Sleep Studies – Patient Instructions
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The Importance of Healthy Sleep
THE IMPORTANCE OF HEALTHY SLEEP Disorders like Sleep Apnea, Periodic Limb Movement Disorder, Narcolepsy and Insomnia negatively impact your health. It is estimated that Sleep Apnea affects approximately 40 million people, with 90% going undiagnosed. TABLE OF CONTENTS Are you at risk?- Sleep Disorders Questionnaire • Epworth Sleepiness Scale • STOP BANG- Sleep Apnea Screening Questionnaire Sleep Disorders • Sleep Apnea • Narcolepsy • Restless Leg Syndrome/Periodic Limb Movement Disorder • Insomnia • Snoring Testing • Polysomnography • Portable Home Sleep Study • Split night • CPAP titration • MSLT- Multiple Sleep Latency Study • High Resolution Pulse Oximetry Screening Types of Treatment • CPAP • Oral Appliances • Surgical Interventions Sleep Health/Good Sleep Hygiene Sleep Lab at Wayne HealthCare Resources and References 3 DID YOU KNOW? According to the National Heart, Lung, and Blood Institute: • Approximately 42 million American adults suffer from sleep-disordered breathing (SDB) • 1 in 5 adults has mild OSA (Obstructive Sleep Apnea) • 1 in 15 has moderate to severe OSA (75% to 90% of severe SDB cases remain undiagnosed) • 9% of middle-aged women suffer from OSA • 25% of middle-aged men suffer from OSA For more information visit www.nhlbi.nih.gov. Sleep apnea that goes untreated can worsen conditions such as: • Coronary Artery Disease • Hypertension • Atrial Fibrillation • Type-2 Diabetes • Congestive Heart Failure • Obesity • Stroke • Glacoma 4 ARE YOU AT RISK? The Epworth Sleepiness Scale How likely are you to doze off or fall asleep in the following situations in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently try to work out how they would have affected you. -
ENO Directory Over 20 Years Ago We Pioneered the Hammock Counter-Culture
ENO Directory Over 20 years ago we pioneered the hammock counter-culture. Environmental Conservation As a hammock company, we know the importance of trees and so do our customers. Since then, we’ve ventured We believe that when given the chance, individuals will use their purchasing power from mountains to sea, to protect the planet, which is why we plant two trees in an area of need for every hammock sold. Additionally, we proudly pledge 1% of our annual sales to support from backyard to backcountry, nonprofit organisations focused on environmental solutions. and everywhere in between. — MEMBER — No matter your passion or pursuit, our tried-and-true products outfit Materials & Chemistry you with an all-access pass to We are committed to the journey of building more sustainable and responsibly made explore, connect and relax... products. This includes sourcing high-quality materials with post-consumer recycled content and bluesign® approved chemistry, as well as adopting safer ingredients for water repellents, colour dyes, and beyond. We have adopted the industry leading bluesign® Restricted Substances List (RSL) which provides a comprehensive system for managing chemical hazards, workplace safety, and environmental impacts during material production. To support our RSL, we have set up a testing program with an accredited third-party laboratory and have placed an emphasis on priority chemicals of concern established by the outdoor industry. We look forward to sharing our progress along the way. Hammocks 3 - 6 Social Responsibility We protect the welfare of our community and the planet from the beginning to the end Specialist Hammocks 7 - 9 of our product life cycle through a strict code of conduct, product repair and take- back programs. -
2021 Magellan Clinical Guidelines for Medical Necessity Review
National Imaging Associates, Inc.* 2021 Magellan Clinical Guidelines For Medical Necessity Review SLEEP STUDY GUIDELINES Effective January 1, 2021 – December 31, 2021 *National Imaging Associates, Inc. (NIA) is a subsidiary of Magellan Healthcare, Inc. Copyright © 2019-2021 National Imaging Associates, Inc., All Rights Reserved Guidelines for Clinical Review Determination Preamble Magellan is committed to the philosophy of supporting safe and effective treatment for patients. The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging. These criteria are designed to guide both providers and reviewers to the most appropriate diagnostic tests based on a patient’s unique circumstances. In all cases, clinical judgment consistent with the standards of good medical practice will be used when applying the guidelines. Determinations are made based on both the guideline and clinical information provided at the time of the request. It is expected that medical necessity decisions may change as new evidence-based information is provided or based on unique aspects of the patient’s condition. The treating clinician has final authority and responsibility for treatment decisions regarding the care of the patient. 2021 Magellan Clinical Guidelines-SLEEP STUDY 2 Guideline Development Process These medical necessity criteria were developed by Magellan Healthcare for the purpose of making clinical review determinations for requests for therapies and diagnostic procedures. The developers of the criteria sets included representatives from the disciplines of radiology, internal medicine, nursing, cardiology, and other specialty groups. Magellan’s guidelines are reviewed yearly and modified when necessary following a literature search of pertinent and established clinical guidelines and accepted diagnostic imaging practices. -
