![]() ![]() Sleep deprivation also raises the risk of high blood pressure, heart disease, diabetes, obesity, depression, and stroke. Insufficient sleep has been linked to car crashes, poor work performance and problems with mood and relationships. Sleep recharges the brain, allowing it to learn and make memories. Sleep is vital to our health, safety and overall well-being. In today's overscheduled society, sleep may feel like a luxury when, in fact it’s a necessity. An estimated 50 to 70 million Americans suffer from a chronic sleep disorder, according to the Institute of Medicine. The most common daytime symptoms of sleep disorders are daytime sleepiness and fatigue.Īll patients with excessive daytime sleepiness must be assessed for inattention or sleepiness when driving, and for accidents or near-miss accidents related to driver sleepiness.Īll patients who are tired, sleepy or fatigued should be screened for sleep apnea.How many times did you hit the snooze button this morning? We all crave sleep, but too many nights we fall short of the seven or eight hours we need to thrive. Screening for excessive daytime sleepiness Inquire about caffeine and other substance use, and consider the effects of alcohol withdrawal on sleep. Review medications that have a CNS-stimulating effect or that disrupt sleep (e.g., diuretics). Screen for specific sleep disorders and for physical and psychiatric conditions that may contribute to insomnia (see “Insomnia” section on facing page). Daytime sleepiness is usually not the leading daytime symptom of insomnia patients with insomnia more often complain about mental exhaustion and an inability to nap during the day. Learn about the patient’s bedtime routine and any disturbing factors in the sleep environment, such as electronic devices, disruptive partners, ambient noise, room temperatures and darkness.Īsk the patient about anxiety, worry, frustration, problem solving, rumination about stressful issues, and the inability to “switch off” before bedtime or when lying awake in bed at night.Īssess daytime sleepiness, mental and physical fatigue and problems with concentration and memory, and inquire about mood and irritability. ![]() If the patient scores higher than 10 on the Athens Insomnia Scale, assess the areas described below.Ĭollect information on bedtimes, the time it takes the patient to fall asleep, the number and duration of nighttime awakenings, the final awakening in the morning, the time the patient gets out of bed and the difference between weeknight and weekend sleep schedules and sleep quality.Īsk about the patient’s beliefs in terms of sleep need and about coping or compensatory behaviours, including excessive time in bed and use of hypnotics. Įxcessive daytime sleepiness is characterized by a complaint of constant or recurrent daytime sleepiness, typically with inappropriate sleep episodes. If left untreated, chronic insomnia can last for decades. In chronic insomnia, the sleep difficulty occurs more than three times a week for more than three months and is not better explained by another sleep disorder ( American Academy of Sleep Medicine, 2014). Short-term (or episodic) insomnia lasts less than three months and is usually triggered by acute medical illness or stress. Daytime symptoms such as fatigue, mood disturbance, difficulty with attention or memory, and behavioural problems, must be present. Insomnia is defined as a persistent difficulty falling or staying asleep and awakening earlier than desired despite adequate circumstances for sleep. This system categorizes sleep disorders as problems initiating and maintaining sleep (insomnia) problems of too much sleep (hypersomnia, excessive sleepiness) circadian rhythm problems and “things that go bump in the night” (parasomnias). More than 80 sleep disorders have been recognized, but a simple rubric exists for classifying symptoms. Goolam Hussain and Colin Shapiro (CAMH, 2019). Text adapted from: "The adult patient with a sleep disorder," in Psychiatry in primary care by Dora Zalai, M.R.
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