Obtaining a Sleep History
➤ A comprehensive sleep history should include inquiries into sleep
patterns (onset, maintenance), sleep quantity and quality, daytime
alertness or somnolence, and other factors that may influence sleep
(e.g., work schedule, sleeping arrangements, use of electronics before
bedtime).
➤ Screening for sleep and circadian rhythm disorders involves both
subjective measures (history-taking and questionnaires) and
objective measures (laboratory studies).
Sleep and Circadian Rhythm Disorders
➤ Sleep disorders are a heterogeneous group of conditions that
diminish the quantity or quality of sleep, leading to sleep deprivation.
➤ Circadian rhythm disorders occur when symptoms arise from a
misalignment of behaviors with the biological rhythm.
• Some of these disorders are intrinsic (delayed sleep phase syndrome),
while others result f rom extrinsic factors ( jet lag disorder or shift work
disorder).
➤ Assessment for the presence of sleep or circadian rhythm disorders
includes a comprehensive sleep history, validated screening
questionnaires, and review of published recommendations for sleep
duration and proper sleep hygiene.
➤ Sleep quality encompasses both subjective and objective dimensions.
• The subjective aspect refers to the patient's satisfaction with overall
sleep, onset, duration, and the absence of disturbances.
• Objective measures include polysomnography parameters such as
sleep eff iciency, wake after sleep onset, and arousal index.
• Some metrics can be measured over several days using actigraphy.
Menopause
➤ Associated vasomotor symptoms adversely affect sleep continuity
and duration. Sleep disruption promotes increased energy intake and
metabolic dysfunction.
Lipedema
➤ Chronic leg pain can disrupt sleep patterns.
Osteoarthritis/Degenerative Joint Disease
➤ Nocturnal pain can disrupt sleep.
Assessment
