Fundamentals of Sleep Medicine
- 2nd Edition - June 30, 2024
- Imprint: Elsevier
- Authors: Richard B. Berry, Mary H. Wagner, Scott M. Ryals
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 8 1 0 8 1 - 4
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 8 1 0 8 2 - 1
Master the basics of sleep medicine with this easy to read, award-winning text! Fundamentals of Sleep Medicine, 2nd Edition, by Drs. Richard B. Berry, Mary H. Wagner, and Scott M.… Read more
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Request a sales quoteMaster the basics of sleep medicine with this easy to read, award-winning text! Fundamentals of Sleep Medicine, 2nd Edition, by Drs. Richard B. Berry, Mary H. Wagner, and Scott M. Ryals, is an ideal resource for sleep medicine fellows and trainees, sleep technicians, and sleep medicine practitioners as a concise, clinically focused alternative to larger references. Beginning with core content, it then proceeds to information useful for everyday practice—all written in a clear, direct style designed for quick and easy access.
- Features video content that demonstrates common sleep disorders.
- Includes more than 350 updated multiple-choice questions and answers for self-assessment and board preparation.
- New! Offers concise Key Points at the end of each chapter, expanding on information from Drs. Berry and Wagner’s popular book Sleep Medicine Pearls to enhance your understanding.
- Provides updated references to AASM scoring guidelines and diagnostic criteria for sleep disorders.
- Illustrated with numerous diagrams, charts, and polysomnograms (sleep studies) to clarify complex concepts.
- An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud.
Sleep medicine specialists
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- Preface
- Acknowledgments
- Video table of contents
- List of Illustrations
- List of Tables
- 1. Sleep stages and basic sleep monitoring
- Sleep stage nomenclature
- EEG monitoring during sleep
- EOG monitoring for sleep
- Chin (submental) EMG monitoring
- Abbreviations
- Clinical review questions
- Answers
- Suggested reading
- References
- 2. The technology and methods of sleep monitoring (differential amplifiers, digital polysomnography, and biocalibration)
- Digital polysomnography overview
- Recording sleep
- Digital system overview
- Grounds and electrical safety
- Abbreviations
- Clinical review questions
- Answers
- Suggested reading
- References
- 3. Staging sleep in adults
- Introduction
- Overview of staging sleep in adults
- Scoring by epochs
- Scoring stage W (wake fulness)
- Scoring stage N1
- Scoring stage N2
- Scoring stage N3
- Scoring stage R (rapid eye movement sleep)
- Major body movements
- Scoring arousals
- Clinical review questions
- Answers
- Suggested reading
- References
- 4. Artifacts and common variants of sleep
- Artifacts
- Common variants seen during sleep monitoring
- Abbreviations
- Clinical review questions
- Answers
- Suggested reading
- References
- 5. Sleep staging in infants and children
- Age range at which scoring rules apply
- Sleep in premature infants
- AASM scoring rules for term infants postmenstrual age 37-48 weeks
- Scoring the sleep stages in term infants with a PMA 37 to 48 weeks
- Sleep architecture in term infants and children
- Sleep scoring in children 2 months post-term or older
- Clinical review questions
- Answers
- Suggested reading
- References
- 6. Normal sleep architecture in adults
- Sleep architecture terminology
- Normal sleep in adults
- Gender differences in sleep architecture
- First-night effect
- Comparison of sleep staging between the AASM scoring manual and rechtschaffen and kales
- Arousal index
- Defining a normal range
- Limitations of the current sleep architecture analysis
- Clinical review questions
- Answers
- Suggested reading
- References
- 7. Normal sleep in children and infants
- Normal sleep in infants and children
- Recommended sleep duration
- Clinical review questions
- Answers
- Suggested reading
- References
- 8. Neurobiology of sleep and wakefulness
- Introduction
- Neurotransmitters/neuromodulators
