Sleep studies

Assess patient sleep complaints, conduct sleep histories, and evaluate sleep studies to recognize day- and nighttime symptoms and characteristics of common sleep disorders. 

A 2-week diary of wet and dry nights prior to intervention is useful in that it can be used to monitor the response to treatment. A first-morning urine specific gravity may help to predict response to desmopressin therapy. Polysymptomatic presentation may require a more elaborate work-up, including voiding cystourethrogram, renal and/or bladder ultrasound, urodynamics, and sleep studies. 

Boutrel, B Monaca, C., Hen, R., Hamon, M. Adrien, J. (2002). Involvement of 5-HTia receptors in homeostatic and stress-induced adaptive regulations of paradoxical sleep studies in 5-HT1A knock-out mice. J. Neurosci. 22, 4686-92. 

Electroencephalogram (EEG) sleep studies on the use of antidepressants in depressed patients have not produced clear evidence of the involvement of REM or non-REM sleep in the mechanisms underlying clinical change. Furthermore, the role of the physiological mechanisms of sleep during treatment with antidepressants is still unclear. Further basic sleep research is necessary (Gillin 1983) to interpret the effects of antidepressants on EEG sleep in terms of the physiological processes of sleep. 

The syndrome is most common in obese males and should be considered when such patients complain of persistent drowsiness. However, the patient s partner provides the key to diagnosis. If the patient s partner reports frequent snoring and gasping for air or has even noticed episodes of apnea, then one should suspect sleep apnea. The final diagnosis is made during a sleep study in which the episodes of apnea can be observed directly. Although obese individuals have an elevated risk for obstructive sleep apnea, there are clearly individuals with sleep apnea who would be considered normal weight. 

Patients suspected of having sleep apnea should undergo a sleep study. If sleep apnea is diagnosed, these patients should be treated with weight reduction, a continuous positive airway pressure (CPAP) machine, and, in extreme cases, surgery. Sleep apnea patients in general should not be prescribed sedative-hypnotics. 

Patients suspected of a nighttime movement disorder should also undergo a sleep study. This will help not only to document the movements but also to determine... 

Narcolepsy can usually be distinguished from insomnia by the presence of one of the auxiliary symptoms (cataplexy, sleep paralysis, hypnagogic hallucinations). When the diagnosis remains unclear, then a sleep study is necessary. 

Seizure Disorders. Narcolepsy is not a form of epilepsy. Although the sleep attacks and cataplexy resemble certain forms of seizures, narcolepsy can easily be distinguished from epilepsy. In particular, those with narcolepsy remain aware of their surroundings during an attack of cataplexy, whereas the epilepsy patient has no recall of events associated with a seizure. Furthermore, the EEC recording during a sleep study typically distinguishes narcolepsy from seizures. 

Extensive sleep studies have been conducted with a variety of sedative-hypnotic drugs, and all of these drugs appear to alter the normal distribution of rapid eye movement (REM) and non-REM sleep. Most of the older sedative-hypnotic agents markedly depress REM sleep. In contrast, when the benzodiazepines are used in appropriate doses, they depress REM sleep to a much smaller extent. As with treatment of anxiety, the choice... 

REM sleep (Rush et ah, 1998). In one of the few sleep studies of children and adolescents treated with fluoxetine, similar findings were noted, with increased light stage 1 sleep, increased number of arousals and REM density, and a largely unaffected REM latency (Armi-tage et ah, 1997). One must keep in mind that studies of depressed children and adolescents suggest that subjects may have sleep polysomnographic abnormalities associated with depression itself (Emslie et ah, 2001). 

Gillin JC Sleep studies in affective illness diagnostic, therapeutic and pathophysiological implications. Psychiatr Ann 13 367-384, 1983a Gilhn JC The sleep therapies of depression. Prog Neuropsychopharmacol Biol Psychiatry 7 351-364, 1983b... 

Kupfer DJ, Ehlers CL, Frank E, et al Persistent effects of antidepressants EEG sleep studies in depressed patients during maintenance treatment. Biol Psychiatry 35 781-793, 1994... 

Stern M, Fram DH, Wyatt R, et al All-night sleep studies of acute schizophrenics. Arch Gen Psychiatry 20 470-477, 1969... 

Polvgraphic sleep studies with antidepressants have traditionally been of great interest since certain forms of depression are characterized by common features in the sleep polygram (very short REM sleep latency, i.e. time until appearance of first REM phase frequent sleep interruptions) and it was found that many antidepressants affect the sleep pattern of healthy subjects in the opposite way to that observed in endogenous depression (Vogel et al., 1990). Typically, many antidepressants lead to a dose-dependent prolongation of REM latency and an overall reduction in the duration of REM sleep. However,... 

Effects on electrophysiological parameters (pharmaco-electroencephalo-gram, evoked potentials) polygraphic sleep studies. 

Long-term insomnia is insomnia that lasts for more than 3 weeks no specific stressor may be identifiable. A more complete medical evaluation is necessary in these patients, but most do not need an all-night sleep study. 

The three most common types of depression are major depression, dysthymia, and bipolar disorder. Major depression, which may occur once but usually occurs several times in a person s life, will interfere with the ability to work, eat, sleep, study, and take pleasure in formerly enjoyed activities. Dysthymia is less severe than major depression but will interfere with feeling good and functioning well. Bipolar disorder (formerly called manic-depression) can be more serious than the other forms of depression. In this illness the person s mood swings from symptoms of depression to extreme excitement with over-activity and feelings of elation. This type of depression can progress to serious mental illness if not treated. 

Carskadon MA, Dement WC. Sleep studies on a 90-minute day. Electroencephalogr Clin Neurophysiol 1975 39 145-55. 

Ferini-Strambi L, Filippi M, Martinelli V, Oldani A, Rovaris M, Zucconi M, Comi G, Smirne S (1994) Nocturnal sleep study in multiple sclerosis correlations with clinical and brain magnetic resonance imaging findings. J Neurol Sci 125 194-197... 

Papadimitriou GN, Kerkhofs M, Kempenaers C, Mendlewicz J (1988) EEG sleep studies in patients with generalized anxiety disorder. Psychiatric Res 26 183-190... 

Buysse DJ, Kupfer DJ (1990) Diagnostic and research applications of electroencephalo-graphic sleep studies in depression Conceptual and methodological issues. J Nerv Ment Dis 178 405 114... 

Reynolds CF 3rd, Soloff PH, Kupfer DJ, Taska LS, Restifo K, Coble PA, McNamara ME (1985) Depression in borderline patients aprospective EEG sleep study. Psychiatry Res 14 1-15... 

Buysse DJ, Kupfer DJ, Frank E, MonkTH, Ritenour A (1992) Electroencephalographic sleep studies in depressed outpatients treated with interpersonal psychotherapy. II Longitudinal studies at baseline and recovery. Psychiatry Res 40 27M0... 

The diagnosis of RLS can be made from the patient s history, whereas for PLMD a PSG sleep study, actigraphy or immobilization test can be used [75], In the case of an impaired elderly person, a detailed history from and of family members and caregivers is considered very useful in diagnosing RLS [74],... 

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