Many patients experience sleep disturbances secondary to their primary illness and this often has a negative effect on their quality of life. This book provides an evidence-based introduction to the interface between sleep wide range of medical disorders. A clinically focused, comprehensive review for physicians and other health providers, this state-of-the-art reference can also serve as a textbook for those who wish to become familiar with the impact of sleep on quality of life.
Clinical practice related to sleep problems and sleep disorders has been expanding rapidly in the last few years, but scientific research is not keeping pace. Sleep apnea, insomnia, and restless legs syndrome are three examples of very common disorders for which we have little biological information. This new book cuts across a variety of medical disciplines such as neurology, pulmonology, pediatrics, internal medicine, psychiatry, psychology, otolaryngology, and nursing, as well as other medical practices with an interest in the management of sleep pathology. This area of research is not limited to very young and old patientsâ€"sleep disorders reach across all ages and ethnicities. Sleep Disorders and Sleep Deprivation presents a structured analysis that explores the following: Improving awareness among the general public and health care professionals. Increasing investment in interdisciplinary somnology and sleep medicine research training and mentoring activities. Validating and developing new and existing technologies for diagnosis and treatment. This book will be of interest to those looking to learn more about the enormous public health burden of sleep disorders and sleep deprivation and the strikingly limited capacity of the health care enterprise to identify and treat the majority of individuals suffering from sleep problems.
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.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Thoroughly updated for its Fourth Edition, this volume is the most authoritative clinical reference on the pharmacologic treatment of psychiatric disorders in elderly patients. This edition provides complete information on new psychotropic drugs, new uses for established drugs, and clinically relevant advances in the neurosciences. Four new chapters cover genes, pharmacokinetics, and their impact on prescribing; new cognitive-enhancing strategies and drugs; late-life depression and physical illness; and depression and cardiac disease in late life. The book offers detailed guidelines—including drug names, dosages, and prescribing recommendations—for pharmacologic treatment of specific disorders. Chapters include clinical vignettes and tables presenting current clinical trial data. Appendices provide succinct information on prescribing and drug interactions.
This book summarises the epidemiological evidence linking sleep deprivation and disruption to several chronic conditions, and explores the public health implications with the view to developing preventive strategies.
Residents of the South Bronx during its promising postwar decades tell their stories in their own words. In the 1930s, word spread in Harlem that there were spacious apartments for rent in the Morrisania section of the Bronx. Landlords, desperate to avoid foreclosure, began putting signs in windows and placing ads in New York’s black newspapers that said “We rent to select colored families”—by which they meant those with a securely employed wage earner and light complexions. Black families moved in by the score, beginning a period in which the Bronx served as a borough of hope and upward mobility. Chronicling a time when African Americans were suspended between the best and worst possibilities of New York City, Before the Fires tells the personal stories of men and women who lived in the South Bronx before the social and economic decline of the late 1960s. Located on a hill overlooking a large industrial district, Morrisania offered migrants from Harlem, the South, and the Caribbean an opportunity to raise children in a neighborhood with better schools, strong churches, more shopping, less crime, and clean air. It also boasted vibrant music venues, giving rise to such titans as Herbie Hancock, Eddie Palmieri, Valerie Simpson, the Chantels, and Jimmy Owens. Rich in detail, these interviews describe growing up and living in communities rarely mentioned in other histories. Before the Fires captures the optimism of the period—as well as the heartache of what was lost in the urban crisis and the burning of the Bronx. “Excellent . . . profound, moving.” —Robert W. Snyder, Rutgers University, Newark
Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.
There are more than 80 different sleep disorders including insomnia, sleep apnea, restless leg syndrome, hypersomnia, circadian rhythm disorders, and parasomnia. Good sleep is necessary for optimal health and can affect hormone levels and weight. The use of artificial intelligence (AI) and biomedical signals and images can help in healthcare diagnostics that are related to these and other sleep disorders. Advancing the Investigation and Treatment of Sleep Disorders Using AI presents an overview of sleep disorders based on machine intelligence methods in order to learn and explore the latest advancements, developments, methods, systems, futuristic approaches, and algorithms towards sleep disorders and to address their challenges. This book also discusses recent and future advancements in various feature extraction techniques and machine learning methods. Covering topics such as biomedical signal processing, augmented reality for clinical investigation, and sleep disorder detection, this book is essential for sleep medicine practitioners, clinical psychologists, psychiatrists, medical technologists, doctors, IT specialists, biomedical engineers, researchers, graduate students, and academicians.
Many in the research and clinical communities are becoming increasingly aware of the interactions between sleep disorders and chronic pain syndromes. There are a number of obstacles on the path to better patient care, and there is considerable room for improvement in the way knowledge is shared between professionals in the sleep and pain communities. This book serves as the first step toward enhancing communication between the sleep and pain communities with the intent of improving patient care.