- Major brain areas important for sleep and wakefulness
- Control of wakefulness
- Control of NREM sleep
- Control and manifestations of REM sleep
- Medications and neurobiology
- Homeostatic drive and circadian control of sleep
- Abbreviations
- Clinical review questions
- Answers
- Suggested reading
- References
- 9. Sleep loss and effects of sleep disorders and medications on sleep
- Effects of sleep loss on sleep architecture
- Effects of sleep disorders and medications on sleep architecture
- Caffeine, cannabis, alcohol, and sleep
- Clinical review questions
- Answers
- Suggested reading
- References
- 10. Monitoring respiration—technology and techniques
- Introduction
- Measuring airflow or tidal volume
- Recommended and alternative sensors for scoring apnea and hypopnea during polysomnography
- Monitoring respiratory effort
- Measuring the arterial oxygen saturation
- Severity of arterial oxygen desaturation
- Measurement of PaCO2 during sleep
- Monitoring technology for home sleep apnea testing
- Clinical review questions
- Answers
- Suggested reading
- References
- 11. Respiratory events in adults—event definitions and scoring rules
- Abbreviations
- History of respiratory definitions
- Respiratory event definitions
- Additional considerations for scoring respiratory events
- Clinical review questions
- Answers
- Selected readings
- References
- 12. Respiratory events in children—event definitions and scoring rules
- Introduction
- Ages for which pediatric respiratory scoring rules apply
- Measuring event durations
- Scoring respiratory events in sleep versus wake
- Scoring rules for respiratory events in children
- Scoring pediatric hypopneas
- Pediatric RERA rule
- Pediatric hypoventilation
- Respiratory parameters reported in pediatric polysomnography
- Clinical review questions
- Answers
- Suggested reading
- References
- 13. Sleep and respiratory physiology
- Introduction
- Arterial blood gases
- Determinants of PaCO2
- Apneic threshold
- Brief summary of brainstem centers involved in ventilatory control
- Upper airway muscles
- Tests of ventilatory control and changes during sleep
- Acid-base physiology
- Pulmonary function testing
- Clinical review questions
- Answers
- Suggested reading
- References
- 14. Cardiac monitoring during polysomnography
- Introduction and ECG nomenclature
- ECG recording during polysomnography
- Sinus rhythm and normative data for heart rate
- Conduction system
- Bradycardia and AV block during sleep
- Premature beats (PBs)
- Tachycardia during sleep
- Adverse events during PSG
- Wide QRS and pacemakers
- Cardiac event reporting
- Clinical review questions
- Answers
- Recommended reading
- References
- 15. Monitoring of limb movements and other movements during sleep
- Abbreviations
- Introduction
- Limb monitoring techniques
- Criteria for scoring leg movements and periodic limb movements
- Other LMs during sleep
- Nocturnal muscle cramps
- Sleep-related bruxism
- Rhythmic movements and the sleep-related rhythmic movement disorder
- Propriospinal myoclonus and hypnic jerks
- Benign sleep myoclonus of infancy (BSMI)
- Scoring REM without atonia (RWA)
- Clinical review questions
- Answers
- Suggested reading
- References
- 16. Polysomnography, home sleep apnea testing, and actigraphy
- Polysomnography—putting it all together
- Indications for polysomnography and home sleep apnea testing
- Polysomnography report and interpretation
- Polysomnography in children
- Home sleep apnea testing (HSAT)
- Actigraphy
- Clinical review questions
- Answers
- Selected references
- References
- 17. Subjective and objective measures of sleepiness
- Excessive daytime sleepiness
- Subjective measures
- Objective measures of sleepiness or the ability to stay awake
- Evaluating sleepiness in children
- Clinical review questions
- Answers
- Selected references
- References
- 18. Obstructive sleep apnea syndrome in adults—diagnosis, epidemiology, variants
- History and definitions
- Adult OSA—diagnostic criteria
- Evaluation of patients
- Epidemiology of adult OSA
- Variants of OSA
- Clinical review questions
- Answers
- Suggested reading
