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Effectively diagnose and manage adult and pediatric sleep disorders with help from Atlas of Sleep Medicine, the most comprehensive and detailed source of pictorial and video guidance available. A full-color design with an entirely new image collection and video segments facilitates the observation and interpretation of sleep-related events and recordings. Whether you are preparing for the sleep medicine fellowship examination, or simply want to offer your patients today's best care, this sleep medicine book is an ideal resource!

  • Consult this title on your favorite device, conduct rapid searches, and adjust font sizes for optimal readability.
  • Confidently treat sleep-related breathing disorders with a practical step-by-step approach to positive pressure titration, summarizing merits, demerits, dangers, and limitations.
  • Observe, evaluate, and treat unusual, uncommon, and often unrecognized PSG patterns.
  • See how clinical and PSG findings correlate in real time for various sleep disorders by watching video segments (new to this edition!) that show sleep movements and polysomnography data side by side.
  • Visually reinforce your understanding of circadian dysrhythmias through dynamic hypnograms and a tantalizing pictorial display.
  • Evaluate indications and choose appropriate dental appliances with step-by-step instruction and supporting video clips.
  • Address undesired phenomena that occur in association with sleep with eight new unique vignettes with associated videos including a variety of parasomnias, cataplexy, and death from obstructive sleep apnea.
  • Access the fully searchable text online including the complete image library, over two dozen videos, and more at Expert Consult.



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Published 27 August 2013
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EAN13 9781455712687
Language English
Document size 92 MB

