The history of sleep medicine and sleep research can be
summarized as a history of remarkable progress and, at
the same time, a history of remarkable ignorance. Since
the publication of the second edition in 1999 enormous
progress has been made in all aspects of sleep science
and sleep medicine. I am pleased to see these rapid
advances in sleep medicine and growing awareness about
the importance of sleep and its dysfunction amongst the
public and the profession.
Treatment is justified if it has significantly improved their wellbeing and function. A combination of medication with psychological techniques is likely to be most beneficial, especially for resistant cases.
Humans spend about a third of the time asleep but why we sleep is not yet fully understood. Sleep is a state of inactivity accompanied by loss of awareness and a markedly reduced responsiveness to environmental stimuli.
Specific questioning about the occurrence of sleep episodes during normal waking hours, both intentional and unintentional, is necessary to determine the extent of the adverse effects of sleepiness on a patient's daytime function. Specific areas to be addressed include the occurrence of inadvertent sleep episodes while driving or in other safety-related settings, sleepiness while at work or school (and the relationship of sleepiness to work and school performance), and the effect of sleepiness on social and family life.
Emerging research is helping to place pain and
addictive disorders on a continuum rather than on
the traditional dichotomy of recent years [12–15].
It is clear to a growing number of clinicians that
pain patients can, and sometimes do have concur-
rent addictive disorders that decidedly complicate
the management of an already challenging patient
population [16–19]. It is possible for pain and
addiction to exist as comorbid conditions such as
the case of the alcoholic with peripheral neuro-
Syd sat in his one room apartment looking out his window onto the
street several stories below. He ate a peanut butter sandwich that stuck
to the roof of his mouth like paste and tried to dislodge it with the bitter
taste of foc. His normal midnight snack.
He thought about how he was in a poor area of Steeple City, and how
even though the people drove battery cars and only ran the room disinfecting
Spaires Machines if they had children, the people walking in the
street below were happier than him. The foc, an anti-depressant and
stimulant, only made his head pound so he set the...
Govender et al. present an important overview of criteria employed to predict
recurrence and progression to MS, with particular attention given to radiological
findings. Guevara Campos and González Guevara focus specifically on Landau
Kleffner syndrome (LKS; sometimes called infantile acquired aphasia), in which
language comprehension and expression impairments emerge after an initial period of
Because there is no clear definition of the asthma
phenotype, researchers studying the development of this
complex disease turn to characteristics that can be
measured objectively, such as atopy (manifested as the
presence of positive skin-prick tests or the clinical
response to common environmental allergens), airway
hyperresponsiveness (the tendency of airways to narrow
excessively in response to triggers that have little or no
effect in normal individuals), and other measures of
Unstable Angina and Myocardial Infarction
(See also Chaps. 238 and 239) Patients with these acute ischemic syndromes usually complain of symptoms similar in quality to angina pectoris, but more prolonged and severe. The onset of these syndromes may occur with the patient at rest, or awakened from sleep, and sublingual nitroglycerin may lead to transient or no relief. Accompanying symptoms may include diaphoresis, dyspnea, nausea, and light-headedness.
The physical examination may be completely normal in patients with chest discomfort due to ischemic heart disease.
Worry had completely defeated me. My mind was so confused and troubled that I could see no joy in living. My nerves were so strained that I could neither sleep at night nor relax by day. My three young children were widely separated, living with relatives. My husband, having recently returned from the armed service, was in another city trying to establish a law practice. I felt all the insecurities and uncertainties of the postwar readjustment period. I was threatening my husband's career, my children's natural endowment of a happy, normal home life, and I was also threatening my...
In both groups (patients with epilepsy and healthy controls) we used a questionnaire
Epworth Scale of Sleepiness (ESS) (Johns, 1991). By answering eight questions about
probability of falling asleep in standard situations we came to the result, i.e. score of
daytime sleepiness ranging from 0 to 24. Rate 0-9 is considered as normal value, above 9 as
elevated daytime sleepiness and value above 16 is considered as remarkably elevated
daytime sleepiness (Watanabe et al., 2003).
here are several forms of depressive disorders that occur in
both women and men. he most common are major depres
sive disorder and dysthymic disorder. Minor depression is
Major depressive disorder, also called major depression, is
characterized by a combination of symptoms that interfere
with a person’s ability to work, sleep, study, eat, and enjoy
once-pleasurable activities. Major depression is disabling and
prevents a person from functioning normally.