Sleep Matters. Ann Sharpley PhD Psychopharmacology Research Unit Department of Psychiatry
|
|
|
- Marvin Daniel
- 5 years ago
- Views:
Transcription
1 Sleep Matters Ann Sharpley PhD Psychopharmacology Research Unit Department of Psychiatry 1
2 Sleep is for Wimps This may explain some of those ill advised 3am tweets! Invade the Dark and we have Occupied the Night 2 July 1967-Nov /7 society Why Do We Sleep? When we are asleep the brain does not shut down Restoration Energy Conservation Brain Processing and Memory Consolidation Sleep is not an Indulgence 2
3 What is so special about the sleep of dolphins? 3
4 Diurnal 4
5 Patients need sleep How Do We Measure Sleep in Humans? Questionnaires Sleep History Sleep Diaries Insomnia Severity Index Morin et.al. (2011) The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. SLEEP:34(5): Thinking about your CURRENT (i.e., LAST 2 WEEKS) insomnia problem(s): CIRCLE the number that best describes your answer for each question None Mild Moderate Severe Very severe 1. Difficulty falling asleep Difficulty staying asleep Problem waking up too early How SATISFIED/DISSATISFIED are you with your sleep pattern? Very Satisfied 0 Satisfied 1 Moderately Satisfied 2 Dissatisfied 3 Very Dissatisfied 4 5
6 5. How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life? Not at all Noticeable 0 A Little 1 Somewhat 2 Much 3 Very Much Noticeable 4 6. How WORRIED/DISTRESSED are you about your current sleep problem? Not at all Worried 0 A Little 1 Some what 2 Much 3 Very Much Worried 4 7. To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.)? Not at all Interfering 0 A Little 1 Somewhat 2 Much Very 3 Much Interfering 4 Add the scores for all seven items 0 7 No clinically significant insomnia 8 14 Sub-threshold insomnia Clinical insomnia (moderate severity) Clinical insomnia (severe) Epworth Sleepiness Scale Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep:14 (6): Situation 1. Sitting & reading 2. Watching television 3. Sitting inactive in a public place e.g. theatre Score 4. Passenger in a car for an hour 5. Lying down to rest in the afternoon 6. Sitting talking to someone 7. Sitting quietly after lunch (no alcohol) 8. In a car, while stopped in traffic Maximum score of 24. Score of 10 or > needs investigating 6
7 Epworth Sleepiness Scale Patients rate their sleepiness during the past week using the following scale 0=Would never doze; 1=Slight chance of dozing 2=Moderate chance of dozing; 3= High chance of dozing Situation Score 1. Sitting & reading 1 2. Watching television 1 3. Sitting inactive in a public place e.g. theatre 1 4. Passenger in a car for an hour 1 5. Lying down to rest in the afternoon 1 6. Sitting talking to someone 0 7. Sitting quietly after lunch (no alcohol) 1 8. In a car, while stopped in traffic 0 Maximum score of 24. Score of 10 or > needs investigating Validated In OSA, narcolepsy, hypersomnia 6 The Pittsburgh Sleep Quality Index Buysse et.al. (1989) The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Research: 28(2), An effective instrument used to measure the quality and patterns of sleep in adults It differentiates poor from good sleep quality by measuring seven areas: Subjective sleep quality Sleep latency Sleep duration Habitual sleep efficiency Sleep disturbances Use of sleeping medications Daytime dysfunction over the last month Validated in: elderly, PTSD, primary insomnia, cancer, TBI, COPD, IPF, OSA, pregnancy, fibromyalgia The following questions relate to your usual sleep habits during the past month only. Your answers should indicate the most accurate reply for the majority of days and nights in the past month During the past month: 1. When have you usually gone to bed? 2. How long (in minutes) has it taken you to fall asleep each night? 3. What time have you usually gotten up in the morning? 4. A. How many hours of actual sleep did you get at night? B. How many hours were you in bed? 7
8 5. During the past month, how often have you had trouble sleeping because you A. Cannot get to sleep within 30 minutes B. Wake up in the middle of the night or early morning C. Have to get up to use the bathroom D. Cannot breathe comfortably E. Cough or snore loudly F. Feel too cold G. Feel too hot H. Have bad dreams I. Have pain J. Other reason (s), please describe, including how often you have had trouble sleeping because of this reason (s): Not during the past month 0 Less than once a week 1 Once or twice a week 2 Three or more times a week 3 Not during the past month 0 Less than once a week 1 Once or twice a week 2 Three or more times a week 3 6. During the past month, how often have you taken medicine (prescribed or over the counter ) to help you sleep? 7. During the past month, how often have you had trouble staying awake while driving, eating meals, or engaging in social activity? 8. During the past month, how much of a problem has it been for you to keep up enthusiasm to get things done? 9. During the past month, how would you rate your sleep quality overall? Very good 0 Fairly good 1 Fairly bad 2 Very bad 3 PSQI: Interpretation of scores The Global Score ranges from 0 to 21 Higher Global Scores = poorer sleep quality Cut-off score of > 5 distinguishes poor sleepers from good sleepers Scoring instructions are provided in the original publication 8
