Oxford Case Histories in Sleep Medicine

Description

• A case-based illustrative approach to the understanding and management of common and important sleep disorders.
• Features a question-and-answer format designed to enhance the reader's diagnostic ability and clinical understanding.
• Comprised of case histories written by the experts with clinical experience of managing patients with sleep disorders, which provides readers with clinical relevant information for day to day practice.

This book provides a case-based illustrative approach to the understanding and management of common and important sleep disorders, including snoring and sleep disordered breathing, insomnia and circadian-rhythm disorders, as well as primary neurological sleep disorders. Case histories are written by well-established experts from University College London Hospitals who have long-standing experience of providing a multi-disciplinary approach to the management of sleep disorders. Cases focus on the recognition of presenting features of sleep disorders and their clinical importance, using real life patients from sleep clinic. Each case report provides a detailed clinical description followed by a clear explanation of the salient points. The text is supported by photographs, diagrams and line drawing and concludes with a list of key learning points. Each case history reads as stand-alone, although a common theme of presenting features, clinical features, investigation and treatment is adhered to. Cases are written in an easy-flowing prose style in an attempt to simulate the experience of seeing and discussing a real life patient case in clinical practice.

The book is of interest to all clinicians who are likely to come across patients with sleep disorders in their clinical practice and wish to improve their understanding and knowledge of sleep disorders.

Readership: This book is useful to GPs, specialist trainees in respiratory medicine, neurologists, psychiatrists, undergraduate medical students and sleep physiologists. In addition, the book provides useful information to non-sleep specialists in medicine, surgery, dentistrty, and anaesthesia who are likely to come across sleep disorders.

Table of Contents

Section I: Snoring and Sleep Disordered Breathing
1: Snoring and witnessed apnoea in a 70 year old thin man
2: An obese post-menopausal woman snored like a tank
3: Severe OSA in overweight Chinese man-craniofacial features
4: Unable to throw a cricket ball & could not breathe at night
5: A sleepy bus driver
6: Rapid onset daytime sleep presenting as transient loss of consciousness
7: Unexplained breathlessness and pulmonary arterial hypertension in an obese man
8: Post-operative apnoeas and hypoxia due to undiagnosed OSA
9: Polycythemia got better with CPAP
10: Hyperphagia and sleep disorder in Prader Willi Syndrome
11: Shot in head - acquired hypothalamic syndrome
12: Collapsed in a Café: Acute Respiratory Failure
13: Overlap syndrome - COPD and OSA
14: Neuropsychological impairment in a psychoanalyst with post-polio syndrome
15: Nocturnal choking in a patient with a goitre and retrosternal extension
16: Obstructive sleep apnoea persists despite removal of a pituitary tumour causing acromegaly
17: CPAP transformed my life
18: Persistent daytime sleepiness despite CPAP
19: CPAP intolerance and non-compliance-treatment with mandibular advancement splint
20: Won't use CPAP - end up with tracheostomy
21: Bariatric surgery cures sleep apnoea
22: Sleep disturbance and daytime sleepiness persists in a snorer despite CPAP - Periodic Limb Movement Syndrome (PLMS)
23: Worrying pauses in breath without choking and snoring-Central Sleep Apnoea
24: Irresistible daytime sleepiness in a young obese woman.
Section II: Snoring and Obstructive Sleep Apnoea: Role of Dental and ENT surgeon
25: Contribution of facial skeletal pattern to sleep apnoea
26: Mandibular advancement splint therapy for severe obstructive sleep apnoea hypopnoea syndrome
27: Effectiveness, compliance and side effects of mandibular advancement splint therapy
28: Allergic rhinitis
29: Nasal polyposis
30: Septoplasty
31: Upper airways resistance syndrome
32: Laser Assisted UvuloPalatoplasty (LAUP)/tonsillectomy
33: Epiglottic trapdoor
34: Tracheostomy
Section III: Neurological Sleep Disorders
35: Sleep groaning
36: Nocturnal punch and fight
37: Jumpy legs
38: Episodic weak legs in a sleepy man
39: Just sleepy all the time
40: Moving and thrashing around during sleep
41: Panic attacks during sleep
42: Frozen in sleep
43: Confused, irritable and sleepy young man
44: Chattering teeth during sleep
45: Sexsomnia
Section IV: Insomnia and Circadian rhythm disorders
46: I keep falling asleep at family dinner
47: I haven't slept in years
48: Spending too long in bed
49: A sleep cycle that keeps moving
50: My body is in London but my body clock is in New York
51: A very, very long day
52: Sleep and alcohol abuse
53: Choosing and using hypnotics
54: Please see this patient who is addicted to sleeping pills
55: My body clock can't keep up