- References
- 19. Pathophysiology of obstructive sleep apnea
- Pathogenesis of upper airway obstruction
- Upper airway activity during apnea and hypopnea
- Gender and OSA
- Arterial oxygen desaturation in OSA
- Endotypes of obstructive sleep apnea
- Clinical review questions
- Answers
- References
- 20. Clinical consequences of obstructive sleep apnea and benefits of treatment
- Introduction
- Pathophysiology of the adverse effects of OSA
- Mortality
- OSA and related cardiovascular disease/effect of CPAP
- Symptom and polysomnography subtypes and cardiovascular risk
- Excessive daytime sleepiness and neurocognitive dysfunction
- Automobile accidents and sleep apnea
- Arterial hypertension
- Pulmonary hypertension (PH)
- Arrhythmias
- Coronary artery disease
- Inflammation, atherosclerosis, thrombosis, and endothelial dysfunction
- Congestive heart failure (CHF)
- Stroke and OSA
- Diabetes and OSA
- Nonalcoholic liver disease
- Erectile dysfunction
- Nocturia
- Clinical review questions
- Answers
- Suggested reading
- References
- 21. Obstructive sleep apnea and obesity hypoventilation syndrome treatment overview
- Introduction
- Treatment of obstructive sleep apnea
- Treatment of the obesity hypoventilation syndrome
- Clinical review questions
- Answers
- Suggested reading
- References
- 22. Medical treatment of obstructive sleep apnea including treatment of residual sleepiness with medications
- Introduction
- Weight loss
- Bariatric surgery indications and precautions
- Posture and positional treatment
- Muscle training by exercise or stimulation
- Supplemental oxygen
- Persistent daytime sleepiness on CPAP
- Treatment of residual sleepiness in OSA patients on CPAP
- Future medical interventions for sleep apnea
- Clinical review questions
- Answers
- Suggested reading
- References
- 23. Positive airway pressure treatment
- Introduction
- Mechanism of action
- Efficacy of PAP
- Indications for PAP treatment
- PAP technology and device flow and leak
- Basic PAP modes
- AutoBPAP
- Comfort measures
- Mask interfaces
- The importance of leak
- Interventions for PAP side effects
- Adherence—definitions and measurement
- Rates of adherence and factors influencing adherence
- Comorbid insomnia, hypnotics
- PAP titration and autotitration
- Starting PAP treatment without a titration
- Follow-up of the PAP patient/use of device data
- Clinical review questions
- Answers
- Suggested reading
- References
- 24. Advanced PAP modes, NIV titration, and phrenic nerve stimulation
- Introduction to advanced PAP modes
- BPAP-ST, BPAP-T, and BPAP-PC modes
- Importance of the backup rate and inspiratory time
- Choosing Ti and understanding the Ti/Ttot and i:e ratio parameters
- Choosing TiMin, TiMax, trigger sensitivity, and cycle sensitivity (resmed devices)
- Backup rate (BPAP-ST)
- Adaptive servoventilation (ASV)
- Volume assured pressure support
- Choosing the advanced PAP mode (VAPS versus ASV versus BPAP-ST)
- NIV (NPPV) titration and treatment
- Long-term follow-up
- Reimbursement for NIV devices
- Home mechanical ventilators
- Transvenous phrenic nerve stimulation
- Clinical review questions
- Answers
- References
- 25. Oral appliance treatment for obstructive sleep apnea
- Oral appliances
- Indications for oral appliances
- Mechanism of action
- Evaluation of the patient and prediction of success of OA treatment
- Exclusions and contraindications
- Tongue stabilizing/retaining devices
- Mandibular advancement devices
- Medicare and insurance coverage of OA(MADs)
- Titration/adjustment of OAs
- Adherence to OA treatment
- Side effects and complications
- Effectiveness of oral appliances and comparison with CPAP
- Combinations of OAT and other treatments
- Follow-up
- Clinical review questions
- Answers
- References
- 26. Surgical treatment for obstructive sleep apnea
- Introduction
- Indications for surgical treatment
- Evaluation for possible surgical treatment
- Surgery for nasal obstruction and snoring
- Surgery for obstructive sleep apnea
- Hypoglossal nerve stimulation (HNS)
- Clinical review questions
- Answers
- Selected reading
- References