9 Eliminating other sleep disorders: preliminary questions Are you a very heavy snorer? Does your partner say that you sometimes stop breathing at night? (obstructive sleep apnoea syndrome (OSAS)) Do your legs often twitch and can t keep still in bed? Do you wake from sleep with jerky leg movements? (restless legs syndrome (RLS), periodic limb movements in sleep (PMLS)) Do you sometimes fall asleep in the daytime completely without warning? Do you have collapses or extreme muscle weakness triggered by emotion, for instance when you re laughing? (narcolepsy) Do you tend to sleep well but just at the wrong times ; and are these sleeping and waking times regular? (circadian rhythm sleep disorder; evidence also from sleep Diary/actigraphy) Do you have unusual behaviours associated with your sleep that trouble you or that are dangerous (parasomnias e.g. RSBD)? Wilson et.al. (2010) BAP consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders. J Psychopharm. 24 (11) Actiwatch Hans Berger Hans Berger: Inventor of the EEG machine 1936 Electroencephalogram An EEG is a device that measures the electrical activity of the brain Frequency How many times the wave occurs within a specific period Amplitude The size of the wave 9
10 Sleep Montage EOG EMG 1953: REM Sleep Discovered EEG Onset of REM Sleep Laboratory 1950s 2016 Ambulatory Technology Oxford Medilog 1980s Embla Titanium % 45% 25% 10
11 Wake SWS REM 30 Second Epochs Sleep Hypnogram Healthy Young Adult So can I ask you to raise your hands if you think you are getting enough sleep? Teenagers are lazy! The elderly need less sleep Early to Bed & Early to Rise Makes you Healthy, Wealthy & Wise 11
12 World Record 1964 Randy Gardner (born 1947) holder of the scientifically documented record for the longest period a human has intentionally gone without sleep not using stimulants of any kind Any Guesses? hours 11 days 24 minutes Day 1 Day 2 Day 3 Day 4 Some fatigue Difficulty focusing his eyes Minor mood changes, poor coordination, speech problems & nausea Irritable, uncooperative, memory losses, poor concentration, hallucinations: including mistaking a street sign for a person In one experiment, he was asked to subtract 7 repeatedly, starting with = = = = = 65..What am I doing? Drummond et. al. (1999) Sleep deprivation-induced reduction in cortical functional response to serial subtraction. Neuroreport: 10(18):
13 Days 6-8 Increasing poor coordination, speech and memory problems Day 9 Fragmented thoughts & speech, blurred vision, paranoia: stated that others were out to ruin his attempt to break the record Previous World Record 260 hours and 17 minutes Disk Jockey Tom Rounds of Honolulu After reaching goal, he slept for hours All speech & memory problems disappeared 1979 Three Mile Island 1986 Chernobyl 1989 Oil Tanker 2010 Air India Grampians National Park to Adelaide Go Straight for 314km! 13
14 Insomnia Disorder Dissatisfaction with Quantity or Quality of Sleep Non Restorative 14
15 a physical illness (cancer, heart or lung disease), resulting in pain a neurological (Parkinson s disease or cerebrovascular disease) a psychiatric disorder (depressive illness, anxiety disorder) Or as a result of medication used to treat the illness Sleep Disturbances in Patients With Advanced Cancer in Different Palliative Care Settings Mercadante et. al. (2015) J Pain Symptom Management: 50 (6): prospectively assessed for 6 months Sleep disturbances in >60% of patients Risk Factors: Younger patients Breast, gastrointestinal, head and neck, lung, and prostate cancers Hormone therapy and use of opioids and corticosteroids High anxiety & depression scores Pain intensity Psychological profile should be assessed as well as concomitant drugs What would appropriate treatment look like? Cognitive Behavioural Therapy for Insomnia (CBT-I) Sleep Restriction Therapy Stimulus Control Instructions Relaxation Techniques Sleep Hygiene Non-pharmacological interventions for sleep promotion in the intensive care unit Cochrane Database of Systematic Reviews Hu et. al Objectives: To assess the efficacy of non-pharmacological interventions for sleep promotion in critically ill adults in the ICU 30 trials; 1569 adults Interventions: ventilator mode or type, earplugs or eye masks or both, massage, relaxation interventions, foot baths, music interventions, nursing interventions, valerian acupressure, aromatherapy and sound masking Results: earplugs or eye masks or both a lower incidence of delirium during ICU stay & positive effect on total sleep time 15
