Sleep Medicine Pearls

Fundamentals of Sleep Medicine 1: Sleep Stages and Electroencephalographic Patterns 1. A 30-year-old man taking a hypnotic nightly 2. A 30-year-old man with insomnia

Fundamentals of Sleep Medicine 2: Electroencephalographic Lead Placement 3. A 50-year-old man with insomnia

Fundamentals of Sleep Medicine 3: Eye Movement Monitoring

Fundamentals of Sleep Medicine 4: Eye Movement Patterns 4. A 20-year-old man with excessive daytime sleepiness

Fundamentals of Sleep Medicine 5: Chin (Submental) Electromyography 5. A 40-year-old man experiencing difficulty falling asleep 6. A 30-year-old woman having trouble falling asleep 7. A 30-year-old man having difficulty staying awake during the day 8. A 35-year-old woman with insomnia 9. A 25-year-old man with a history of sleep-walking 10. A 20-year-old man with daytime sleepiness 11. A 40-year-old man with a history of snoring and daytime sleepiness 12. A 34-year-old man with sleep disturbance 13. A 22-year-old woman with frequent awakenings during sleep secondary to chronic pain 14. A 40-year-old man being treated for depression

Fundamentals of Sleep Medicine 6: Additional Sleep Staging Rules 15. A 30-year-old man with severe snoring and occasional breathing lapses 16. A 35-year-old woman experiencing uncontrollable episodes of sleep

Fundamentals of Sleep Medicine 7: Sleep Architecture Definitions 17. A 23-year-old man with difficulty sleeping 18. A 25-year-old man with daytime sleepiness and fatigue

Fundamentals of Sleep Medicine 8: Polysomnography 19. A 30-year-old man having difficulty staying awake during the day 20. A 25-year-old man complaining of excessive daytime sleepiness 21. A 30-year-old man with loud snoring 22. A 40-year-old man with complaints of snoring 23. Two patients with recording artifacts 24. A 29-year-old man struggling with daytime sleepiness

Fundamentals of Sleep Medicine 9: Multiple Sleep Latency Test and Maintenance of Wakefulness Test 25. A 25-year-old man with daytime sleepiness

Fundamentals of Sleep Medicine 10: Monitoring Respiration During Sleep 26. A 45-year-old man with possible sleep apnea 27. A 50-year-old man with possible central apnea 28. A 30-year-old man with heavy snoring 29. A 33-year-old man complaining of daytime sleepiness

Fundamentals of Sleep Medicine 11: Excessive Daytime Sleepiness 30. A 45-year-old man with a snoring problem 31. A 40-year-old woman with mild” sleep apnea

Fundamentals of Sleep Medicine 12: Respiratory Arousals 32. A 30-year-old woman with severe fatigue 33. A 30-year-old man with heavy snoring and daytime sleepiness 34. A 45-year-old man with a distinct pattern of desaturation

Fundamentals of Sleep Medicine 13: Treatment of Obstructive Sleep Apnea 35. A 30-year-old man with weight loss and sleep apnea

Fundamentals of Sleep Medicine 14: Positive Airway Pressure Titration 36. A 55-year-old man with heavy nighttime snoring and daytime sleepiness 37. A 50-year-old man with problems during a CPAP titration 38. A patient refusing to accept treatment for obstructive sleep apnea

