Fundamentals of Sleep Medicine 1st edition by Richard Berry ISBN 0323245357 9780323245357

Chapter 1: Sleep Stages and Basic Sleep Monitoring

Eeg Electrode Placement

Eog Monitoring for Sleep

Chapter 2: The Technology of Sleep Monitoring: Differential Amplifiers, Digital Polysomnography, and Filters

Referential and Bipolar Recording

Filters (Low-Frequency, High-Frequency, and Notch Filters)

Amplifier Filter Settings for Digital Sleep Recording

Digitial PSG System Overview

Chapter 3: Sleep Staging in Adults

Scoring by Epochs

Transitions between Definite Stage N2 and Stage R

Epochs with a Mixture of SSs/KCs and REMs

Transitions Between Stage N1 and Stage R (FAQ V7 AASM Scoring Rules)

Effects of Arousals and MBMs: Stage N2 Versus Stage R Rules

Major Body Movements

Chapter 4: Biocalibration, Artifacts, and Common Variants of Sleep

Calibrations and Biocalibrations

Artifacts

Common Variants Seen During Sleep Monitoring

Chapter 5: Sleep Staging in Infants and Children

Bipolar Electroencephogram Recording

Sleep in the Premature Infant and Infants Younger Than 48 Weeks CA

Scoring Sleep in Infants Older Than 48 Weeks CA and Children

Chapter 6: Sleep Architecture Parameters, Normal Sleep, and Sleep Loss

Normal Sleep in Adults

Changes in Sleep Architecture with Aging (Adults)

Alternations in REM Latency

Comparison of Sleep Staging Between the Aasm Scoring Manual and Rechtschaffen and Kales

Normal Sleep in Infants and Children

Arousals

Sleep Fragmentation

Chapter 7: Neurobiology of Sleep

Major Brain Areas Important for Sleep and Wake

Control of Nrem Sleep

Features of Rem Sleep

Chapter 8: Monitoring Respiration—Technology and Techniques

Techniques to Measure Airflow or Tidal Volume

Measuring Respiratory Effort

Measuring SaO2

Pulse Oximetry

SpO2 and Sleep Monitoring

Measurement of PaCO2 During Sleep

PETCO2

TcPCO2 Monitoring

Accuracy of PETCO2 and TcPCO2

Snoring Sensors

Chapter 9: Monitoring Respiration—Event Definitions and Examples

Respiratory Events in Adults

Respiratory Event Scoring Rules in Children

Chapter 10: Sleep and Respiratory Physiology

Arterial Blood Gases

Oxygen Transport and Saturation

Determinants of PaCO2

Normal Changes in Ventilation During Sleep

Tests of Ventilatory Control

Acid-Base Physiology

Pulmonary Function Testing

Obesity

Muscle Strength

Appendix 10-1 Severity Criteria for Pulmonary Function Testing

Chapter 11: Cardiac Monitoring during Polysomnography

ECG Recording during Polysomnography

Sinus Rhythm and Normative Data for Heart Rate

Conduction System

Bradycardia and AV Block during Sleep

Tachycardias during Sleep

Adverse Events during PSG

Pacemakers and Wide-Complex QRS

Chapter 12: Monitoring of Limb Movements and Other Movements during Sleep

Limb Monitoring Techniques

Criteria for LMs and PLMs

LMs Associated with Respiratory Events Are Not Scored

Association of Arousals with PLM

Periodic Limb Movements in Sleep

Periodic Limb Movements in Wake

Suggested Immobilization Test

Clinical Significance of PLMS

Other LMs during Sleep

Alternating Leg Muscle Activation

Hypnagogic Foot Tremor

Excessive Fragmentary Myoclonus

Bruxism

Rhythmic Movements and the Sleep-Related Rhythmic Movement Disorder

RBD: Scoring PSG Features

Chapter 13: Polysomnography, Portable Monitoring, and Actigraphy

Polysomnography

Portable Monitoring (home sleep testing, out of center sleep testing)

Actigraphy

Appendix 13-1 AASM Practice Parameters for Polysomnography (Selected Statements)

Appendix 13-2 Clinical Guidelines for the Use of Unattended Portable Monitors in the Diagnosis of Obstructive Sleep Apnea in Adult Patients

Appendix 13-3 First Coast Services Durable Medical Area Contractor (DMAC Region I)

Chapter 14: Subjective and Objective Measures of Daytime Sleepiness

Subjective Measures

Objective Measures

Appendix 14-1 Federal Aviation Administration Policy Concerning Fitness to Fly in Sleep Apnea Patients

Chapter 15: Obstructive Sleep Apnea Syndromes: Definitions, Epidemiology, Diagnosis, and Variants

History And Definitions

Epidemiology Of Osa

Diagnosis Of Osa

Variants Of Snoring And Osa

Pediatric Osa

Appendix 15-1 Berlin Questionnaire

Appendix 15-2 STOP-BANG Scoring Model

Chapter 16: Pathophysiology of Obstructive Sleep Apnea

Pathogenesis of Upper Airway Obstruction

Lung Volume Effects

Ventilatory Control and OSA

Stage R Effects

Gender and OSA

Mechanisms of Apnea Termination and Arousal

Upper Airway Sensation

Arterial Oxygen Desaturation

Chapter 17: Consequences of Obstructive Sleep Apnea and the Benefits of Treatment

Pathophysiology

Mortality

Excessive Daytime Sleepiness and Neurocognitive Dysfunction

Automobile Accidents and Sleep Apnea

Arterial Hypertension

Pulmonary Hypertension

Arrhythmias

Coronary Artery Disease

Atherosclerosis and Thrombosis

Congestive Heart Failure

Cerebrovascular Accidents and OSA

Erectile Dysfunction

Diabetes

Nocturia

Consequences of Childhood OSA

Chapter 18: Obstructive Sleep Apnea Treatment Overview and Medical Treatments

Introduction

Should Mild OSA Patients Be Treated?