16 Pharmacological Interventions for Insomnia Z-drugs and short-acting benzodiazepines are efficacious for insomnia (Ia) Safety : adverse events and carryover effects are fewer and less serious with decreasing half-lives (Ib) Prolonged release melatonin improves sleep onset latency and quality in patients over 55 (Ib) Wilson et.al. (2010) BAP consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders. J Psychopharm. 24 (11) a neurological disease REM Sleep Behaviour Disorder Lack of muscle paralysis Violent & frightening, causing injury to themselves & bed partner Link between RSBD & Parkinson s Disease Make the bedroom safe Clonazepam Melatonin Aurora RN et al. Best practice guide for the treatment of REM sleep behavior disorder (RBD). J Clin Sleep Med: JCSM : Off Publ Am Acad Sleep Med. 2010;6(1):85 95 a psychiatric disorder Subjective Sleep Changes in Depression 60-90% report sleep disturbance Insomnia >80% Hypersomnia 15-35% Delayed sleep onset Shorter duration of sleep Early morning awakenings Nonrestorative sleep Kloss et. al. (2003): Insomnia in psychiatric disorders. In: Insomnia: Principles and Management. New York: Cambridge University Press,
17 Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 BAP guidelines Cleare et. al. (2015) J Psychopharm. 29(5): SPECIAL CONSIDERATIONS decreased tolerability of the elderly to antidepressants high risk of depressive relapse in the elderly with comorbid medical illness COMORBID MEDICAL ILLNESS increasing severity of comorbid medical illness and painful conditions are associated with poorer response to antidepressants & a greater risk of depressive relapse potential drug drug interactions and routinely choose antidepressants with a lower risk of interaction in patients on multiple medications A result of medication used to treat the illness Impact of morphine, fentanyl, oxycodone or codeine on patient consciousness, appetite and thirst when used to treat cancer pain Cochrane Database of Systematic Reviews Wiffen et.al Objectives: To determine the impact of opioid treatment on patient consciousness, appetite and thirst in randomised controlled trials of morphine, fentanyl, oxycodone or codeine for treating cancer pain 77 studies; 5619 adults Results: 23% for somnolence 17
18 Palliative pharmacological sedation for terminally ill adults Cochrane Database of Systematic Reviews Beller et.al Objective: To assess the evidence for the benefit of palliative pharmacological sedation on quality of life, survival, and specific refractory symptoms in terminally ill adults during their last few days of life adults; 1137 received palliative sedation 95% cancer Conclusion: insufficient evidence about the efficacy of palliative sedation in terms of a person s quality of life or symptom control There was evidence that palliative sedation did not hasten death Family Caregivers Sleep Problems, Anxiety, and Global Self-Rated Health Among Hospice Family Caregivers Washington (2017) Am J Hospice & Palliative Care Bidirectional link between sleep, stress & health Increased fatigue, cognitive impairment & negative mood Encourage family caregivers to reflect & seek support
Sleep Insomnia Severity Index (SISI) Pittsburgh Sleep Quality Inventory. POMS Vigor subscale
Physical GLOBAL HEALTH PROMIS completed already Sleep PROMIS-Sleep Sleep Insomnia Severity Index () Pittsburgh Sleep Quality Inventory 8 items 7 items 18 items Vigor Vigor subscale 6 items 1 Sleep- PROMIS
Psychological Sleep Services Sleep Assessment
Psychological Sleep Services Sleep Assessment Name Date **************************************************** Insomnia Severity Index For each question, please CIRCLE the number that best describes your
Not Sleepy HO Q1 D2 Q3 Q4 ]5 D6 j7 Q8 Q9 Q10 Extremely Sleepy
![Not Sleepy HO Q1 D2 Q3 Q4 ]5 D6 j7 Q8 Q9 Q10 Extremely Sleepy](/thumbs/96/127246551.jpg "Not Sleepy HO Q1 D2 Q3 Q4 ]5 D6 j7 Q8 Q9 Q10 Extremely Sleepy")
Health Benefits Employee Services HBE Preventive Health - Sleep Assessment Form Please bring your completed assessment form to your appointment. To schedule an appointment please call 505 844-HBES (4237).
Treating Insomnia in Primary Care. Judith R. Davidson Ph.D., C. Psych. Kingston Family Health Team
Treating Insomnia in Primary Care Judith R. Davidson Ph.D., C. Psych. Kingston Family Health Team jdavidson@kfhn.net Disclosure statement Nothing to disclose A ruffled mind makes a restless pillow. ~ Charlotte
Assessment of Sleep Disorders DR HUGH SELSICK
Assessment of Sleep Disorders DR HUGH SELSICK Goals Understand the importance of history taking Be able to take a basic sleep history Be aware the technology used to assess sleep disorders. Understand
Help I Have Problems with My Sleep!
Help I Have Problems with My Sleep! Over An 85 Year Lifespan Sleep 31% Work 21% Exercise 1% Food and Drink 11% Sleep Is Important! You can survive without food for up to 2 months Without water 3-5 days
Sleep Health Center. You have been scheduled for an Insomnia Treatment Program consultation to further discuss your
Sleep Health Center You have been scheduled for an Insomnia Treatment Program consultation to further discuss your sleep. In the week preceding your appointment, please take the time to complete the enclosed
Article printed from
What Are Sleep Disorders? Sleep disorders are conditions that affect how much and how well you sleep. The causes range from poor habits that keep you awake to medical problems that disrupt your sleep cycle.
