Sleep Medicine in Neurology -- Copyright -- Contents -- Contributors -- Series Foreword -- Preface -- Acknowledgments -- 1 Introduction to Sleep Medicine -- Introduction -- A brief history of sleep and sleep medicine -- Normal sleep -- Sleep disorders: a brief review -- Insomnias -- Sleep-related breathing disorders -- Hypersomnias -- Circadian rhythm sleep disorder -- Parasomnias -- Sleep-related movement disorders -- Isolated symptoms -- Other sleep disorders -- Helpful resources -- The future of sleep medicine -- References -- Further reading -- 2 The History and Physical Examination of the Sleep Patient -- Introduction -- The sleep history -- General sleep questions -- Focusing the history -- Insomnia -- Movement disorders and parasomnias -- Past medical history -- Medications -- Social history -- Family history -- Review of systems -- Supplemental information -- The physical examination -- Conclusion -- Further reading -- 3 Subjective and Objective Sleep Testing -- Introduction -- Subjective testing -- Sleepiness -- Obstructive sleep apnea screening tests -- Sleep quality -- Insomnia -- Restless legs syndrome -- Objective sleep testing -- Polysomnography -- Out-of-center sleep testing (OCST) -- Multiple Sleep Latency Test -- Maintenance of Wakefulness Test -- Actigraphy -- Suggested Immobilization Test -- Conclusion -- References -- Appendix 1 Sleep diary -- Appendix 2 Stanford Sleepiness Scale -- Appendix 3 Insomnia Severity Index (ISI) -- 4 Approach to a Patient with Excessive Daytime Sleepiness -- Introduction -- History -- Determining and measuring sleepiness -- Overview of a typical night's sleep and daytime activity -- Daytime naps -- Co-morbid conditions -- Pulmonary diseases -- Cardiovascular diseases -- Neurological diseases -- Psychiatric diseases -- Other medical conditions -- Medications -- Disease-specific questions.

Physical examination -- General physical examination -- Nasal and oropharyngeal examination -- Cardiopulmonary examination -- Neurological examination -- Psychiatric examination -- Investigations and diagnostic tests -- Polysomnogram -- Multiple Sleep Latency Test -- Maintenance of Wakefulness Test -- Sleep logs -- Actigraphy -- Conclusion -- References -- 5 Approach to a Patient with Narcolepsy -- Introduction -- Epidemiology -- Clinical symptoms -- Major symptoms -- Associated symptoms -- Pathophysiology -- Differential diagnosis -- Diagnosis -- Laboratory studies -- Imaging studies -- Polysomnography -- Management -- Approach to pharmacotherapy -- Prognosis and complications -- Future treatments and therapies -- References -- 6 Evaluation and Medical Management of Sleep-Disordered Breathing -- Introduction and epidemiology -- Pathogenesis -- Pathophysiology of obstructive sleep apnea -- Pathophysiology of central sleep apnea -- Treatment-emergent central sleep apnea -- Postulated mechanisms of sleep-disordered breathing ' s effect on end-organ systems -- Clinical presentation -- History (Box 6.1) -- Populations at high risk for sleep-disordered breathing (Box  6.2) -- Physical examination -- General examination -- Airway examination -- Diagnosis -- Diagnostic approach -- Sleep study modalities -- Diagnostic criteria -- Management of obstructive sleep apnea -- Positive airway pressure -- Behavioral interventions -- Oral appliances -- Nasal expiratory positive airway pressure -- Medication -- Surgical interventions -- Emerging therapies -- Outcome variables -- Management of central sleep apnea -- Positive airway pressure therapy -- Oxygen therapy -- Medication -- Outcomes in neurological patients with sleep-disordered breathing -- Conclusion -- References -- 7 Surgical Management of Sleep-Disordered Breathing -- Surgical evaluation.

