This text provides a thorough understanding of the use of polysomnography and other technologies in the evaluation and management of sleep disorders. Its coverage includes in-depth reviews of the neurophysiology and cardiopulmonary aspects of sleep and the pathophysiology of sleep disorders. It contains detailed sections on polysomnography that include recording procedures, identifying and scoring sleep stages and sleep-related events, and report generation. Chapters in this book discuss therapeutic interventions including positive airway pressure, supplemental oxygen, surgical and pharmacologic treatments, and patient education. A section focuses on pediatric sleep disorders and polysomnography. Also included are chapters on establishing and managing a sleep center and accrediting a sleep program.

Table of Contents

OVERVIEW OF SLEEP MEDICINE: The Evolution of Polysomnographic Technology / The Scope of Modern Sleep Medicine PHYSIOLOGY OF NORMAL SLEEP: Neurophysiologic Basis of Sleep and Wakefulness / Normal Patterns and Phenomena of Sleep, Arousal, and Wakefulness / Sleep Deprivation / Sleep Across the Life Cycle / Sleep and Aging / Sleep in Women / Circadian Rhythms CARDIOPULMONARY ASPECTS OF SLEEP: The Airway and Mechanics of Breathing / Breathing Control Mechanisms / Gas Exchange and Transport / Normal Cardiac Physiology (Including Electrophysiology) SLEEP DISORDERS: Obstructive Sleep Apnea / Central Sleep Apnea / Circadian Rhythm Sleep Disorders / Periodic Leg Movements of Sleep / Restless Legs Syndrome / Narcolepsy / Parasomnias / Insomnia / Sleep and Medical Disorders / Cardiopulmonary Disorders Affecting Sleep in the Elderly / Sleep Disorders and Degenerative Neurologic Disorders / Sleep Disorders and Vascular Disorders / Psychiatric Disorders That Affect Sleep PREPARATION FOR POLYSOMNOGRAPHY: Patient Interviewing / Assessment and Accommodation for Special Needs / Patient Preparation POLYSOMNOGRAPHIC RECORDING PROCEDURES: Fundamentals of Electroencephalography and Other Biopotentials / Polysomnography Recording Systems / Principles of Recording Biopotentials RECOGNIZING AND SCORING RECORDED EVENTS: Sleep Stages and Sleep Architecture / Noninvasive Monitoring of Gas Exchange During Sleep / Sleep-Disordered Breathing / Cardiac Arrhythmias / Report Generation / Recording Quality and Artifacts / Motor Events / Nocturnal Seizures / Pharmacologic Effects on the Polysomnogram EVALUATION OF HYPERSOMNIA: Multiple Sleep Latency Test and Maintenance of Wakefulness Test / Wrist Actigraphy / Subjective Evaluation of Sleepiness INTERVENTIONS AND THERAPEUTICS: Positive Pressure Airway Therapy / Titration of Continuous Positive Airway Pressure and Application and Adjustment of Positive Airway Pressure Devices / Enhancing Therapeutic Compliance / Bilevel Positive Pressure Airway Devices and Titration of Bilevel Positive Airway Pressure / Autotitrating Devices for Positive Airway Pressure / Noninvasive Ventilation for Sleep-Disordered Breathing / Oxygen Administration in the Sleep Center / Dental Sleep Medicine / Surgical and Pharmacologic Treatment of Sleep Disorders / Sleep Hygiene / Treatment of Insomnia / Patient and Family Education PEDIATRIC SLEEP: Preparation of Infants and Children for Polysomnography / Infant and Toddler Polysomnography / Sleep-Related Breathing Disorders in Children / Nonrespiratory Pediatric Sleep Disorders / Neuromuscular Disorders Affecting Sleep in Children / Pulmonary Disorders Affecting Sleep in Children / Parasomnias in Children / Interventions in the Pediatric Sleep Laboratory, Including Positive Airway Pressure / Pediatric Scoring SLEEP CENTER MANAGEMENT: Professionalism / Staffing a Sleep Center / Sleep Center Policies and Procedures / Safety Considerations for the Sleep Center / Accrediting a Sleep Program ESTABLISHING A SLEEP CENTER: The Sleep Center and Physical Plant / Audiovisual Equipment in the Sleep Center / Evaluating and Replacing Equipment in the Sleep Center RESEARCH IN THE SLEEP CENTER: Regulations on Research, Recruitment of Subjects, and Subject Rights / Funding, Writing, and Obtaining Grants / Pediatric Research APPENDICES: Certification of Polysomnographic Technologists / Board of Registered Polysomnographic Technologists Standards of Conduct: Professional Discipline Committee / Board of Registered Polysomnographic Technologists Rules and Procedures Regarding Ethical and Professional Discipline Complaints / Introduction to the New International Classification of Sleep Disorders