Intake Questionnaire
Intake Questionnaire In order to make the best use of your appointment time, please complete this form prior to your initial appointment. What is your name? (Who filled in this form?) (Y= yes N=no DK=
SLEEP DISORDERS CENTER QUESTIONNAIRE
Carteret Health Care Patient's name DOB Gender: M F Date of Visit _ Referring physicians: Primary care providers: Please complete the following questionnaire by filling in the blanks and placing a check
Balboa Island Dentistry (949)
Do You Snore? Are you always tired? Snoring is no laughing matter! It may be more than an annoying habit. It may be a sign of. How well do you sleep? Just about everyone snores occasionally. Even a baby
This copyright in this form is owned by the University of Pittsburgh and may be reprinted without charge only for non-commercial research and
This copyright in this form is owned by the University of Pittsburgh and may be reprinted without charge only for non-commercial research and educational purposes. You may not make changes or modifications
130 Preston Executive Drive Cary, NC Ph(919) Fax(919) Page 1 of 6. Patient History
130 Preston Executive Drive Cary, NC 27513 Ph(919)462-8081 Fax(919)462-8082 www.parkwaysleep.com Page 1 of 6 Patient History *Please fill out in dark BLACK INK only. General Information Name Sex: Male
Patient Information. Name: Date of Birth: Address: Number & Street City State Zip Code. Home Number: ( ) Cell Number: ( )
Patient Information Name: Date of Birth: Age: Address: Number & Street City State Zip Code Home Number: ( ) Cell Number: ( ) Social Security Number: Marital Status: Religion: Race: Height: Weight: Sex:
Insomnia. Dr Terri Henderson MBChB FCPsych
Insomnia Dr Terri Henderson MBChB FCPsych Plan Basics of insomnia Pharmacology Medication CBT Details of insomnia Unsatisfactory sleep that impairs daytime well-being Starts with specific problem or change
PATIENT NAME: M.R. #: ACCT #: HOME TEL: WORK TEL: AGE: D.O.B.: OCCUPATION: HEIGHT: WEIGHT: NECK SIZE: GENDER EMERGENCY CONTACT: RELATIONSHIP: TEL:
SLEEP DISORDERS INSTITUTE HOSPITAL: DePaul Building Street Address City, State Zip Tel: (202) 555-1212 Fax: (202) 555-1212 SLEEP QUESTIONNAIRE PATIENT NAME: M.R. #: ACCT #: STREET ADDRESS: CITY: STATE:
Beyond Sleep Hygiene: Behavioral Approaches to Insomnia
Beyond Sleep Hygiene: Behavioral Approaches to Insomnia Rocky Garrison, PhD, CBSM Damon Michael Williams, RN, PMHNP-BC In House Counseling Laughing Heart LLC 10201 SE Main St. 12 SE 14 th Ave. Suite 10
Sleep Disorders Diagnostic Center 9733 Healthway Drive, Berlin, MD , ext. 5118
Sleep Questionnaire *Please complete the following as accurate as possible. Please bring your completed questionnaire, insurance card, photo ID, Pre-Authorization and/or Insurance referral form, and all
Sleep. Anil Rama, MD Medical Director, Division of Sleep Medicine The Permanente Medical Group
Sleep Anil Rama, MD Medical Director, Division of Sleep Medicine The Permanente Medical Group Assistant Adjunct Clinical Faculty Stanford School of Medicine Circadian Rhythm of Sleep Body temperature 7
An Introduction to Identifying and Treating Sleep Disorders in Adults
An Introduction to Identifying and Treating Sleep Disorders in Adults REFERENCES/RESOURCES TOOLS & MEASURES: SLEEP DIARY: Carney, C., et al. (2012). The Consensus Sleep Diary: Standardizing prospective
Sleep Medicine Questionnaire
Please bring this completed questionnaire with you to your sleep medicine appointment. Our sleep medicine staff strives to understand your sleep symptoms, which may be complex in nature. Thank you for
Height: Weight: Neck Size: Does your work involve shift work? Yes No. Where did you hear about us: Physician Media Friend Other
Personal Information Name: Date of birth: Sex: Male Female Marital Status: Nationality: MRN(for KAUH Patients): Height: Weight: Neck Size: Address: Occupation: Length of work day: Does your work involve
Sleep History Questionnaire B/P / Pulse: Neck Circum Wgt: Pulse Ox
2700 Campus Drive, Ste 100 2412 E 117 th Street Plymouth, MN 55441 Burnsville, MN 55337 P 763.519.0634 F 763.519.0636 P 952.431.5011 F 952.431.5013 www.whitneysleepcenter.com Sleep History Questionnaire
WELCOME TO THE NORTHSHORE UNIVERSITY HEALTHSYSTEM SLEEP CENTERS
WELCOME TO THE NORTHSHORE UNIVERSITY HEALTHSYSTEM SLEEP CENTERS Prior to your office visit, we request that you complete this questionnaire. It asks questions not only about your sleeping habits and behavior
Sleep & Wakefulness Disorders in Parkinson s Disease: The Challenge of Getting a Good Night s Sleep
Sleep & Wakefulness Disorders in Parkinson s Disease: The Challenge of Getting a Good Night s Sleep Helene A. Emsellem, MD March 25, 2017 The Center for Sleep & Wake Disorders PFNCA Symposium Sleep is
New Patient Sleep Intake
New Patient Sleep Intake Name: Date of Birth: Primary Care Physician: Date of Visit: Referring Physician and/or Other Physicians: Retail Pharmacy: Mail Order Pharmacy: Address: Mail Order Phone #: Phone
Sleep Center. Have you had a previous sleep study? Yes No If so, when and where? Name of facility Address
Patient Label For office use only Appt date: Clinician: Sleep Center Main Campus Highlands Ranch Location 1400 Jackson Street 8671 S. Quebec St., Ste 120 Denver, CO 80206 Highlands Ranch, CO 80130 Leading
WHY CAN T I SLEEP? Deepti Chandran, MD
WHY CAN T I SLEEP? Deepti Chandran, MD Sleep and Aging How does sleep change as we age? Do we need less sleep as we get older? Can a person expect to experience more sleep problems or have a sleep disorder
General Information. Name Age Date of Birth. Address Apt. # City State Zip. Home Phone Work Phone. Social Security Number Marital Status
Accredited Member Center of The American Academy of Sleep Medicine 400 Riverside Drive, Suite 1500, Bourbonnais, IL 60914 Phone (815) 933-2874 Fax (815) 939-9413 www.riversidemc.net/sleep General Information
Insomnia. F r e q u e n t l y A s k e d Q u e s t i o n s
Insomnia Q: What is insomnia? A: Insomnia is a common sleep disorder. If you have insomnia, you may: Lie awake for a long time and have trouble falling asleep Wake up a lot and have trouble returning to
604 NORTH ACADIA ROAD, Suite 210 THIBODAUX, LA SLEEP HISTORY QUESTIONNAIRE
604 NORTH ACADIA ROAD, Suite 210 THIBODAUX, LA 70301 985-493-4759 SLEEP HISTORY QUESTIONNAIRE DATE: / / NAME: AGE (First) (Middle) (Last) ADDRESS: (Street) (City) (State) (Zip) PHONE: Home( ) Work:( )
Are you skimping on sleep, or could you have a sleep disorder?