Pertinent history -- Focused physical examination -- Ancillary studies -- Nasopharyngoscopy -- Radiographic cephalometry -- Dynamic magnetic resonance imaging -- Surgical treatment -- In-office minor procedures -- Surgical procedures -- Tonsillectomy and adenoidectomy -- Nasal surgery -- Uvulopalatopharyngoplasty -- Lingual tonsillectomy/partial glossectomy -- Hyoid myotomy and suspension -- Genioglossus advancement -- Maxillomandibular advancement -- Tracheostomy -- Follow-up -- Conclusion -- References -- 8 Medical Co-morbidities Associated with Obstructive Sleep Apnea -- Introduction -- Mortality -- Cardiovascular consequences and co-morbidities -- Pulmonary hypertension -- Cardiac arrhythmias -- Congestive heart failure -- Cardiovascular disease -- Cerebrovascular disease/stroke -- Endocrine consequences and co-morbidities -- Neurocognitive consequences and co-morbidities -- Psychological co-morbidity -- Decreased quality of life -- Other sleep disorders -- Conclusion -- Disclaimer -- References -- 9 Non-Pharmacological Treatments of Insomnia and Circadian Rhythm Disorder: Special Focus on Neurology Patients -- Introduction -- Insomnia -- Diagnostic definitions of insomnia -- Insomnia and mood disturbance in the general population -- Polysomnography and physiological markers and insomnia -- Sleepiness or fatigue? -- Pharmacological management of insomnia: the basics -- Mood disturbance and insomnia in neurological patients -- Additional causes of insomnia in neurological diseases -- Non-pharmacological treatment of insomnia -- Treatment plan -- Additional behavioral therapies -- Circadian rhythm disorder -- Diagnostic definitions of circadian rhythm disorder -- Behavioral and pharmacological treatment of circadian rhythm disorders -- Circadian rhythm disorder and neurology -- Conclusion -- References -- 10 Using Medications to Treat Insomnia.

Introduction -- Sleep requirements -- Sleep architecture -- Sleep disorders -- Insomnia -- Drugs used in treatment of insomnia -- Benzodiazepine receptor agonists (BzRA) -- Ramelteon (Rozerem) -- Sedating antidepressants -- Antihistamines -- Other prescription drugs (used off label) -- Other over-the-counter agents -- Conclusion -- References -- 11 Parasomnias: Diagnosis, Evaluation, and Treatment -- Types of parasomnias -- NREM parasomnias -- REM parasomnias -- Other parasomnias -- Evaluation of the patient with a parasomnia -- Physical examination -- Parasomnia identification and initial testing -- Routine EEG -- Polysomnography for parasomnias -- The algorithm (Figure 11.1) -- Treatment of parasomnias -- Conclusion -- References -- 12 Restless Legs Syndrome, Periodic Limb Movements, and Other Movement Disorders in Sleep -- Introduction -- Restless legs syndrome -- Demographics -- Diagnosis and clinical presentation -- Pathophysiology -- Management -- Consequences -- Periodic limb movement disorder -- Other movement disorders of sleep -- Rhythmic movement disorder -- Sleep starts (hypnic jerks) -- Sleep-related bruxism -- Propiospinal myoclonus at sleep onset -- Excessive fragmentary myoclonus -- Hypnogogic foot tremor and alternating leg movement activation -- Further reading -- 13 Sleep and Neurological Disorders -- Introduction -- Parkinson's disease and other alpha-synucleinopathies -- REM sleep behavior disorder -- Hypersomnia -- Insomnia -- Sleep-disordered breathing -- Alzheimer's disease and other dementias -- Insomnia and circadian rhythm disturbance -- Obstructive sleep apnea -- REM sleep behavior disorder -- Epilepsy -- Overview of sleep disruption in epilepsy -- Obstructive sleep apnea -- Seizures versus parasomnias -- Stroke -- Sleep-disordered breathing -- Other sleep-wake disturbances -- Multiple sclerosis -- Insomnia.

Restless legs syndrome -- Sleep-disordered breathing -- Narcolepsy -- Neuromuscular disease -- Sleep-disordered breathing -- Hypersomnia -- Conclusion -- Further reading -- 14 Cognition, Driving, and Sleep -- Introduction -- Acute sleep deprivation -- Sleepiness -- Attention and executive functions -- Cortical function other than executive functions -- Chronic sleep deprivation -- Accidents and safety -- Work-hour regulation in the medical field -- Cognition and obstructive sleep apnea -- Driving and sleep -- Conclusion -- References -- 15 Pediatric Sleep Medicine -- Introduction -- Sleep onset insomnia -- Restless legs syndrome (RLS) and RLS variants -- Medical disorders frequently associated with sleep onset insomnia -- Circadian rhythm disturbance - delayed sleep phase (DSP) type -- Behavioral insomnia of childhood - sleep onset association disorder (BIC-SOAD) -- Behavioral insomnia of childhood - limit setting disorder (BIC-LSD) -- Psychophysiological insomnia -- Sleep maintenance insomnia -- Nightmare disorder -- Breathing disorders -- Obstructive sleep apnea (OSA) -- Other breathing disorders -- Hypersomnias -- Circadian rhythm disturbances -- Parasomnias -- Nocturnal epileptic events -- Nocturnal epilepsy syndromes (by typical age of onset) -- Summary -- Sleep-related movements -- Conclusion -- Further reading -- Index.