Principles and Practice of Sleep Medicine

By Meir H. Kryger, MD. FRCPC, Professor, Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut;

Thomas Roth, PhD, Division Head, Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, Michigan

William C. Dement, MD, PhD, Lowell W. and Josephine Q. Berry Professor of Psychiatry and Behavioral Sciences; Stanford University School of Medicine, Sleep Sciences and Medicine, Stanford, California

Section 1: Normal Sleep and Its Variance

1. History of Sleep Physiology and Medicine

2. Normal Human Sleep: An Overview

3. Normal Aging

4. Daytime Sleepiness and Alertness

5. Sleep Deprivation

6. Genetics of Normal Human Sleep

Section 2: Sleep Mechanisms and Phylogeny

7. Neural Control of Sleep in Mammals

8. Rapid Eye Movement Sleep

9. Novel Techniques for identifying Sleep Mechanisms and Disorders

10. Sleep in Animals: A State of Adaptive Inactivity



Section 3: Physiology in Sleep

11. Relevance of Sleep Physiology for Sleep Medicine Clinicians

12. What Brain Imaging Reveals about Sleep Generation and Maintenance?

13. Cardiovascular Physiology and Coupling with Respiration: Central and Autonomic Regulation

14. Cardiovascular Physiology: Autonomic Control in Health and in Sleep Disorders

15. Respiratory Physiology: Central Neural Control of Respiratory Neurons and Motoneurons during Sleep

16. Respiratory Physiology: Understanding the Control of Ventilation

17. Physiology of Upper and Lower Airways

18. Respiratory Physiology: Sleep at High Altitudes

19. Sleep and Host Defense

20. Endocrine Physiology in Relation to Sleep and Sleep Disturbances

21. Thermoregulation in Sleep and Hibernation

22. Memory Processing in Relation to Sleep

23. Sensory and Motor Processing During Sleep and Wakefulness

24. Opiate Action on Sleep and Breathing

25. Pathophysiology of Sleep-wake Disturbances After Traumatic Brain Injury



Section 4: Genetics and Genomic Basis of Sleep

26. Introduction: Genetics and Genomics of Sleep

27. Genetics and Genomics of Circadian Clocks

28. Genetics and Genomic Basis of Sleep in Simple Model Organisms

29. Genetics and Genomic Basis of Sleep in Rodents

30. Genetics and Genomic Basis of Sleep in Healthy Humans

31. Genetics and Genomic Basis of Sleep Disorders in Humans



Section 5: Chronobiology

32. Introduction: Master Circadian Clock and Master Circadian Rhythm

33. Anatomy of the Mammalian Circadian System

34. Physiology of the Mammalian Circadian System

35. Human Circadian Timing System and Sleep-Wake Regulation

36. Sleep Homeostasis and Models of Sleep Regulation

37. Circadian Rhythms in Sleepiness, Alertness, and Performance

38. Central and Peripheral Circadian Clocks

39. Circadian Dysregulation and Mental and Physical Health

40. Circadian Disorders of the Sleep-Wake Cycle



Section 6: Pharmacology

41. Hypnotic Medications: Mechanisms of Action and Pharmacologic Effects

42. Clinical Pharmacology of Other Drugs Used as Hypnotics

43. Wake-Promoting Medications: Basic Mechanisms and Pharmacology

44. Wake-Promoting Medications: Efficacy and Adverse Effects

45. Drugs That Disturb Sleep and Wakefulness

46. Effects of Hypnotic Drugs on Driving Performance



Section 7: Psychobiology and Dreaming

47. Introduction

48. Why We Dream

49. Dream Content: Quantitative Findings

50. Brain Correlates of Sucessful Dream Recall

51. Neurobiology of Dreaming

52. Lucid Dreaming

53. Nightmares and Nightmare Function

54. Incorporation of waking Experiences into Dreams

