Diagnostic Tools and Testing in the Sleepless and Restless Patient
Fig. 9.1 Example of a sleep diary (a) and actigraphy (b) for patient with insomnia due to delayed sleep phase disorder Bedtime Sleep onset latency (SOL)—time taken to fall asleep…
Key History and Physical Examination Findings for the Sleepless or Restless Patient
Fatigue or malaise Cognitive impairment (attention, concentration, memory issues) Poor work or school performance Mood disturbance or irritability Daytime sleepiness Decreased work performance Lack of motivation or initiative reduction Errors…
The Sleepy Child
Health condition Relative frequencya Inadequate sleep hygiene ++++ Sedation from drugs (prescription or over the counter) +++ Depression ++ Sleep apnea–hypopnea syndrome ++ Narcolepsy ++ Neoplastic, traumatic, and inflammatory brain…
Central Nervous System Hypersomnias
Medication Starting dose Maximum daily dose Medications for the treatment of excessive daytime sleepiness (EDS) Dextroamphetamine or methamphetamine 5–10 mg per daya 60 mg Methylphenidate 10–20 mg per daya 60…
Sleep Deprivation
54. Gangwisch JE, et al. Inadequate sleep as a risk factor for obesity: analyses of the NHANES I. Sleep. 2005;28(10):1289.PubMed 55. Spiegel K, et al. Sleep loss: a novel risk…
Key History and Physical Examination Findings in the Sleepy Patient
Age Race M/F Sleepy: Y/N Sleep schedule: Symptoms Tired: Y/N Work days Snoring: Y/N Fatigue: Y/N Bedtime: _____ am/pm Frequent snoring Y/N Sleepy during day with: Time. to sleep _____ Heard outside…
Sleepiness in High-Consequence Industries
Medically qualified to drive commercial vehicles if driver meets either of the following: In-service evaluation (ISE) recommended if driver falls into any one of the following five major categories (3-month…
Approaches to the Orbit: A 360-Degree View
Fig. 31.1 Axial T2-weighted MR image showing a large cavernous hemangioma in the lateral region of the left orbit causing optic nerve compression The secondary tumors originate elsewhere and invade…
Bypass and Vascular Reconstruction for Posterior Circulation Aneurysms
Fig. 41.1 Management protocol for posterior circulation aneurysms (Note that age is given in years) 41.3 Collateral Circulation and Parent Vessel Sacrifice The effect of occlusion of the posterior circulation…
Bypass and Vascular Reconstruction for Anterior Circulation Aneurysms
Large/or giant saccular aneurysms ≥ 14 mm Calcified or atherosclerotic sac, heavily thrombosed Complex or absent neck Neck diameter >4 mm Neck encompasses > 90° of vessel circumference Dome/neck ratio < 1.5 Atherosclerosis, calcification Fusiform aneurysms…