Whom to Treat

Treatment Selection

Patient Education Before Treatment

Follow-Up and Outcomes Assessment

Medical Treatments for OSA

Chapter 19: Positive Airway Pressure Treatment

Mechanism of Action

Effectiveness

Modes of PAP

Volume-Targeted BPAP

Comfort Measures

Indications for PAP Treatment

Adherence—Definitions and Measurement

CPAP/BPAP Titration for OSA

Alternative Methods of Starting PAP Treatment

Appendix 19-1 Practice Parameters for APAP and CPAP/BPAP (Selected Recommendations)

Appendix 19-2 The details of local carrier determinations can vary by region and are frequently updated.

Appendix 19-3 Medicare Criteria for Reimbursement for Respiratory-Assist Devices

Chapter 20: Oral Appliance and Surgical Treatment for Obstructive Sleep Apnea

Oral Appliance Treatment for OSA

Surgical Treatments for OSA

Surgery for Pediatric OSA

Appendix 20-1 Summary of AASM Practice Parameters for the Use of Oral Appliances for Treatment of Snoring and Obstructive Sleep Apnea

Appendix 20-2 Excerpts from Local Coverage Determination for Oral Appliances for Obstructive Sleep Apnea (L28606)

Appendix 20-3 Summary of Practice Parameters for Surgical Treatment of Obstructive Sleep Apnea in Adults

Chapter 21: Central Sleep Apnea and Hypoventilation Syndromes

Classification of Csa Syndromes

Pathophysiology of Csa

Hypocapnic Csa Syndromes

Csb with Csa

Complex Sleep Apnea

High-Altitude Periodic Breathing

Hypercapnic Csa and hypoventilation syndromes not due to lung disease

Appendix 21–1 Sleep-Related Hypoventilation Syndromes—Diagnostic Criteria

Chapter 22: Sleep and Obstructive Lung Disease

Obstructive Ventilatory Dysfunction

Chronic Obstructive Pulmonary Disease

Asthma

Chapter 23: The Restless Leg Syndrome, Periodic Limb Movements in Sleep, and the Periodic Limb Movement Disorder

Restless Legs Syndrome

Periodic Limb Movements in Sleep

Periodic Limb Movement Disorder

Treatment of RLS and PLMD

Chapter 24: Hypersomnias of Central Origin

Narcolepsy Syndromes

Cataplexy: N+C

Diagnostic Testing for Narcolepsy

Treatment of Narcolepsy

Narcolepsy Due to Medical Condition

Idiopathic Hypersomnia

Chapter 25: Insomnia

Prevalence of Insomnia and Risk Factors

Insomnia Subtypes

Evaluation of Insomnia Complaints

Physiologic Findings in Primary Insomnia

Individual Insomnia Subtypes

Treatment of Insomnia

Appendix 25-1 Dysfunctional Beliefs and Attitudes about Sleep Worksheet

Chapter 26: Circadian Rhythm Sleep Disorders

Melatonin

The SCN and Sleep-Wake Cycle

Markers of Circadian Phase

Shifting the Circadian Rhythms

Genomics of CRSD

Circadian Rhythm Sleep Disorders

Chapter 27: Clinical Electroencephalography and Nocturnal Epilepsy

Electroencephalographic Monitoring

Bipolar Monitoring and Standard Montages

Waveform and Seizure Terminology

Phase Reversal

Localization in Referential and PSG Montages

Normal Sleep Waveforms in the 10-Second Window

Ictal Activity

Classification of Seizures and Terminology

Temporal Lobe Epilepsy

Nocturnal Frontal Lobe Epilepsy

Generalized Epilepsy Syndromes with Nocturnal Seizures

Ictal Effects on Sleep

Antiepileptic Drugs—Effects on Sleep

Epilepsy and Obstructive Sleep Apnea

Chapter 28: Parasomnias

Nrem Parasomnias

Parasomnias Usually Associated With Rem Sleep (Stage R)

Other Parasomnias

Other Nocturnal Behaviors In The Differential Diagnosis Of Parasomnia

The Differential Diagnosis Of Parasomnias

Chapter 29: Psychiatry and Sleep

Mood Disorders

Anxiety Disorders

Appendix 29-1 Patient Health Questionnaire (PHQ-9)

Chapter 30: Sleep and Nonrespiratory Physiology—Impact on Selected Medical Disorders

Endocrine Physiology and Sleep

Growth Hormone

Sleep and the Corticotropic Axis

Sleep and the Thyroid Axis

Sleep and Prolactin Secretion

Sleep and the Gonadal Axis

Leptin and Ghrelin

Obesity and Sleep Duration

Sleep and Glucose Tolerance

Sleep and Gastrointestinal Physiology and Disorders

Sleep and Rheumatology

Sleep and Renal

Chapter 31: Sleep and Neurologic Disorders

Sleep and Neurodegenerative Disorders

Appendix 31-1 Medications Used to Treat Alzheimer’s Disease

Glossary

Index