRefGoogle Scholar
  24. Edwards C, Mukherjee S, Simpson L, Palmer LJ, Almeida OP, Hillman DR. Depressive symptoms before and after treatment of obstructive sleep apnea in men and women. J Clin Sleep Med. 2015;11(9):1029–38.PubMedPubMedCentralGoogle Scholar
  25. Eisele DW, Smith PL, Alam DS, Schwartz AR. Direct hypoglossal nerve stimulation in obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 1997;123(1):57–61.PubMedCrossRefGoogle Scholar
  26. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539–52.PubMedPubMedCentralCrossRefGoogle Scholar
  27. Freedman NS, Kotzer N, Schwab RJ. Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. Am J Respir Crit Care Med. 1999;159(4):1155–62.PubMedCrossRefGoogle Scholar
  28. Friedman M, Hwang MS, Yalamanchali S, Pott T, Sidhu M, Joseph NJ. Provent therapy for obstructive sleep apnea: impact of nasal obstruction. Laryngoscope. 2016;126(1):254–9.PubMedCrossRefGoogle Scholar
  29. Garbarino S, Guglielmi O, Sanna A, Mancardi GL, Magnavita N. Risk of occupational accidents in workers with obstructive sleep apnea: systematic review and meta-analysis. Sleep. 2016;39(6):1211–8.PubMedPubMedCentralCrossRefGoogle Scholar
  30. Giglio P, Undevia N, Spire J-P. The primary parasomnias: a review for neurologists. Neurologist. 2005;11(2):90–7.PubMedCrossRefGoogle Scholar
  31. Gillespie MB, Soose RJ, Woodson BT, et al. Upper airway stimulation for obstructive sleep apnea: patient-reported outcomes after 48 months of follow-up. Otolaryngol Head Neck Surg. 2017;156(4):765–71.PubMedCrossRefGoogle Scholar
  32. Heiser C, Maurer JT, Hofauer B, Sommer JU, Seitz A, Steffen A. Outcomes of upper airway stimulation for obstructive sleep apnea in a multicenter German postmarket study. Otolaryngol Head Neck Surg. 2017a;156(2):378–84.PubMedCrossRefGoogle Scholar
  33. Heiser C, Edenharter G, Bas M, Wirth M, Hofauer B. Palatoglossus coupling in selective upper airway stimulation. Laryngoscope. 2017b;127:E378–83.PubMedCrossRefGoogle Scholar
  34. Hillman DR, Lack LC. Public health implications of sleep loss: the community burden. Med J Aust. 2013;199(8):S7–S10.PubMedCrossRefGoogle Scholar
  35. Hillman D, Singh B, McArdle N, Eastwood P. Relationships between ventilatory impairment, sleep hypoventilation and type 2 respiratory failure. Respirology. 2014;19(8):1106–16.PubMedCrossRefGoogle Scholar
  36. Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015a;1(1):40–3.PubMedCrossRefGoogle Scholar
  37. Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s updated sleep duration recommendations. Sleep Health: J Natl Sleep Found. 2015b;1(4):233–43.CrossRefGoogle Scholar
  38. Hofauer B, Strohl K, Knopf A, et al. Sonographic evaluation of tongue motions during upper airway stimulation for obstructive sleep apnea-a pilot study. Sleep Breath. 2017;21(1):101–7.PubMedCrossRefGoogle Scholar
  39. Jaimchariyatam N, Rodriguez CL, Budur K. Sleep-related cortical arousals in adult subjects with negative polysomnography. Sleep Breath. 2014;19:989–96.PubMedCrossRefGoogle Scholar
  40. Joint Commission. Health care worker fatigue and patient safety. Sentinel Event Alert. 2011;48(48):1–4.Google Scholar
  41. Kezirian EJ, Goding GS Jr, Malhotra A, et al. Hypoglossal nerve stimulation improves obstructive sleep apnea: 12-month outcomes. J Sleep Res. 2014;23(1):77–83.PubMedCrossRefGoogle Scholar
  42. Kohler M, Smith D, Tippett V, Stradling JR. Predictors of long-term compliance with continuous positive airway pressure. Thorax. 2010;65(9):829–32.PubMedCrossRefGoogle Scholar
