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Sleep Disorders in Selected Psychiatric Settings: A Clinical Casebook

✍ Scribed by Imran S. Khawaja (editor), Thomas D. Hurwitz (editor)


Publisher
Springer
Year
2021
Tongue
English
Leaves
176
Category
Library

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✦ Synopsis


According to research, more than 50% of patients seen in psychiatric clinics have sleep problems. Despite this fact, there is a lack of sleep medicine training in psychiatric residency programs especially for disorders like insomnia and sleep-related problems in women and children. Also, there is a lack of education on treating sleep problems in special situations like ICU settings or managing sleep problems via telemedicine. Sleep physicians, on the other hand, are uncomfortable treating patients with the psychiatric disorders, particularly in this demographic. Pediatricians are also not trained to work with children suffering from sleep disturbances or psychiatric disorders. They often struggle to correctly identify a particular disorder and lack confidence to adequately treat and manage these issues. In total, there are only about 250 clinicians trained in both sleep medicine and psychiatry, despite the millions of patients who could benefit from both disciplines.

While Springer does have a forthcoming text on sleep and psychiatric disturbances that addresses comorbid sleep disorders in the general population, there is still no resource that examines the intricacies of insomnia in women and children. This text highlights the importance of common medical comorbidities and illuminates the salient points for treatment, diagnosis, and management of these conditions as they relate particularly to these special populations. Written by experts in both sleep medicine and psychiatry, the text takes a cutting-edge, reader-friendly approach to topics that include sleep disturbances in pregnancy, sleep tele-medicine, sleep disturbances related to difficulties in schools, and substance-induced disturbances. Each chapter follows a consistent format, making it an excellent tool for the busy clinician who is not able to sift through scientific literature or didactic texts.

Psychiatric Sleep Disorders in Women and Children is an excellent resource for all clinicians who may work with special populations struggling with sleep and psychiatric comorbidities, including psychiatrists, sleep medicine physicians, internists, primary care and family medicine physicians, pediatricians, obstetrics/gynecologists, psychologists and others.