Are you skimping on sleep, or could you have a sleep disorder? Look around you: the guy nodding off on the bus, the co-worker snoozing during a dull presentation, the people with heavy eyelids lined up
PATIENT DEMOGRAPHICS
PATIENT DEMOGRAPHICS NPSG CPAP CPAP Retitration Split Night PATIENT INFORMATION: Name: Last First Middle Initial Address: City: State: Zip: Social Security #: DOB: Gender: Age: Phone Number: Cell: Work:
PULMONARY & CRITICAL CARE CONSULTANTS OF AUSTIN 1305 West 34 th Street, Suite 400, Austin, TX Phone: Fax:
Name: Sex: Age: Date: Date of Birth Height Weight Neck size Referring Physician: Primary Care MD: Main Sleep Complaint(s) trouble falling asleep trouble remaining asleep excessive sleepiness during the
SNORING AND OBSTRUCTIVE SLEEP APNOEA WAYS TO DEAL WITH THESE PROBLEMS
SNORING AND OBSTRUCTIVE SLEEP APNOEA WAYS TO DEAL WITH THESE PROBLEMS Laugh and the world laughs with you; snore and you sleep alone. These words by novelist Anthony Vergess ring true with all too many
Narendra Kumar, M.D. PC Board Certified ENT Board Certified Sleep Medicine
Narendra Kumar, M.D. PC Board Certified ENT Board Certified Sleep Medicine PATIENT DEMOGRAPHICS Who is the Physician that referred you to us? Who is the primary care Physician? Date: Do you want this report
PATIENT SLEEP QUESTIONNAIRE
PATIENT SLEEP QUESTIONNAIRE Name: Date of Birth: Today s Date Primary Care Physician Telephone # Physician ordering test (Other than PCP): Physician s Tel. #: _ Age: Years Height: Feet Inches Weight: Lb
Sleep Symptoms & History
Sleep Symptoms & History In your own words, please tell us what brings you to the sleep clinic today? How long have you been experiencing your sleep problems? yrs. mos. To give us a precise understanding
HEALTHY LIFESTYLE, HEALTHY SLEEP. There are many different sleep disorders, and almost all of them can be improved with lifestyle changes.
HEALTHY LIFESTYLE, HEALTHY SLEEP There are many different sleep disorders, and almost all of them can be improved with lifestyle changes. HEALTHY LIFESTYLE, HEALTHY SLEEP There are many different sleep
Associated Neurological Specialties and Sleep Disorder Center
Sleep Center Questionnaire Name: Sex: Age: Date: Date of Birth: Height: Weight: Neck Size: Primary Care Physician: Referring Physician: Main Sleep Issues/Complaints Trouble falling asleep Trouble staying
Emergency Contact Information Name: Phone: Address: Employer Information Employer Name: Address/Street: City: Zip: Phone: Fax:
SUNSET SLEEP LABS PATIENT INFORMATION FORM Patient Information Name: Sex: M F Date of Birth: Address/Street: City: Zip: Phone: Alt Phone: Parent/Guardian: Phone: Social Security Number: Drivers License:
Sleep This factsheet is available in a downloadable PDF here. Table of Contents Introduction Insomnia How Long does Insomnia Last? How much Sleep should You get? Symptoms of Insomnia Causes of Insomnia
Healthy Sleep Tips Along the Way!