55. Dreams and Nightmares in Posttraumatic Stress Disorder

56. Emotion, Motivation, and Reward in Relation to Dreaming



Section 8: Impact, Presentation, and Diagnosis

57. Approach to the Patient with Disordered Sleep

58. Cardinal Manifestations of Sleep Disorders

59. Physical Examination in Sleep Medicine

60. Use of Clinical Tools and Tests in Sleep Medicine

61. Classification of Sleep Disorders

62. Epidemiology of Sleep Medicine

63. Sleep Medicine, Public Policy, and Public Health

64. Sleep and Athletic Performance





Section 9: Legal Topics in Sleep Medicine

65. Sleep Forensics: Criminal Culpability for Sleep-Related Violence

66. Legal Obligations of Persons Who Have Sleep Disorders or Who Treat or Hire Them

67. Legal Aspects of Fatigue-and Safety-Sensitive Professions

68. Sleep Medicine Clinical Practice and Compliance - United States

69. Sleep Medicine Clinical Practice and Compliance - Europe



Section 10: Occupational Sleep Medicine

70. Introduction

71. Performance Deficits During Sleep Loss and Their Operational Consequences

72. Sleep and Performance Prediction Modeling

73. Fatigue Risk Management Systems

74. Drowsiness in Transportation Workers

75. Shift Work, Shift-Work Disorder, and Jet Lag

76. Sleep Problems in First Responders and in Deployed Military Personnel

77. Sleep, Occupational stress, and Burnout

78. Optimizing Shift Scheduling

79. Obstructive Sleep Apnea in the Workplace



Section 11: Insonmnia

80. Insomnia: Recent Developments and Future Directions

81. Insomnia: Epidemiology and Risk Factors

82. Etiology and Pathophysiology of Insomnia

83. Insomnia Diagnosis Assessment, and Evaluation

84. Insomnia and Health

85. Cognitive Behavioral Therapies for Insomnia I: Approaches and Efficacy

86. Psychological and Behavioral Treatments for Insomnia II: Implementation and Specific Population

87. Pharmacologic Treatment of Insomnia: Benzodiazepine Receptor Agonists

88. Pharmacologic Treatment of Insomnia: Other Medication



Section 12: Neurological Disorders

89. Narcolepsy: Genetic, Immunology, and Pathophysiology

90. Narcolepsy: Diagnosis and Management

91. Idiopathic Hypersomnia

92. Parkinsonism

93. Sleep and Stroke

94. Sleep and Neuromuscular Diseases

95. Restless Legs Syndrome and Periodic Limb Movements During Sleep

96. Alzheimer's Disease and Other Dementias

97. Epilepsy, Sleep, and Sleep Disorders

98. Other Neurological Disorders

99. Sleep Disorders after Traumatic Brain Injury

100. Kleine-Levin Syndrome



Section 13: Parasomnias

101. Parasomnias: Overview and Approach

102. Non-Rapid Eye Movement Parasomnias: Clinical Spectrum, Diagnostic Features, and Management

103. Rapid Eye Movement Sleep Parasomnias

104. Nightmares and Dream Disturbances

105. Other Parasomnias

106. Sleep-Related Movement Disorders and Their Unique Motor Manifestations



Section 14: Sleep Breathing Disorders

107. Sleep Related Breathing Disorders: Classification

108. Sleep Breathing Disorders: Clinical Overview

109. Central Sleep Apnea: Definitions, and Pathophysiology, Genetics, and Epidemiology

110. Central Sleep Apnea: Diagnosis and Management

111. Anatomy and Physiology of Upper Airway Obstruction

112. Snoring and Pathologic Upper Airway Resistance Syndromes

113. Obstructive Sleep Apnea: Phenotypes and Genetics

114. Obstructive Sleep Apnea: Clinical Features, Evaluation, and Principles of Management

115. Positive Airway Pressure Treatment for Obstructive Sleep Apnea