  43. Kotecha BT, Hall AC. Role of surgery in adult obstructive sleep apnoea. Sleep Med Rev. 2014;18(5):405–13.PubMedCrossRefGoogle Scholar
  44. Leproult R, Holmbäck U, Van Cauter E. Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss. Diabetes. 2014;63(6):1860–9.PubMedPubMedCentralCrossRefGoogle Scholar
  45. Lie J-AS, Kjuus H, Zienolddiny S, Haugen A, Stevens RG, Kjærheim K. Night work and breast cancer risk among Norwegian nurses: assessment by different exposure metrics. Am J Epidemiol. 2011;173(11):1272–9.PubMedCrossRefGoogle Scholar
  46. Logan AG, Perlikowski SM, Mente A, et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension. J Hypertens. 2001;19(12):2271–7.PubMedCrossRefGoogle Scholar
  47. Loke YK, Brown JW, Kwok CS, Niruban A, Myint PK. Association of obstructive sleep apnea with risk of serious cardiovascular events: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2012;5(5):720–8.PubMedCrossRefGoogle Scholar
  48. Malhotra A. Hypoglossal-nerve stimulation for obstructive sleep apnea. N Engl J Med. 2014;370(2):170–1.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013;368(25):2366–76.PubMedPubMedCentralCrossRefGoogle Scholar
  50. Moon K, Punjabi NM, Aurora RN. Obstructive sleep apnea and type 2 diabetes in older adults. Clin Geriatr Med. 2015;31(1):139–47. ixPubMedCrossRefGoogle Scholar
  51. Morin CM. Cognitive-behavioral approaches to the treatment of insomnia. J Clin Psychiatry. 2004;65(Suppl 16):33–40.PubMedGoogle Scholar
  52. Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR. Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Sleep. 1999;22(8):1134–56.PubMedCrossRefGoogle Scholar
  53. Mwenge GB, Rombaux P, Dury M, Lengele B, Rodenstein D. Targeted hypoglossal neurostimulation for obstructive sleep apnoea: a 1-year pilot study. Eur Respir J. 2013;41(2):360–7.PubMedCrossRefGoogle Scholar
  54. National Sleep Foundation. Sleep in America poll. Washington, DC: National Sleep Foundation. http://sleepfoundation.org/sleep-polls-data/sleep-in-america-poll/2005-adult-sleep-habits-and-styles (2005). Accessed Apr 2015.
  55. Nielsen L, Danielsen K, Sørensen T. Short sleep duration as a possible cause of obesity: critical analysis of the epidemiological evidence. Obes Rev. 2011;12(2):78–92.PubMedCrossRefGoogle Scholar
  56. Nigam G, Pathak C, Riaz M. Effectiveness of oral pressure therapy in obstructive sleep apnea: a systematic analysis. Sleep Breath. 2016;20(2):663–71.PubMedCrossRefGoogle Scholar
  57. Oksenberg A, Silverberg DS. The effect of body posture on sleep-related breathing disorders: facts and therapeutic implications. Sleep Med Rev. 1998;2(3):139–62.PubMedCrossRefGoogle Scholar
  58. Owens J. Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014;134(3):e921–32.PubMedCrossRefGoogle Scholar
  59. Ozsancak A, D’Ambrosio C, Hill NS. Nocturnal noninvasive ventilation. Chest. 2008;133(5):1275–86.PubMedCrossRefGoogle Scholar
  60. Patel AV, Hwang D, Masdeu MJ, Chen GM, Rapoport DM, Ayappa I. Predictors of response to a nasal expiratory resistor device and its potential mechanisms of action for treatment of obstructive sleep apnea. J Clin Sleep Med. 2011;7(1):13–22.PubMedPubMedCentralGoogle Scholar
  61. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000;342(19):1378–84.PubMedCrossRefGoogle Scholar
  62. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177(9):1006–14.PubMedPubMedCentralCrossRefGoogle Scholar
