Obstructive Sleep Apnea: Improving Patient Outcomes in the Primary Care Setting. Most care takes place in the primary care setting, and sleep disorders are no exception. Although 30% of the general population report symptoms of sleep disruption and greater than 50% of primary care patients have sleep complaints, there is documented under-treatment of sleep-related disorders.

Case 3: A 46-Year-Old Male Hotel Night Manager With Hypertension Who Feels Chronically Tired and Run Down.

Case 2: A 52-Year-Old Male Security Guard Who Falls Asleep on the Early Morning Shift. Shift work disorder may affect any person who works a job with nonconventional hours, leading to excessive sleepiness and impaired functioning. This case illustrates the impact of shift work disorder on patient performance and quality of life and how appropriate assessment can aid in the differential diagnosis and treatment recommendations.

Case 1: A 37-Year-Old, Female 911 Operator Who Works the Night Shift and Complains of Insomnia and Depression. Shift work disorder has a significant impact on relationships, mood, and performance as well as on the hallmark symptoms of insomnia and daytime sleepiness. Symptoms of shift work disorder and depression may appear to be similar but may have subtle differences.

The Evaluation and Management of Obstructive Sleep Apnea Syndrome. In their day-to-day practice, primary care providers (PCPs) confront a plethora of clinical issues. In turn, they are faced with the challenge to prioritize these issues in order of importance, despite increased limits on time and resources. Historically, sleep-related concerns such as insomnia, tiredness, and sleepiness have taken a lower priority than other medical conditions such as cardiovascular and metabolic disease; therefore, they have not been adequately addressed.

Recognizing and Managing Shift Work Disorder, an Underdiagnosed Condition: Improving Quality of Life. Nearly 18% of the U.S. labor force works alternative hours that place individuals at risk for shift work disorder (SWD). Although SWD poses serious risks to the patient’s functioning, health, safety, and quality of life, it is one of the sleep/wake disorders that is largely undiagnosed and undertreated.

When You Can’t Fall Asleep, Maybe it’s Your Clock That’s Broken. Delayed sleep phase disorder is the most common circadian rhythm sleep disorder and may be present in as many as 10% of adolescence though the numbers decline in older cohorts. It is under recognized, misdiagnosed as insomnia, and too often mistreated resulting in excessive daytime sleepiness, social, work, and scholastic dysfunction, and even depression.

Best Practices in Recognition, Diagnosis, and Treatment of Circadian Rhythm Disorders: An Online Activity for Primary Care Clinicians. Underlying human physiology and behavior are rhythms which wax and wane with 24-hour periodicity, regulating core body temperature, insulin secretion, alertness, mood, and other biologic parameters. To ensure homeostatic balance these and other circadian rhythms must be synchronized by various timekeepers, particularly the environmental light/dark cycle.

Sleep Deprived? Shut Down the Computer! According to a new poll released by the National Sleep Foundation, a significant number of Americans aren’t getting the sleep they need, a problem likely exacerbated by the pervasive use of communications technology in the hour before bed. The poll found that 43% of Americans between the ages of 13 and 64 say they rarely or never get a good night's sleep on weeknights.

Obstructive Sleep Apnea: Recognition, Treatment, and Adherence in the Primary Care Setting. The National Institutes of Health report that approximately 18 million Americans suffer from obstructive sleep apnea. Despite the prevalence of this common condition, studies show that 90% of people with OSA remain undiagnosed.

Obstructive Sleep Apnea Syndrome: Recognition, Treatment, and Adherence - Part II. Management of obstructive sleep apnea syndrome (OSAS) consists of not only specific interventions but also appropriate education. The patient needs to be educated about the importance of OSAS, the risk factors, and the importance of treatment, as well as the consequences of untreated OSAS. In addition, education should include discussion about the potential for accidents, particularly motor vehicle accidents, as well as job-related accidents, and accidents around the home.

Recognition of Obstructive Sleep Apnea: Part I. Obstructive sleep apnea syndrome is a disorder that is characterized by repetitive episodes of upper airway obstruction that occur during sleep. These episodes are typically either apneas, which are complete obstructions, or partial obstruction events called hypopneas.