116. Medical and Device Treatment for Obstructive Sleep Apnea: Alternative, Adjunctive, and Complementary Therapies

117. Obstructive Sleep Apnea and the Central Nervous System: Neural Adaptive Processes, Cognition and Performance

118. Obstructive Sleep Apnea and Metabolic Disorders

119. Overlap Syndromes of Sleep and Breathing Disorders

120. Obesity Hypoventilation Syndrome

121. Obstructive Sleep Apnea, Obesity, and Bariatric Surgery

122. Sleep and Breathing at High Altitude



Section 15: Cardiovascular Disorders

123. Sleep and Cardiovascular Disease: Present and Future

124. Sleep-Related Cardiac Risk

125. Cardiac Arrythmogenesis during Sleep: Mechanisms, Diagnosis, and Therapy

126. Cardiovascular Effects of Sleep-Related Breathing Disorders

127. Systemic and Pulmonary Hypertension in Obstructive Sleep Apnea

128 Coronary Artery Disease and Obstructive Sleep Apnea

129. Heart Failure



Section 16: Other Medical Disorders

130. Sleep and Fatigue in Cancer Patients

131. Fibromyalgia and Chronic Fatigue Syndromes

132. Endocrine Disorders

133. Pain and Sleep

134. Sleep and Chronic Kidney Disease

135. Sleep in Critically Ill Patients



Section 17: Psychiatric Disorders

136. Anxiety Disorders and Posttraumatic Stress Disorder

137. Unipolar Major Depression

138. Bipolar Disorder

139. Schizophrenia

140. Medication and Substance Abuse

141. Sleep Disturbances in Attention-Deficit/Hyperactivity Disorder



Section 18: Dentistry and Otolaryngology in Sleep Medicine

142. Role of Dentistry and Otolaryngology in Sleep Medicine

143. Orophayngeal Growth & Skeletal Malformations

144. Sleep Bruxism: Definition, Prevalence, Classification, Etiology, and Consequences

145. Sleep Bruxism: Diagnostic Considerations

146. Orofacial Pain and Temporomandibular Disorders in Relation to Sleep-Disordered Breathing and Sleep Bruxism

147. Oral Appliances for the Treatment of Obstructive Sleep Apnea-Hypopnea Syndrome and for Concomitant Sleep Bruxism

148. Anesthesia in Upper Airway Surgery for Obstructive Sleep Apnea

149. Upper Airway Surgery to Treat Obstructive sleep-Disordered Breathing

150. Pharmacotherapy, Complementary, Alternative Medicine for Sleep Bruxism



Section 19: Sleep in Older Adults

151. Psychiatric and Medical Comorbidities, and Effects of Medications in Older Adults

152. Obstructive Sleep Apnea in Older Adults

153. Insomnia in Older Adults

154. Circadian Rhythms in Older Adults



Section 20: Sleep in Women

155. Sex Differences and Menstrual-Related Changes in Sleep and Circadian Rhythms

156. Sleep and Sleep Disorders Associated with Pregnancy

157.Sleep-Disordered Breathing in Pregnancy

158. Postpartum Period and Early Motherhood

159. Sleep and Menopause



Section 21: Instrumentation and Methodology

160. Polysomnography and Beyond

161. Sleep Stage Scoring

162. Central Nervous System Arousals & Cyclic Alternating Patterns

163. Neurologic Monitoring Techniques

164. Monitoring Techniques for Evaluating Suspected Sleep-Related Breathing Disorders

165. Home Sleep Testing

166. Cardiopulmonary Coupling Sleep Spectrograms

167. Pulse Wave Analysis During Sleep

168. Recording and Scoring Sleep-Related Movements

169. Evaluating Sleepiness

170. Chronobiologic Monitoring Techniques

171. Actigraphy

"More than a textbook - it is an experience ... A must-have for sleep professionals...an essential addition to the library of any clinician interested in learning more about how sleep medicine interrelates with nearly every field of medicine." - JAMA, review of the last edition