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Atlas of Sleep Medicine
Sudhansu Chokroverty, MD, FRCP, FACP Professor and Co-Chair of Neurology Program Director, Clinical Neurophysiology and Sleep Medicine, New Jersey Neuroscience Institute at JFK Medical Center and Seton Hall University, Edison, New Jersey Clinical Professor of Neurology, Robert Wood Johnson Medical School, New Brunswick, New Jersey Robert J. Thomas, MD, MMSc Associate Professor of Medicine, Harvard Medical School, Department of Medicine, Division of Pulmonary, Critical Care, and Sleep, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Table of Contents
Cover image
Title page
Chapter 1: Polysomnographic Recording Technique Patient Preparation And Laboratory Environment Respiratory Monitoring Technique
Measurement Of Airflow
Esophageal PH
Body Position Monitoring Snoring Monitoring Of Penile Tumescence
PSG Calibration
Ending The Test
Scoring Of Arousals
Indications For Polysomnography And Video-Polysomnography
Portable Monitoring
Digital Polysomnography
Artifacts During Polysomnographic Recording
Pitfalls Of Polysomnography
Chapter 2: Electroencephalography for the Sleep Specialist Method Of Electroencephalographic Recording Normal Waking And Sleep Electroencephalographic Rhythms In Adults
Abnormal Electroencephalographic Patterns
Recognition Of Epileptiform Patterns In The Polysomnographic Tracing
Electroencephalographic Signs Of Epilepsy
Nonepileptiform Patterns Mimicking Epileptiform Discharges
Epileptiform Patterns In Sleep
Diagnostic Approach To Patients With Suspected Nocturnal Seizures
Chapter 3: Sleep Stages and Scoring Technique Introduction To Sleep Stage Scoring Parameters For Staging Human Sleep
Electroencephalographic Activity During Wakefulness And Sleep
Stages Of Sleep Conclusion
Chapter 4: Sleep-Disordered Breathing and Scoring Current Considerations In The Scoring Of Respiratory Events
Chapter 5: Basic Circadian Rhythms and Circadian Sleep Disorders Circadian Rhythm Biology Circadian Rhythm Sleep Disorders
Chapter 6: Hypnogram Analysis
Chapter 7: Sleep-Related Movements and Scoring Techniques
Chapter 8: Cardiac Arrhythmias
Chapter 9: Uncommon, Atypical, and Often Unrecognized PSG Patterns
Chapter 10: Motor Disorders During Sleep
Chapter 11: Sleep and Epilepsy
Chapter 12: Sleep Dysfunction and Sleep-Disordered Breathing in Miscellaneous Neurological Disorders Regulation Of Sleep-Wake Cycles Control Of Breathing In Sleep And Wakefulness
Sleep-Disordered Breathing And Other Sleep Dysfunction In Neurological Diseases
Chapter 13: Neuroimaging Techniques
Normal Sleep
Obstructive Sleep Apnea Narcolepsy Restless Legs Syndrome And Periodic Limb Movements Parasomnias Insomnia Conclusion
Chapter 14: Specialized Techniques
Technique Of Multiple Sleep Latency Test
Indications For Multiple Sleep Latency Test
Reliability, Validity, And Limitation Of The Multiple Sleep Latency Test
Maintenance Of Wakefulness Test
Technique Of The MWT
Indications For The MWT
Indications For Actigraph
Advantages Of Actigraph Over Polysomnography
Disadvantages And Limitations Of Actigraph Recordings Definition Method Of Measurement Microarousal Recognition Using Pulse Transit Time (Figures 14C.2 And 14C.3) Respiratory Effort (Figures 14C.4, 14C.6, And 14C.7)
Limitations Of The Technique (Figure 14C.8)
False Pulse Transit Time Values (Figure 14C.9) Medication Pulse Transit Time As A Measure Of Respiratory Effort Under Noninvasive Ventilation (Figures 14C.10 And 14C.11) Conclusion Phasic Events Of Non–Rapid Eye Movement Sleep
Definition Of Cyclic Alternating Pattern
Definition Of Non–Cyclic Alternating Pattern
Cyclic Alternating Pattern And Nonrestorative Sleep
The Cyclic Alternating Pattern Phases And Sleep Disorders
Theoretical Principles
Summary Of Technology
Clinical Applications Conclusions
Chapter 15: Positive Pressure Titration Overview Recognition Of Strong Chemoreflex Influences On Sleep Respiration
Recognition Of The Role Of Rapid Eye Movement Sleep In Positive Pressure Titration
Recognition Of The Role Of Non–Rapid Eye Movement Sleep States In Titration
Responding To Periodic Motor Activation
Common Errors During Bilevel Titration
Bilevel Ventilation Practice Points
Adaptive Ventilation And Volume-Assured Ventilation
Titration With The Adaptive Ventilators
Carbon Dioxide Therapeutic Modulation: Positive Airway Pressure Gas Modulator And Enhanced Expiratory Rebreathing Space Nasal Resistance Valves And Internally Generated Expiratory Positive Pressure Therapy
Chapter 16: Oral Appliances and Surgical Techniques for Obstructive Sleep Apnea Syndrome Therapy
Oral Appliances
Upper Airway Surgery
Chapter 17: Pediatric Polysomnography Pediatric Polysomnography: General Considerations Standard And Custom Polysomnographic Montages
Normal Sleep In Infants
Normal Sleep In Children
Abnormal Polysomnographic Findings In Children
Electroencephalographic Abnormalities
Artifacts Unique To Pediatric Polysomnography
Vignette 1: Narcolepsy—Unequivocal Diagnosis After Split-Screen, Video-Polysomnographic Analysis of a Prolonged Cataplectic Attack
Vignette 2: Obstructive Sleep Apnea Associated With Cerebral Hypoxemia
Vignette 3: The Rapid Eye Movement Sleep Behavior Disorder Leading to a Subdural Hemorrhage
Vignette 4: Isolated Sleep Paralysis: An REM-“Sleep” Polysomnographic Phenomenon as Documented With Simultaneous Clinical and Electrophysiological Assessment
Vignette 5: Confusional Arousals
Vignette 6: Sleepwalking
Vignette 7: Hypnagogic Hallucination
Vignette 8: Sleep Terrors
1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 ATLAS OF SLEEP MEDICINE ISBN: 978-1-4557-1267-0 Copyrigdt © 2014, 2005 by SaunDers, an imprint of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies, and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website:www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods, they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any liability for any injury and/or damage
to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Library of Congress Cataloging-in-Publication ata Chokroverty, Sudhansu, author. Atlas of sleep medicine / Sudhansu Chokroverty, Robert J. Thomas. -- Second edition.  p. ; cm. Includes bibliographical references and index. ISBN 978-1-4557-1267-0 (hardback : alk. paper) I. Thomas, Robert J. (Professor of medicine), author. II. Title. [DNLM: 1. Sleep Disorders--diagnosis--Atlases. 2. Polysomnography--Atlases. WL 17] RC547 616.8’498--dc23 2013032574 Content Strategist:Helene Caprari Content Development Specialist:Maria Holman Publishing Services Manager:Anne Altepeter Senior Project Manager:Doug Turner Design Direction:Louis Forgione Printed in Canada Last digit is theprint number: 9 8 7 6 5 4 3 2 1
To my wife, Manisha Chokroverty, MD, my love and gratitude for your lifelong support in my academic endeavors despite being left alone for days and weeks during the production of this and other books
SC To my wife, Shubha, who has developed the steel will to deal with my never-ending hyperdrive, and to my best friend, Sudha, who played a very important part in sculpting me into who I am today RJT