Fundamentals of Sleep Medicine 15: Positive Pressure Airway Treatment: Improving Acceptance & Adherence 40. A 55-year-old man with obstructive sleep apnea still sleepy on nasal CPAP 41. A 50-year-old man unable to sleep on CPAP due to mask leak and claustrophobia 42. A 55-year-old man having difficulty with CPAP because of nasal congestion 43. A 30-year-old man unable to tolerate nasal CPAP because of too much pressure” 44. A 55-year-old man unable to use nasal CPAP due to intractable nasal congestion 45. A 45-year-old man with intolerance to nasal CPAP because of difficulty exhaling 46. A 60-year-old man with a suboptimal CPAP titration 47. A 55-year-old obese man with desaturation during a nasal CPAP trial 48. A 30-year-old woman with fatigue and mild daytime sleepiness 49. A 50-year-old man with a return of snoring 6 months after uvulopalatopharyngo-plasty 50. A 55-year-old man with severe daytime sleepiness and limited treatment options 51. A 40-year-old man with sleep apnea unable to tolerate nasal CPAP 52. A 45-year-old man still experiencing daytime sleepiness after uvulopalatopharyngo-plasty 53. A 50-year-old man needing objective confirmation of his ability to stay awake 54. A 45-year-old man falling asleep at the wheel while driving 55. A 30-year-old man with severe snoring 56. A 30-year-old choir singer with heavy snoring 57. A 50-year-old man with severe hypertension 58. A 55-year-old man with premature ventricular contractions during sleep 59. A 30-year-old pregnant woman with onset of snoring 60. A 45-year-old man with snoring and hypercapnia 61. A 55-year-old man with hypercapnic respiratory failure 62. A 57-year-old man with severe obstructive sleep apnea treated with oxygen 63. A 5-year-old child with behavior problems 64. A 6-year-old boy with large tonsils 65. A 20-year-old woman with daytime sleepiness since childhood 66. A 55-year-old man with chronic obstructive pulmonary disease and nocturnal desaturation 67. A 60-year-old man with leg swelling 68. A 55-year-old man with chronic obstructive pulmonary disease and severe pedal edema 69. A 60-year-old pink puffer” with insomnia 70. A 52-year-old man with chronic obstructive pulmonary disease and pedal edema 71. A 35-year-old woman with asthma and poor sleep at night

Fundamentals of Sleep Medicine 16: Central Sleep Apnea 72. A 58-year-old man with daytime sleepiness 73. A 55-year-old man with central sleep apnea 74. A 70-year-old man with daytime sleepiness and pedal edema 75. A 60-year-old man with severe congestive heart failure and daytime sleepiness 76. A 60-year-old man with obstructive sleep apnea and numerous central apneas on CPAP 77. A 12-year-old boy with daytime CO2 retention 78. A 75-year-old man with a history of polio

Fundamentals of Sleep Medicine 17: The Restless Leg Syndrome and Periodic Leg Movements in Sleep 79. A 50-year-old man with snoring and leg kicks 80. A 56-year-old man with crawling sensations in his legs at bedtime 81. A 40-year-old man who kicks in his sleep 82. A 50-year-old man who kicks during sleep 83. A 72-year-old man with worsening symptoms during treatment for restless legs 84. A 58-year-old man with sleep apnea and leg jerks during sleep

Fundamentals of Sleep Medicine 18: Narcolepsy 85. A 30-year-old man with daytime sleepiness and episodes of weakness 86. A 23-year-old man with daytime sleepiness, but no symptoms of cataplexy 87. A 25-year-old man with narcolepsy who is still sleepy on medication 88. A 25-year-old man with frequent episodes of cataplexy 89. A 24-year-old man with narcolepsy who was irritable and lost weight on methylphenidate 90. A 35-year-old man with sleep apnea and a short REM latency 91. A 40-year-old man with sleep apnea and persistent daytime sleepiness 92. A 35-year-old man requesting stimulant medication 93. A 64-year-old man with daytime sleepiness since age 21 Fundamentals of Sleep Medicine 19: Parasomnias 94. A 20-year-old man with severe nightmares” 95. A 25-year-old woman walking in her sleep 96. A 55-year-old man with violent dreams 97. A 50-year-old man with an interesting chin EMG

Fundamentals of Sleep Medicine 20: Monitoring for Nocturnal Seizures 98. A 55-year-old man with unusual movements during sleep 99. A 60-year-old man with a rhythmic EEG pattern during a CPAP titration 100. A 30-year-old man who got out of bed during sleep

Fundamentals of Sleep Medicine 21: Evaluation of Insomnia 101. A 30-year-old woman having difficulty falling asleep 102. A 30-year-old woman with insomnia 103. A 40-year-old man with difficulty falling asleep after the death of his brother

Fundamentals of Sleep Medicine 22: Circadian Sleep Disorders 104. A 40-year-old woman complaining of difficulty falling asleep 105. A 70-year-old man with early morning awakening 106. A 44-year-old man with jet lag 107. A 40-year-old woman with fibromyalgia 108. A 40-year-old woman with fatigue and disturbed sleep 109. A 45-year-old man with persistent insomnia while on treatment for depression 110. A 45-year-old man with hyperphagia and hypersomnia 111. A 50-year-old veteran of the Vietnam War with upsetting dreams 112. A 40-year-old woman with terrifying awakenings