Women and Sleep What You Will Learn The Benefits and Importance of Sleep States and Stages of the Sleep Cycle Unique Physiology of Women s Sleep Common Disorders in Women that Affect Sleep Women s Role
Sleep and Sleep Hygiene in an Occupational Health & Safety Context
Sleep and Sleep Hygiene in an Occupational Health & Safety Context Glenn Legault Ph.D. Center for Research in Occupational Safety and Health, Laurentian University Nov. 12, 2014 Overview: Sleep what is
Huron Medical Sleep Center Saad S. Ahmad, MD
Authorization and Consent for Sleep Testing I authorize the release of any medical information necessary to the durable medical equipment company for therapy, if applicable. I authorize the use of audio
Sleep Center New Patient Questionnaire
For office use only Appt date: Sleep Center Clinician: Main Campus Highlands Ranch Location 1400 Jackson Street 8671 S. Quebec St., Ste 120 Denver, CO 80206 Highlands Ranch, CO 80130 #1 respiratory hospital
Patient Scheduled Letter Thunderbird Internal Medicine Sleep Center 5620 W. Thunderbird Rd., Suite C-1 Glendale, AZ (602)
Patient Scheduled Letter Thunderbird Internal Medicine Sleep Center 5620 W. Thunderbird Rd., Suite C-1 Glendale, AZ 85306 (602) 938 6960 Dear Patient, Your Doctor has requested you be scheduled for a sleep
The Implications of a Hospital Break Policy: A Comparison of Two Regional Hospitals Using Survey Data
The Implications of a Hospital Break Policy: A Comparison of Two Regional Hospitals Using Survey Data Samantha M. Riedy, BS, RPSGT Experimental Psychology Doctoral Program Sleep and Performance Research
Denver, CO Welcome Packet
Fax: (303) 957-5414 or 720-542-8699 For any after-hours questions, please call (303) 956-5145 Dear Mountain Sleep Patient, You have been scheduled for a sleep study at 1210 S Parker Road, Suite 101, Denver,
BMI: Family physician : Neck circumference (cm) Hypertension + 4 cm Snoring + 3 cm Witnessed apnea + 3cm Total
Last and first names: F M Date: Date of birth: / / YYYY MM DD Weight: kg /lbs Profession/job: Height: _ cm /ft.in. BMI:_ Family physician : ANC (adjusted neck circumference) : Neck circumference (cm) Hypertension
The following questions are about your sleep. Please consider both what others have told you about your sleep and what you know yourself.
Sleep History Form FORM CODE: SLE VERSION A 1/29/2009 PARTICIPANT ID NUMBER: CONTACT YEAR: 0 9 LAST NAME: INITIALS: INSTRUCTIONS: This form should be completed during the participant's clinic visit. ID
PATIENT QUESTIONNAIRE Boise Location 7272 W. Potomac Drive Boise, ID (208)
PATIENT QUESTIONNAIRE Boise Location 7272 W. Potomac Drive Boise, ID 83704 (208)884-2922 ***Questionnaire MUST be completed PRIOR to arrival for appointment*** Today s Date / / / / Last First MI DOB Referring
Chronic Insomnia: DSM - V. Insomnia DSM - V. Patient Symptoms. Insomnia: Assessment and Overview of Management. Insomnia Management in the Digital Age
Insomnia Management in the Digital Age Dr Anup Desai Sleep & Respiratory Medicine MBBS (syd), PhD (syd), FRACP Senior Staff Specialist, POW Hospital Medical Director, Sydney Sleep Centre Senior Lecturer,
Littleton, CO Welcome Packet 8151 Southpark Lane, Suite 200 Littleton, CO 80120
Littleton, CO Welcome Packet For any after-hours questions, please call (303) 956-5145 Dear Mountain Sleep Patient, You have been scheduled for a sleep study at 8151 Southpark Lane, Suite 200, Littleton,
SLEEP DISORDERS. Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children
SLEEP DISORDERS Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children Distinctive Features of Pediatric Sleep Daytime sleepiness uncommon
Sleep History Questionnaire. Sleep Disorders Center Duke University Medical Center. General Information. Age: Sex: F M (select one)
Sleep History Questionnaire Sleep Disorders Center Duke University Medical Center Part I: General Information Name: Address: Date: Phone: Age: Sex: F M (select one) Education (years of school): Occupation:
Original Sleep Hygiene Rules*
Original Sleep Hygiene Rules* 1. Sleep as much as needed to feel refreshed and healthy during the following day, but not more. Curtailing time in bed a bit seems to solidify sleep; excessively long times
MEDICAL HISTORY QUESTIONNAIRE
MEDICAL HISTORY QUESTIONNAIRE NAME: SEX: DATE: DOB: AGE: Primary Doctor / Care Manager: Additional doctors to receive sleep study results: Chief sleep related complaint: What made you decide to have this
Huron Medical Sleep Center Saad S. Ahmad, MD
Authorization and Consent for Sleep Testing I authorize the release of any medical information necessary to the durable medical equipment company for therapy, if applicable. I authorize the use of audio
YOU REALLY NEED TO SLEEP: Several methods to improve your sleep
YOU REALLY NEED TO SLEEP: Several methods to improve your sleep Sleep is essential to our well-being. When humans fail to get good sleep over a period of time, numerous problems can occur. CAN T SLEEP!!