Excessive Daytime Sleepiness in Children and Adolescents Across the Weight Spectrum
Excessive Daytime Sleepiness in Children and Adolescents across the Weight Spectrum by Lilach Kamer A thesis submitted in conformity with the requirements for the degree of Master of Science Institute of Medical Science University of Toronto © Copyright by Lilach Kamer 2011 Excessive Daytime Sleepiness in Children and Adolescents across the Weight Spectrum. Lilach Kamer Master of Science Institute of Medical Science University of Toronto 2011 Abstract A relationship between overweight and excessive daytime sleepiness (EDS) has been suggested in the adult population, and to a limited extent in the pediatric population. Daytime sleepiness can interfere with various components of daytime function. In light of the increase in the rates of pediatric overweight and obesity, the aim of this study was to investigate the relationship between weight and EDS in a pediatric population. Using a retrospective approach, data collected in a pediatric sleep clinic was analyzed. Objective measures of EDS were correlated with age, gender, body mass index percentile, and overnight sleep test recording variables. In males and in all children under the age of 13 years old, EDS was more common in those weighing above the normal range, EDS was present particularly during mid-morning hours. Additionally, weight above the normal range correlated with evidence of EDS after adjusting for measures of sleep pathologies. - ii - Acknowledgments First and foremost, I would like to thank my supervisor, Dr. Colin Shapiro for the opportunity to work and learn at the Youthdale Child and Adolescent Sleep Center, and for patiently developing my budding research skills. To the staff at the Youthdale Child and Adolescent Sleep Center, especially Dragana Jovanovic and Inna Voloh, for introducing me into the intricate world of pediatric sleep testing as well as Dora Zalai and Rose Lata for their patience, advice, dedication and willingness to accommodate my research needs…and for smiling while they do this. -
Contemporary DIY Four Poster Bed
Contemporary DIY Four Poster Bed Here are a few housekeeping items before you start that will make this project even easier to tackle. First, this bed needs to be assembled in the space in the bedroom it will be in. The assembled parts are larger than a doorway. I stained and waxed my wood pieces before assembling. Since the wood was already finished, I placed a heavy moving blanket on the floor to protect the wood from scratches. Time to complete: 2-3 days Lumber: 2 - 1” x 2” x 8ft poplar 16 - 1” x 3” x 6ft poplar 2 – 2” x 2” x 6ft poplar 6 - 1” x 6” x 6ft maple 3 – 2” x 2” x8ft maple 2 – 2” x 3” x 8ft maple 2 – 2” x 6” x 6ft maple 4 – 3” x 3” x 8ft maple Materials: Pocket screws 1 ¼ Pocket screws 2 ” Wood screws 1 ¼ ” Wood screws 1 ½ “ Wood glue Sand paper Stain or paint to finish Cut List: Maple 4 - 3” x 3” at 78 ¾” bed posts 2 - 2” x 2” at 60 ½“ top rails 2 - 2” x 6” at 60 ½” footboard and lower headboard planks 6 – 1” x 6” at 60 ½” headboard planks 2 – 2” x 2” at 80 ½” upper rails 2 – 2” x 4” at 80 ½” lower side rails Poplar 2 – 1’ x 2’ at 80 ½” slat cleat 1 – 2’ x 2’ at 80 ½” center support 1 – 2” x 2” at 9 ¼” center support legs 16 – 1” x 3” at 60 ½” slats Preparation Cut, sand and finish all of the maple pieces. -
Sleeping While Awake Lant
CONSCIOUSNESS REDUX “It was literally true: I was going through life asleep. My body had no more feeling than a drowned corpse. My very existence, my life in the world, seemed like a hallucination. A strong wind would make me think my body was about to be blown to the end of the earth, to some land I had never seen or heard of, where my mind and body would separate forever.” —From Sleep, by Haruki Murakami, 1989 PHYSIOLOGY turn off—your mind remains hypervigi- Sleeping While Awake lant. You toss and turn but can’t find the blessed relief of sleep. The reasons for During microsleep, the entire brain nods off so briefly that we often don’t notice it. sleeplessness may be many, but the con- ) Now research shows that individual neurons in the brain can slumber, too, sequences are always the same: You are Koch fatigued the following day, you feel especially when we are sleep-deprived E ( sleepy, you nap. Attention wanders, your B CA We’ve all been there. You go to bed, reaction time slows, you have less cogni- C close your eyes, blanket your mind and tive-emotional control. Fortunately, BY CHRISTOF KOCH wait for consciousness to fade. A timeless fatigue is reversible and disappears after ); SEAN M Christof Koch is president interval later, you wake up, refreshed a night or two of solid sleep. and chief scientific officer at and ready to face the challenges of a new We spend about one third of our lives the Allen Institute for Brain day (note how you can never catch your- in a state of repose, defined by relative illustration Science in Seattle. -