  63. Phillips CL, Grunstein RR, Darendeliler MA, et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med. 2013;187(8):879–87.PubMedCrossRefGoogle Scholar
  64. Poudel GR, Innes CR, Bones PJ, Watts R, Jones RD. Losing the struggle to stay awake: divergent thalamic and cortical activity during microsleeps. Hum Brain Mapp. 2014;35(1):257–69.PubMedCrossRefGoogle Scholar
  65. Riaz M, Certal V, Nigam G, et al. Nasal expiratory positive airway pressure devices (Provent) for OSA: a systematic review and meta-analysis. Sleep Disord. 2015;2015:734798.PubMedPubMedCentralCrossRefGoogle Scholar
  66. Rosenthal L, Massie CA, Dolan DC, Loomas B, Kram J, Hart RW. A multicenter, prospective study of a novel nasal EPAP device in the treatment of obstructive sleep apnea: efficacy and 30-day adherence. J Clin Sleep Med. 2009;5(6):532–7.PubMedPubMedCentralGoogle Scholar
  67. Roth T, Roehrs T. Insomnia: epidemiology, characteristics, and consequences. Clin Cornerstone. 2003;5(3):5–15.PubMedCrossRefGoogle Scholar
  68. Rye DB, Trotti LM. Restless legs syndrome and periodic leg movements of sleep. Neurol Clin. 2012;30(4):1137–66.PubMedCrossRefGoogle Scholar
  69. Safiruddin F, Vanderveken OM, de Vries N, et al. Effect of upper-airway stimulation for obstructive sleep apnoea on airway dimensions. Eur Respir J. 2015;45(1):129–38.PubMedCrossRefGoogle Scholar
  70. Scammell TE. Narcolepsy. N Engl J Med. 2015;373(27):2654–62.PubMedCrossRefGoogle Scholar
  71. Schellenberg JB, Maislin G, Schwab RJ. Physical findings and the risk for obstructive sleep apnea. The importance of oropharyngeal structures. Am J Respir Crit Care Med. 2000;162(2 Pt 1):740–8.PubMedCrossRefGoogle Scholar
  72. Schwab RJ, Kim C, Siegel L, et al. Examining the mechanism of action of a new device using oral pressure therapy for the treatment of obstructive sleep apnea. Sleep. 2014;37(7):1237–47.PubMedPubMedCentralCrossRefGoogle Scholar
  73. Schwartz AR, Bennett ML, Smith PL, et al. Therapeutic electrical stimulation of the hypoglossal nerve in obstructive sleep apnea. Arch Otolaryngol Head Neck Surg. 2001;127(10):1216–23.PubMedCrossRefGoogle Scholar
  74. Siegel JM. Clues to the functions of mammalian sleep. Nature. 2005;437(7063):1264–71.PubMedCrossRefGoogle Scholar
  75. Smolensky MH, Di Milia L, Ohayon MM, Philip P. Sleep disorders, medical conditions, and road accident risk. Accid Anal Prev. 2011;43(2):533–48.PubMedCrossRefGoogle Scholar
  76. Sofi F, Cesari F, Casini A, Macchi C, Abbate R, Gensini GF. Insomnia and risk of cardiovascular disease: a meta-analysis. Eur J Prev Cardiol. 2014;21(1):57–64.PubMedCrossRefGoogle Scholar
  77. Soose RJ, Woodson BT, Gillespie MB, et al. Upper airway stimulation for obstructive sleep apnea: self-reported outcomes at 24 months. J Clin Sleep Med. 2016;12(1):43–8.PubMedPubMedCentralCrossRefGoogle Scholar
  78. Stanchina ML, Malhotra A, Fogel RB, et al. The influence of lung volume on pharyngeal mechanics, collapsibility, and genioglossus muscle activation during sleep. Sleep. 2003;26(7):851–6.PubMedCrossRefGoogle Scholar
  79. Stein MB, Belik S-L, Jacobi F, Sareen J. Impairment associated with sleep problems in the community: relationship to physical and mental health comorbidity. Psychosom Med. 2008;70(8):913–9.PubMedCrossRefGoogle Scholar
  80. Stickgold R. Sleep-dependent memory consolidation. Nature. 2005;437(7063):1272–8.PubMedCrossRefGoogle Scholar
  81. Strollo PJ Jr, Soose RJ, Maurer JT, et al. Upper-airway stimulation for obstructive sleep apnea. N Engl J Med. 2014;370(2):139–49.PubMedCrossRefGoogle Scholar