Sweet Dreams: The Relationship between Sleep Health and Your Weight
Sweet Dreams: The Relationship between Sleep Health and Your Weight Jason C. Ong, PhD Associate Professor Department of Neurology Center for Circadian and Sleep Medicine Northwestern University Feinberg
Robert E. McMichael, M.D. Medical Director Patient Instructions for a Diagnostic Sleep Study
NORTH TEXAS SLEEP DISORDERS CENTER Neurology Associates of Arlington, P.A 811 West Interstate 20, Suite G12 Arlington, Texas 76017 (817) 419-6375 Fax (817) 419-6371 Robert E. McMichael, M.D. Medical Director
SLEEP STUDY - PATIENT QUESTIONNAIRE
NOTE: You cannot fill out this form on Mozilla Firefox, please try another browser. You have two options for completing a questionnaire: - Enter the information on the fillable PDF and click Print at the
Brunswick Pulmonary and Sleep Medicine Lawrence Davanzo, DO, FCCP 49 Veronica Ave, Somerset, NJ Phone# Fax#
REGISTRATION FORM (Please Print) Today s date: PCP: PATIENT INFORMATION Patient s last name: First: Middle: Mr. Mrs. Miss Ms. Marital status (circle one) Single / Mar / Div / Sep / Wid If not, what is
Home Sleep Testing Questionnaire
Home Sleep Testing Questionnaire Patient Name: DOB: / / Gender: Male Female Study Date: / / Marital Status: Married Cohabitate Single Divorced Widow/Widower Email: Phone: Height: Weight: Neck Size: What
Sleep Questionnaire Name: Sex: Age: Da te: Da te of birth: Height: Weight: Neck siz e: Ref erring Physician: Primary Car e MD:
www.myvcmf.com 1133 E. Stanley Blvd., Suite 101 Livermore, CA 94550 925 454-4280 5725 W. Las Positas Blvd., Suite 110 Pleasanton, CA 94588 925-416-6767 Sleep Questionnaire Name: Sex: Age: Da te: Da te
1960 FP CENTER FOR SLEEP DISORDERS
1960 FP CENTER FOR SLEEP DISORDERS Sleep Questionnaire Name: Date: Date of Birth: / / Age: Gender: Height: Weight: lbs. Referring Physician: Occupation: Please give a brief description of your sleep problem
Facts about Sleep. Circadian rhythms are important in determining human sleep patterns/ sleep-waking cycle
Sleep Sleep is described as a state of unconsciousness or partial consciousness from which a person can be roused by stimulation Period of rest and recovery People spend about a third of their lives sleeping
Patient Adult Information History
Patient Adult Information History Patient name: Age: Date: What is the main reason for today s evaluation? Infant History Birth delivery: Normal C-section Delayed Epidural Premature: No Yes If yes, how
493 Blackwell Road, Suite 317-A, Warrenton, VA
493 Blackwell Road, Suite 317-A, Warrenton, VA. 20186 Dear Sleep Study Patient, Attached is the patient questionnaire for your sleep study. Please complete and mail or fax the enclosed forms as soon as
Maintenance for Wakefulness Testing (MWT)
SLEEP DISORDERS CENTER St. Joseph Mercy Ann Arbor 5305 Elliott Drive, Ypsilanti, MI 48197 734-712-2276 / Fax 734-712-2967 Maintenance for Wakefulness Testing (MWT) Dear, Your Maintenance for Wakefulness
EPWORTH SLEEPINESS SCALE
EPWORTH SLEEPINESS SCALE Name: Sponsors last 4 of SSN#: DOB: Today s Date: Age (years): Gender (circle): MALE FEMALE How likely are you to doze off or fall asleep in the following situation, in contrast
SLEEP HISTORY QUESTIONNAIRE
Date of birth: Today s date: Dear Patient: SLEEP HISTORY QUESTIONNAIRE Thank you for taking the time to fill out a sleep history questionnaire. This will help our healthcare team to provide the best possible
TOP 10 LIST OF SLEEP QUESTIONS. Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children
TOP 10 LIST OF SLEEP QUESTIONS Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children QUESTION #1: ARE SLEEP ISSUES IN CHILDREN THE SAME AS IN ADULTS? Distinctive Features
INSOMNIA SEVERITY INDEX
Name: Date: INSOMNIA SEVERITY INDEX For each of the items below, please circle the number that most closely corresponds to how you feel. 1. Please rate the CURRENT (i.e. last 2 weeks) severity of your
Many people with physical
FACTSHEET How to Sleep Better Many people with physical disabilities suffer from sleep disturbances, and sleep tends to become more disrupted as we get older. Not sleeping well can negatively impact your
Date of Study: Arrive at: P.M.
Date of Study: Arrive at: P.M. Depart at 5: AM (Note: Sleep technicians leave the premises at 6 AM) Please notify the Palos Pulmonary staff in advance if you require any special assistance / accommodations
Individual Planning: A Treatment Plan Overview for Individuals Sleep Disorder Problems.
COURSES ARTICLE - THERAPYTOOLS.US Individual Planning: A Treatment Plan Overview for Individuals Sleep Disorder Problems. Individual Planning: A Treatment Plan Overview for Individuals Sleep Disorder Problems.
Parkinson s Disease Associated Sleep Disturbance Ehsan M. Hadi, MD, MPH. Dignity Health Neurological Institute
Parkinson s Disease Associated Sleep Disturbance Ehsan M. Hadi, MD, MPH. Dignity Health Neurological Institute Parkinson s Disease 2 nd most common neurodegenerative disorder Peak age at onset is 60 years
*521634* Sleep History Questionnaire. Name of primary care doctor:
*521634* Today s Date: Sleep History Questionnaire Appointment Date: Please answer the following questions before coming to your appointment. Please arrive 15 minutes early with this packet filled out.
Sleep and Traumatic Brain Injury (TBI)
Sleep and Traumatic Brain Injury (TBI) A resource for individuals with traumatic brain injury and their supporters This presentation is based on TBI Model Systems research and was developed with support
Index. sleep.theclinics.com. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Actigraphy, 475, 485, 496 Adolescents, sleep disorders in, 576 578 Adults, sleep disorders in, 578 580 Advanced sleep phase disorder, 482 Age,
Sleep and Ageing. Siobhan Banks PhD. Body and Brain at Work, Centre for Sleep Research University of South Australia
Sleep and Ageing Siobhan Banks PhD Body and Brain at Work, Centre for Sleep Research University of South Australia Health and Active Ageing, 22 nd September 2015 Sleep and Aging How does sleep change as
Sleep Dysfunction in Multiple System Atrophy DR CALLUM DUPRE NEUROLOGY/SLEEP MEDICINE CAPITAL HEALTH SYSTEM
Sleep Dysfunction in Multiple System Atrophy DR CALLUM DUPRE NEUROLOGY/SLEEP MEDICINE CAPITAL HEALTH SYSTEM Categories of Disturbance Sleep Breathing Disorders Parasomnias Sleepiness Insomnia Breathing?