Evaluating and Managing Sleep Disorders
Evaluating & Managing Sleep Disorders Julia Aziz, M.D. Daniel Lewin, Ph.D., D.ABSM Division of Pediatric Pulmonology and Sleep Medicine Children’s National Health System Washington, D.C. Future of Pediatrics, 2019 Topics • Basics about sleep • Effects of insufficient sleep • Common sleep problems and disorders: signs symptoms and treatment Awake Drowsy Stage 1 Stage 2 Stage 3 Stage REM Hypnogram Sleep Stage Distribution Wake REM Stage 1 Stage 2 Stage 3 Time 2200 2400 200 400 600 800 NonREM Stage 3 is dominant during the first half of night Sleep stage REM is dominant during the second half of night Process S Sleep Homeostatic Process C Circadian Sleep Academic Award, Gerald Rosen Process S Sleep drive Homeostatic Reduced Sleep drive 1st sleep 2nd sleep Process C Circadian Sleep Academic Award, Gerald Rosen Sleep Time and Timing Sleep and Circadian Health Effects • Metabolism regulation and energy expenditure • Physical restoration • Tissue repair • Neuronal recalibration • Memory consolidation The Sleep Habits Assessment Bedtime EDS Awakenings Regularity Snoring (Excessive Daytime Somnolence) .Routine .Hyperactivity .Call outs .Schedule .Volume .Resistance .Irritability .Partial Arousal .Age .Pauses .Fears .Difficulty waking .Restlessness .Periodicity Adapted from: Mindel, JA, & Owens. A Clinical Guide to Pediatric Sleep: Diagnosis and Management of Sleep Problems. Lippincott, Williams & Wilkins. Philadelpha (2003) Outline I. Evaluating & Managing obstructive sleep apnea (OSA) – Clinical assessment of OSA – Who, when, where and how to -
THE SLEEP CENTER at BACHARACH Treating Sleep Problems in Adults and Children in the Region's Most Advanced
Our sleep center has been designed to make you feel relaxed and comfortable, with amenities you’d find at a luxury hotel: • Flat screen TV in every sleep suite • Extended-tier cable • Individually decorated suites • Private bathroom with shower • Wireless high-speed Internet access THE SLEEP CENTER • Continental breakfast AT BACHARACH • Individual room temperature control 54 West Jimmie Leeds Road Pomona, NJ 08240 Advanced sleep medicine in a luxurious setting The Sleep Center. It’s one more reason we are recommended by our peers. Honored by our profession. Applauded by our patients. The Sleep Center is open Monday–Friday, 8:30 a.m. - 4:30 p.m. Testing is available 24/7. THE SLEEP CENTER AT BACHARACH Treating sleep problems in adults and children in the region’s most advanced (and comfortable) setting. bacharach.org • (609) 748-5405 bacharach.org • (609) 748-5405 THE BACHARACH SLEEP PROBLEMS IN CHILDREN Does the thought of falling SLEEP TEAM CAN HELP In children, a sleep disorder may be the culprit in cases Normal sleep follows a predictable structure, moving of obesity, bedwetting, sleepwalking, nightmares and asleep fill you with worry? in stages from drowsiness to deep sleep. Sleep disorders difficulty in school. Bacharach is proud to be the only disrupt this cycle, robbing your body of the rest it needs pediatric sleep center in the region. Do you spend your nights to function. But don’t despair, our Sleep Center is fully equipped to diagnose sleep problems with a variety of A PLAN THAT WILL snoring or gasping for testing options. LET YOU REST EASY First, you’ll meet with a physician — board-certified in The sleep team brings together advanced diagnostic tools breath? Do you awake Sleep Medicine — who will perform a physical exam and and years of experience to develop a care plan that’s take a comprehensive history. -
WHO Technical Meeting on Sleep and Health
WHO technical meeting on sleep and health Bonn Germany, 22-24 January 2004 World Health Organization Regional Office for Europe European Centre for Environment and Health Bonn Office ABSTRACT Twenty-one world experts on sleep medicine and epidemiologists met to review the effects on health of disturbed sleep. Invited experts reviewed the state of the art in sleep parameters, sleep medicine and, long-term effects on health of disturbed sleep in order to define a position on the secondary and long- term effects of noise on sleep for adults, children and other risk groups. This report gives definitions of normal sleep, of indicators of disturbance (arousals, awakenings, sleep deficiency and fragmentation); it describes the main sleep pathologies and disorders and recommends that when evaluating the health impact of chronic long-term sleep disturbance caused by noise exposure, a useful model is the health impact of chronic insomnia. Keywords SLEEP ENVIRONMENTAL HEALTH NOISE Address requests about publications of the WHO Regional Office to: • by e-mail [email protected] (for copies of publications) [email protected] (for permission to reproduce them) [email protected] (for permission to translate them) • by post Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark © World Health Organization 2004 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. -
