Abstract: How to identify and manage common sleep problems “. . . sleep and watchfulness, both of them when immoderate constitute disease” Hippocrates c 400BC All medical students can doubtless relate to the immediate consequences of disturbed sleep.1 The average UK medical student, however, receives little or no training in sleep medicine,2 yet this vital physiological process will occupy a third of our adult lives and disrupted sleep has immediate and long term consequences on physical and mental health.3 In most Western societies, we live in a world of sleep restriction and shift working, with the average adult now sleeping an hour a night less compared with the turn of the century.4 This article will provide the tools to identify when someone presents with signs or symptoms associated with poor sleep, when to take a sleep history, and how to identify and manage common sleep disorders, which can be a cause of considerable morbidity in hospitals and in the community.5 Sleep disorders fall into one or more of four categories: hypersomnia, insomnia, circadian rhythm disorders, and parasomnias. Common evening and night time disorders also include restless legs syndrome and associated periodic limb movements of sleep. Screening questions often help to identify the sleep problem that you are dealing with (box 1). Thereafter, sleep problems are best characterised on the basis of a thorough history. A collateral history from the bed partner is often helpful to define any restless legs, sleepwalking or parasomnia, snoring, and breathing abnormalities. Discussing the patient’s ideas about sleep, any concerns they might have, and their expectations of normal sleep is often worth while. #### Box 1: Sleep history questions
Publication Year: 2014
Publication Date: 2014-07-01
Language: en
Type: article
Indexed In: ['crossref']
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