Authors

Himender Makker, Consultant Physician in Respiratory Medicine, North Middlesex University & University College London (UCL) Hospital, London, UK, Matthew Walker, Professor of Neurology, UCL Institute of Neurology, Queen Square, London, UK, Hugh Selsick, Psychiatrist, Royal London hospital for Intergrated Medicine, University College London Hospitals and Guy's Hospital., Bhik Kotecha, Consultant ENT Surgeon and Lead Clinician for Snoring and Sleep service, The Royal National Throat Nose and Ear Hospital, UCL, London & Barking, Havering and Redbridge University Hospital, London, UK, and Ama Johal, Senior Clinical Lecturer/Hon Consultant Orthodontist, Academic & Clinical Lead Orthodontics Institute of Dentistry Bart's & The London School of Medicine & Dentistry, Queen Mary College, London, UK

Dr Himender Makker is a Consultant Respiratory Physician with a special interest in sleep apnoea. He developed interest in sleep medicine while working as a Senior Registrar at the Birmingham Heartlands Hospital (1995-1997). On his appointment as a Consultant at UCLH in 1997, he developed a sleep service and established protocols and guidelines for the management of sleep apnoea. He created sleep research group in collaboration with neuropsychologists and medical physicists to investigate neuropsychological impairment in sleep apnoea. The research was funded by the CDRC grant, presented at the conferences, published in peer review journals, and contributed to MD of a research fellow. He organises and teaches at sleep apnoea the NE Thames Respiratory SpRs study days and the UCLH sleep apnoea course. He has a wider experience of raising awareness of sleep-disordered breathing through writing articles for the local newspaper and health magazines, and interview/talks on Radio and TV.

Prof Matthew Walker graduated from Cambridge University and St Thomas' Hospital in 1989, and is now Professor of Neurology at the Institute of Neurology, UCL and Consultant Neurologist at the National Hospital for Neurology and Neurosurgery. He specializes in epilepsy, neurological sleep disorders, and video-EEG telemetry. In addition, he has an active research laboratory investigating synaptic physiology and epilepsy. He is also associate editor of Epilepsia and Therapeutic Advances in Neurological Disorders, an executive member of the Joint Epilepsy Council of Great Britain and Ireland and a council member of the UK chapter of the ILAE.

Dr Hugh Selsick graduated with a BSc in Physiology, a BSc Honours in Experimental Physiology and MBBCh at the University of the Witwatersrand, Johannesburg. He is the lead consultant psychiatrist at the Insomnia Clinic in the Royal London Hospital for Integrated Medicine/University College London Hospitals and also works as a consultant in sleep medicine at the Sleep Disorders Centre at Guyâs Hospital in London. He is the chair of the Sleep Working Group in the Faculty of Neuropsychiatry at the Royal College of Psychiatrists. His special interests are insomnia and the relationship between sleep and psychiatric disorders.

Mr Bhik Kotecha graduated from Cardiff in 1984 and started his training in ENT in Manchester as an SHO and a Registrar. He then moved to Sussex University to complete his M.Phil. thesis on Ototoxicity before joining Royal National Throat, Nose & Ear Hospital as a Senior Registrar. He was appointed as an ENT Consultant in 1995 and has helped in establishing the Sleep disorder Unit at RNTNEH. In 2004, we were awarded the Hospital Doctor Team of the Year award for Sleep Medicine. He is an examiner for MRCS at Royal College of Surgeons of England and an assistan Editor for Journal of Laryngology and Otology. He is the immediate past president of the Sleep Medicine Section at the Royal Society of Medicine (2009-2011).

Ama Johal is a Senior Clinical Lecturer /Hon. Consultant Orthodontist at Bart's and The London School of Medicine and Dentistry, Queen Mary University of London. He is both Academic and Clinical lead for Orthodontics, within the Institute of Dentistry. Both his research and clinical work has been rewarded with numerous National and International prizes and grants. His research interests include the impact of quality of life in orthodontics and the management of patients with sleep-related breathing disorders, in which he has published widely. His specialist Clinical interests include multidisciplinary care of patients with orthodontic-restorative needs and sleep disorders management using mandibular advancement appliances. He is a member of The Angle Society of Europe.