Safe Sleep: Information for Parents
Safe Sleep: Information for Parents SIDS Crib The term SIDS, or sudden infant death syndrome, A crib can be a crib, bassinet, Pack-N-Play, is used to describe when babies die in their sleep play-yard, or playpen, but it should have a firm without any warning before their first birthday. In mattress and be covered with a well-fitted sheet the early 1990s, parents were told to stop putting only. It is very dangerous for babies to sleep on babies on their tummies to sleep. They were told to a sofa or armchair, because they can wiggle as put them on their backs or sides only. Later, they sleep and get trapped and be smothered. It experts said the side position wasn’t safe either, so is also not safe for them to sleep in a car seat, parents were told to put their babies only on their bouncy seat, swing, baby carrier, or sling, backs. because their neck can bend in ways that makes it hard for them to breathe. Today, we know that just putting babies on their backs to sleep is not enough to keep some of them There are some other very important things that from dying in their sleep. There are many other can help babies sleep safely: easy things parents can do to keep their babies safe Smoking—Keep babies away from people when they sleep. who smoke. We know that babies who are around people who smoke or babies born to Safe Sleep mothers who smoke have a higher risk of “ABC” is an easy way to remember how to make SIDS. -
Sleep Services: Sleep Study, Insomnia
Sleep Services: Sleep Study, Insomnia POLICY INITIATED: 06/30/2019 MOST RECENT REVIEW: 06/30/2019 POLICY # HH-4826 Overview Statement The purpose of these clinical guidelines is to assist healthcare professionals in selecting the medical service that may be appropriate and supported by evidence to improve patient outcomes. These clinical guidelines neither preempt clinical judgment of trained professionals nor advise anyone on how to practice medicine. The healthcare professionals are responsible for all clinical decisions based on their assessment. These clinical guidelines do not provide authorization, certification, explanation of benefits, or guarantee of payment, nor do they substitute for, or constitute, medical advice. Federal and State law, as well as member benefit contract language, including definitions and specific contract provisions/exclusions, take precedence over clinical guidelines and must be considered first when determining eligibility for coverage. All final determinations on coverage and payment are the responsibility of the health plan. Nothing contained within this document can be interpreted to mean otherwise. Medical information is constantly evolving, and HealthHelp reserves the right to review and update these clinical guidelines periodically. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from HealthHelp. All trademarks, product names, logos, and brand names are the -
Effectiveness of Weighted Blankets As an Intervention for Sleep Problems in Children with Autism”
EFFECTIVENESS OF WEIGHTED BLANKETS AS AN INTERVENTION FOR SLEEP PROBLEMS IN CHILDREN WITH AUTISM Thesis submitted in partial fulfilment of a Master of Science in Child and Family Psychology at the University of Canterbury by Jane Charleson University of Canterbury 2014 2 Contents List of Tables ................................................................................................................. 6 List of Figures ................................................................................................................ 7 Acknowledgements ........................................................................................................ 8 Abstract .......................................................................................................................... 9 Chapter 1 Introduction ................................................................................................. 10 Definition of autism spectrum disorder ................................................................... 11 Development of sleep in children ............................................................................ 12 Assessment of sleep ................................................................................................. 14 Definition of sleep problems .................................................................................... 16 Prevalence and nature of sleep problems in children with autism ........................... 18 Development and maintenance of sleep problems in children with autism ............