In this issue, guest editors bring their considerable expertise to this important topic.Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.
In this issue, guest editors bring their considerable expertise to this important topic.Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.
This issue of Sleep Medicine Clinics, edited by Song Tar Toh in collaboration with Consulting Editor, Teofilo Lee-Chiong, is devoted to the Preventing, Screening, and Treatments for Obstructive Sleep Apnea, beyond Positive Airway Pressure (PAP). Topics covered in this issue include: Prevention and Screening of Obstructive Sleep Apnea (OSA); Anatomical and Physiologic Considerations in Surgical Treatment for OSA; Medical and Surgical Options for Weight Management in OSA; Positional Therapy for OSA; Oral Appliances in Adults and Pediatrics; Myofunctional Therapy for OSA; Drug-induced Sleep Endoscopy in Treatment Options Selection; Establishing a Patent Nasal Passage in OSA; Palatal Surgery: From Ablation to Reconstruction; Volumetric Tongue Reduction Surgery in Clinical Practice; Transoral Robotic Surgery for OSA; Genioglossus Advancement and Hyoid Surgery; Maxillomandibular Rotational Advancement: Airway, Aesthetics, and Angle Considerations;
Sleep and Health provides an accessible yet comprehensive overview of the relationship between sleep and health at the individual, community and population levels, as well as a discussion of the implications for public health, public policy and interventions. Based on a firm foundation in many areas of sleep health research, this text further provides introductions to each sub-area of the field and a summary of the current research for each area. This book serves as a resource for those interested in learning about the growing field of sleep health research, including sections on social determinants, cardiovascular disease, cognitive functioning, health behavior theory, smoking, and more. - Highlights the important role of sleep across a wide range of topic areas - Addresses important topics such as sleep disparities, sleep and cardiometabolic disease risk, real-world effects of sleep deprivation, and public policy implications of poor sleep - Contains accessible reviews that point to relevant literature in often-overlooked areas, serving as a helpful guide to all relevant information on this broad topic area
There are at least four reasons why a sleep clinician should be familiar with rating scales that evaluate different facets of sleep. First, the use of scales facilitates a quick and accurate assessment of a complex clinical problem. In three or four minutes (the time to review ten standard scales), a clinician can come to a broad understanding of the patient in question. For example, a selection of scales might indicate that an individual is sleepy but not fatigued; lacking alertness with no insomnia; presenting with no symptoms of narcolepsy or restless legs but showing clear features of apnea; exhibiting depression and a history of significant alcohol problems. This information can be used to direct the consultation to those issues perceived as most relevant, and can even provide a springboard for explaining the benefits of certain treatment approaches or the potential corollaries of allowing the status quo to continue. Second, rating scales can provide a clinician with an enhanced vocabulary or language, improving his or her understanding of each patient. In the case of the sleep specialist, a scale can help him to distinguish fatigue from sleepiness in a patient, or elucidate the differences between sleepiness and alertness (which is not merely the inverse of the former). Sleep scales are developed by researchers and clinicians who have spent years in their field, carefully honing their preferred methods for assessing certain brain states or characteristic features of a condition. Thus, scales provide clinicians with a repertoire of questions, allowing them to draw upon the extensive experience of their colleagues when attempting to tease apart nuanced problems. Third, some scales are helpful for tracking a patient’s progress. A particular patient may not remember how alert he felt on a series of different stimulant medications. Scale assessments administered periodically over the course of treatment provide an objective record of the intervention, allowing the clinician to examine and possibly reassess her approach to the patient. Finally, for individuals conducting a double-blind crossover trial or a straightforward clinical practice audit, those who are interested in research will find that their own clinics become a source of great discovery. Scales provide standardized measures that allow colleagues across cities and countries to coordinate their practices. They enable the replication of previous studies and facilitate the organization and dissemination of new research in a way that is accessible and rapid. As the emphasis placed on evidence-based care grows, a clinician’s ability to assess his or her own practice and its relation to the wider medical community becomes invaluable. Scales make this kind of standardization possible, just as they enable the research efforts that help to formulate those standards. The majority of Rating Scales in Sleep and Sleep Disorders:100 Scales for Clinical Practice is devoted to briefly discussing individual scales. When possible, an example of the scale is provided so that readers may gain a sense of the instrument’s content. Groundbreaking and the first of its kind to conceptualize and organize the essential scales used in sleep medicine, Rating Scales in Sleep and Sleep Disorders:100 Scales for Clinical Practice is an invaluable resource for all clinicians and researchers interested in sleep disorders.
The WHO Regional Office for Europe set up a working group of experts to provide scientific advice to the Member States for the development of future legislation and policy action in the area of assessment and control of night noise exposure. The working group reviewed available scientific evidence on the health effects of night noise, and derived health-based guideline values. In December 2006, the working group and stakeholders from industry, government and nongovernmental organizations reviewed and reached general agreement on the guideline values and key texts for the final document of the "Night noise guidelines for Europe". Considering the scientific evidence on the thresholds of night noise exposure indicated by "Lnight,outside" [L suffix night,outside] as defined in the Environmental Noise Directive (2002/49/EC), an Lnight, outside of 40 dB should be the target of the night noise guideline (NNG) to protect the public, including the most vulnerable groups such as children, the chronically ill and the elderly. "Lnight,outside" value of 55 dB is recommended as an interim target for the countries where the NNG cannot be achieved in the short term for various reasons, and where policy-makers choose to adopt a stepwise approach. These guidelines are applicable to the Member States of the European Region, and may be considered as an extension to, as well as an update of, the previous WHO "Guidelines for community noise" (1999). [Ed.]
Cognitive behavioral therapy for insomnia (CBT-I) has emerged as the standard first-line treatment for insomnia. The number of patients receiving non-medication treatments is increasing, and there is a growing need to address a wide range of patient backgrounds, characteristics, and medical and psychiatric comorbidities. Adapting Cognitive Behavioral Therapy for Insomnia identifies for clinicians how best to deliver and/or modify CBT-I based on the needs of their patients. The book recommends treatment modifications based on patient age, comorbid conditions, and for various special populations. - Summarizes research on cognitive behavior therapy for insomnia (CBT-I) - Directs clinicians how to modify CBT-I for comorbid patient conditions - Discusses comorbid sleep, psychiatric, and medical disorders - Specifies modifications across the lifespan for different client ages and conditions - Includes special populations: short sleepers and more