  82. Strollo PJ Jr, Gillespie MB, Soose RJ, et al. Upper airway stimulation for obstructive sleep apnea: durability of the treatment effect at 18 months. Sleep. 2015;38(10):1593–8.PubMedPubMedCentralCrossRefGoogle Scholar
  83. Stubbs B, Vancampfort D, Veronese N, et al. The prevalence and predictors of obstructive sleep apnea in major depressive disorder, bipolar disorder and schizophrenia: a systematic review and meta-analysis. J Affect Disord. 2016;197:259–67.PubMedCrossRefGoogle Scholar
  84. Sutherland K, Vanderveken OM, Tsuda H, et al. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med. 2014;10(2):215–27.PubMedPubMedCentralGoogle Scholar
  85. Tononi G, Cirelli C. Sleep and the price of plasticity: from synaptic and cellular homeostasis to memory consolidation and integration. Neuron. 2014;81(1):12–34.PubMedPubMedCentralCrossRefGoogle Scholar
  86. Tregear S, Reston J, Schoelles K, Phillips B. Obstructive sleep apnea and risk of motor vehicle crash: systematic review and meta-analysis. J Clin Sleep Med. 2009;5(6):573–81.PubMedPubMedCentralGoogle Scholar
  87. Unruh ML, Redline S, An MW, et al. Subjective and objective sleep quality and aging in the sleep heart health study. J Am Geriatr Soc. 2008;56(7):1218–27.PubMedCrossRefGoogle Scholar
  88. Van de Heyning PH, Badr MS, Baskin JZ, et al. Implanted upper airway stimulation device for obstructive sleep apnea. Laryngoscope. 2012;122(7):1626–33.PubMedCrossRefGoogle Scholar
  89. Vanderveken OM, Maurer JT, Hohenhorst W, et al. Evaluation of drug-induced sleep endoscopy as a patient selection tool for implanted upper airway stimulation for obstructive sleep apnea. J Clin Sleep Med. 2013;9(5):433–8.PubMedPubMedCentralGoogle Scholar
  90. Walker MP, Stickgold R. Sleep, memory, and plasticity. Annu Rev Psychol. 2006;57:139–66.PubMedCrossRefGoogle Scholar
  91. Watanabe T, Isono S, Tanaka A, Tanzawa H, Nishino T. Contribution of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep-disordered breathing. Am J Respir Crit Care Med. 2002;165(2):260–5.PubMedCrossRefGoogle Scholar
  92. Waterhouse J, Reilly T, Atkinson G, Edwards B. Jet lag: trends and coping strategies. Lancet. 2007;369(9567):1117–29.PubMedCrossRefGoogle Scholar
  93. White DP. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med. 2005;172(11):1363–70.PubMedCrossRefGoogle Scholar
  94. Woodson BT, Soose RJ, Gillespie MB, et al. Three-year outcomes of cranial nerve stimulation for obstructive sleep apnea: the STAR trial. Otolaryngol Head Neck Surg. 2016;154(1):181–8.PubMedCrossRefGoogle Scholar
  95. Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med. 2002;165(9):1217–39.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • David Hillman
    • 1
    • 5
  • Olivier Vanderveken
    • 2
    • 3
  • Atul Malhotra
    • 4
  • Peter Eastwood
    • 5
    • 6
    Email author
  1. 1.Department of Pulmonary Physiology and Sleep MedicineWest Australian Sleep Disorders Research Institute, Sir Charles Gairdner HospitalPerthAustralia
  2. 2.Faculty of Medicine and Health SciencesUniversity of AntwerpAntwerpBelgium
  3. 3.Department of ENT, Head and Neck SurgeryAntwerp University HospitalEdegemBelgium
  4. 4.Critical Care and Sleep MedicineUC San Diego School of MedicineLa JollaUSA
  5. 5.Centre for Sleep Science, School of Human SciencesUniversity of Western AustraliaPerthAustralia
  6. 6.West Australian Sleep Disorders Research Institute, Sir Charles Gairdner HospitalPerthAustralia

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