✦ Table of Contents


Preface
Contents
Contributors
Part I: Cases of Insomnia
1: Benzodiazepine Withdrawal Insomnia
Benzodiazepine Withdrawal Insomnia
Outpatient Medications
Vital Signs
Physical Exam
Mental Status Exam
Labs
EKG
Diagnosis
Discussion
References
2: Case Study: Brief CBT-I and Medication Taper with a Veteran Experiencing Insomnia and Suicidal Ideation
Clinical History/Case
Pharmacologic Interventions
Treatment Episode
Cognitive Behavioral Therapy for Insomnia
Special Studies
Session One
Session Two
Session Three
Session Four
Results
Post-treatment
Follow-Up
Differential Diagnosis and Diagnosis
General Remarks
References
Suggested Reading
Part II: Substances and Sleep
3: Some Say Marijuana Helps with Sleep. Is It True?
Clinical History
Clinical Examination
Diagnostic Testing
Results of Testing
Further Investigations
Diagnosis
Discussion
Pathophysiology
Sleep Disturbance
Insomnia
Chronic Pain
References
4: People Think Alcohol Helps with Sleep
Clinical History/Case
Examination/Mental Status Exam
References
5: When Counting Sheep Doesn’t Help: The Effects of Cocaine on Sleep
History
Exam/Mental Status
Mental Status Exam
Tests
Results
Polysomnography
Cocaine History and Demographics
How to Diagnose a Stimulant-Induced Sleep Disorder?
General Cocaine-Related Sleep Effects
Sleep Disturbances During Active Drug Use
Cocaine-Related Sleep Disturbances During the Abstinence Phase
Potential Treatments in Cocaine-Induced Insomnia
References
Part III: Sleep Issues in Pregnancy
6: Insomnia in Pregnancy
Clinical History
Special Studies
Actigraphy
Polysomnogram
Results
Question: What Is the Diagnosis? What Would You Recommend to Improve Sleep Quality?
Differential Diagnosis and Diagnosis
General Remarks
Suggested Reading
7: Obstructive Sleep Apnea in Pregnancy
Clinical History/Case
Examination/Mental Status Exam
Special Studies
Polysomnography
Results
Differential Diagnosis and Diagnosis
General Remarks
Suggested Readings (References)
8: Management of Restless Legs in Pregnancy: An Obstetrician, Internal Medicine Physician, and Perinatal Psychiatrist Work Together in an Obstetric Clinic
Obstetrician
History
Physical Examination
Provisional Diagnosis
Management Plan
Sleep Medicine Physician
Management
Perinatal Psychiatrist
Past Psychiatric History
Substance Use History
Family History
Social History
Mental State Examination
Formulation
Management
Multidisciplinary Team Meeting
Progress
Outcome
Diagnosis
Differential Diagnosis
Discussion
Management
References
Suggested Reading
Part IV: Sleep Issues in Children and Adolescents
9: Insufficient Sleep in Adolescence: Individual Interventions and Interventions That Scale
Clinical History
Examination
Questions
Diagnosis
Remarks
References
10: What Is Wrong with My Child? Narcolepsy and Its Emotional Burden on Parents
Chapter Outline
Clinical History
Diagnostic Testing Performed
Results
Narcolepsy Type 1
Discussion
References
Part V: Medication Induced Sleep Problems
11: Stimulant-Induced Sleep Disorder in Children with ADHD
Introduction
The Case of a 9-Year-Old Boy with ADHD
History
Mental Status Examination
Tests and Results
Polysomnography
Nocturnal Session Sleep Characteristics
Recommendations
Clinical Question and Case Discussion
Discussion
Conclusion
References
12: Running From Depression: A Case of Antidepressant-Induced Restless Legs Syndrome
Clinical History/Case
Examination/Mental Status Exam
Results
Polysomnography
Blood Work
Questions
Differential Diagnosis and Diagnosis
General Remarks
References
Part VI: Sleep Disturbances in Hospital Setting
13: Sleep Disturbance During an Acute Manic Episode
Clinical History
Discussion Points
Insomnia: Differential Diagnosis
Sleep Hygiene and Nonpharmacologic Interventions for Insomnia
Pharmacologic Management of Insomnia During an Acute Manic Episode
Clinical Pearls
Summary
References
14: Sleep in the ICU
Introduction
Clinical History/Case
Examination/Mental Status Exam
Questions
General Remarks
References
Part VII: Other Sleep and Co-morbid Issues
15: Nocturnal Panic Disorder: Afraid to Sleep!
Clinical Case History
Physical Examination and Mental Status Examination
Results
Differential Diagnosis
Final Diagnosis
Discussion
Outcome of Case
References
16: Psychosocial Issues of Narcolepsy
Clinical History
Diagnostic Evaluation
Questions
General Remarks
Psychosocial Issues of Narcolepsy
Management
References (Suggested Reading)
17: Severe OSA and Claustrophobia, Ultimately Treated with Hypoglossal Nerve Stimulation
Clinical History/Case
Examination/Mental Status Exam
Results
Questions
Differential Diagnosis and Diagnosis
General Remarks
References
18: Neuropsychological Outcomes of Disordered Sleep
Clinical History/Case
Social History
Evaluation Methods
Clinical Observations
Evaluation 1 Test Results
Evaluation 2 Test Results
Question
Diagnostic Impressions
General Remarks
Sleep Duration
Sleep Fragmentation
Physiologic Changes
References
19: Telesleep Medicine
Introduction
Telemedicine and Sleep-Disordered Breathing (SDB)
Application of Telemedicine for Diagnosis of SDB
Application of Telemedicine for Management of SDB
TS and Initiation of PAP Treatment
TS and Follow-Up of PAP Treatment
Telemedicine and Behavioral Sleep Medicine (Mary Rose)
Technical Aspects of Telemedicine
References
Index


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