Beyond Sleep Apnoea. Dr Justin Pepperell DA SODIT 2017
Beyond Sleep Apnoea Dr Justin Pepperell DA SODIT 2017 disclosures Introduction Sleep and its disorders Obstructive sleep apnea Other common sleep disorders Critical illness sleep disorders Bonus BIS monitoring
Maintenance for Wakefulness Testing (MWT)
Maintenance for Wakefulness Testing (MWT) Dear, Your Maintenance for Wakefulness Testing (MWT) will begin on the morning of at 7 a.m. and will end at 5 p.m. ARRIVAL TIME: If you are not able to arrive
Sleep Hygiene. William M. DeMayo, M.D. John P. Murtha Neuroscience and Pain Institute Conemaugh Health System Johnstown, PA
Sleep Hygiene William M. DeMayo, M.D. John P. Murtha Neuroscience and Pain Institute Conemaugh Health System Johnstown, PA Why Is Sleep Important? Symptoms of Sleep Deprivation: Irritability / Poor Stress
Sleep History Questionnaire
Sleep History Questionnaire Name: DOB: Phone: Date of Consultation: Consultation is requested by: Primary care provider: _ Preferred pharmacy: Chief complaint: Please tell us why you are here: How long
Your physician has ordered a sleep study for you on. Your arrival time is scheduled for.
Dear Patient: Your physician has ordered a sleep study for you on. Your arrival time is scheduled for. The Texas State Sleep Lab is located in the Health Professions Building on the Texas State University
Reference document. Sleep disorders
Reference document Sleep disorders Table of contents Introduction 2 Definition 2 Myths 2 Major determinants 2 Major sleep disorders 3 The consequences of sleep deprivation 3 Tips for better sleep 4 Conclusion
Contents. Page. Can t sleep 3. Insomnia 4. Sleep 5. How long should we sleep? 8. Sleep problems 9. Getting a better night s sleep 11
I Cannot Sleep Contents Page Can t sleep 3 Insomnia 4 Sleep 5 How long should we sleep? 8 Sleep problems 9 Getting a better night s sleep 11 Treatment for insomnia 15 For more information 19 2 Can t sleep
EMORY SLEEP CENTER Sleep and Health Questionnaire
EMORY SLEEP CENTER Sleep and Health Questionnaire Demographics Today s Date: / / Name: Date of Birth: / / Address: Sex: Male Female City/State/Zip: Preferred Contact Number: Work Home Cell Occupation:
Improving Your Sleep Course. Session 1 Understanding Sleep and Assessing Your Difficulties
Improving Your Sleep Course Session 1 Understanding Sleep and Assessing Your Difficulties Course Information Session Details Sessions Session 1 Session 2 Session 3 Session 4 Optional Review Session 5 Session
Humble Dreams Sleep Center. Humble, TX 77339
Humble Dreams Sleep Center 8901 FM 1960 Bypass West, Ste. 306 Humble, TX 77339 Dear Humble Dreams Sleep Study Patient, Thank you for allowing Humble Dreams Sleep Center to provide your sleep study as requested
Sleep and Parkinson's Disease
Parkinson s Disease Clinic and Research Center University of California, San Francisco 505 Parnassus Ave., Rm. 795-M, Box 0114 San Francisco, CA 94143-0114 (415) 476-9276 http://pdcenter.neurology.ucsf.edu
WHAT YOU NEED TO KNOW ABOUT SLEEP APNEA
WHAT YOU NEED TO KNOW ABOUT SLEEP APNEA Wayne Driscoll Clinical Education Specialist 2 SLEEP APNEA IN THE NEWS Carrie Fisher died from sleep apnea, other factors, coroner says USA Today NJ Transit engineer
Milena Pavlova, M.D., FAASM Department of Neurology, Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School Medical
Milena Pavlova, M.D., FAASM Department of Neurology, Brigham and Women's Hospital Assistant Professor of Neurology, Harvard Medical School Medical Director, Faulkner EEG and Sleep Testing Center Course
Sleep: A Forgotten Component of Overall Health Demarcus Sneed Health and Human Sciences Educator Madison County October 5, 2016
Sleep: A Forgotten Component of Overall Health Demarcus Sneed Health and Human Sciences Educator Madison County October 5, 2016 Lesson Objectives Understand the importance of having consistent, quality
TOP "Rnwrd. Sleep Disorders Questionnaire. da^
Sleep Disorders Questionnaire This questionnaire Is a screeningtooi for physicians to assist their clinical evaluation of Insomnia, it can be used to screen for a sleep disorder. See page 2 for guide to
HYPERSOMNIA NEW PATIENT QUESTIONNAIRE please fax back to us at : Current Medications:
HYPERSOMNIA NEW PATIENT QUESTIONNAIRE please fax back to us at 404-712-8145: Name: Date: Date of Birth: Sex: M F (circle) Height: Weight: Current Medications: At what age did your sleepiness begin? years