- 27. Pediatric obstructive sleep apnea—diagnosis and treatment
- Introduction
- Epidemiology
- Diagnosis
- Treatment of pediatric OSA
- Clinical review questions
- Answers
- Suggested reading
- References
- 28. Sleep and cardiovascular disease
- Introduction
- Normal sleep-related changes in autonomic activity
- Heart rate and blood pressure during sleep
- Nighttime acute cardiac events
- Premature ventricular complexes and ventricular arrhythmias
- Atrial fibrillation
- Myocardial ischemia and infarction
- Congestive heart failure
- Insomnia, daytime sleepiness, and cardiovascular disease
- Clinical review questions
- Answers
- References
- 29. Sleep and lung disease
- Introduction
- Obstructive ventilatory defect and associated disorders
- Chronic obstructive pulmonary disease
- Overlap Syndrome
- Treatment of Overlap Syndrome
- Asthma
- Clinical review questions
- Answers
- Suggested reading
- References
- 30. Central sleep apnea and sleep-related hypoventilation disorders
- Introduction
- Pathophysiology of central sleep apnea
- Hypocapnic central sleep apnea
- Non-hypocapnic CSA and hypoventilation disorders
- OSA, CSA, and complex sleep apnea
- Hypocapnic central sleep apnea disorders
- Non-hypocapnic CSA disorders
- Primary central sleep apnea of infancy
- Primary central sleep apnea of prematurity
- Sleep-related hypoventilation disorders
- Clinical review questions
- Answers
- Suggested reading
- References
- 31. Restless legs syndrome (Willis-Ekbom disease), periodic limb movements in sleep, and periodic limb movement disorder
- Introduction
- Restless legs syndrome
- Periodic limb movements in sleep
- Periodic limb movement disorder
- Treatment of RLS and PLMD
- Clinical review questions
- Answers
- Suggested reading
- References
- 32. Central disorders of hypersomnolence
- Introduction
- Narcolepsy
- Importance of hypocretin neurons
- Idiopathic hypersomnia
- Kleine-Levin syndrome (KLS)
- Hypersomnia due to a medical disorder
- Hypersomnia due to a medication or substance
- Hypersomnia associated with a mental disorder
- Insufficient sleep syndrome and long sleeper
- Clinical review questions
- Answers
- Suggested reading
- References
- 33. Insomnia diagnosis and treatment
- Chronic insomnia disorder (CID)
- Treatment of insomnia
- Pharmacologic treatment of insomnia
- Clinical review questions
- Answers
- Suggested reading
- References
- 34. Circadian rhythm sleep-wake disorders
- Introduction
- Suprachiasmatic nucleus
- Melatonin
- Circadian rhythm sleep-wake disorders
- Markers of circadian phase
- Shifting the circadian rhythms
- Genomics of CRSWD
- Circadian rhythm sleep-wake disorders
- Clinical review questions
- Answers
- References
- 35. Clinical electroencephalography and nocturnal epilepsy
- Electroencephalographic (EEG) monitoring
- Bipolar monitoring and standard montages
- Importance of video monitoring
- Waveform terminology
- Classification of seizures and terminology
- Sleep-related epilepsy syndromes
- Ictal effects on sleep
- Antiepileptic drugs (AEDs) – effects on sleep
- Epilepsy and obstructive sleep apnea
- Sudden unexpected death in epilepsy (SUDEP)
- Clinical review questions
- Answers
- Suggested reading
- References
- 36. Parasomnias
- Introduction
- Evaluation of parasomnias
- NREM parasomnias
- Sleep-related eating disorder
- NREM parasomnia in anti-IgLON-5 disease
- Nocturnal epilepsy versus NREM parasomnia
- Sleep-related dissociative disorders
- Parasomnias usually associated with REM sleep
- Other parasomnias
- Isolated symptoms and normal variants
- Clinical review questions
- Answers
- Suggested reading
- References
- 37. Psychiatry and sleep
- Introduction
- Mood disorders and mood episodes
- Depressive disorders
- Bipolar disorders
- Treatment of unipolar depression
- Treatment of bipolar disorders
- Anxiety disorders affecting sleep
- Generalized anxiety disorder
- Posttraumatic stress disorder
- Clinical review questions
- Answers
- Suggested reading
- References
- 38. Sleep and nonrespiratory physiology
- Introduction
- Endocrine physiology and sleep
- Sleep and gastrointestinal physiology and disorders
- Sleep and renal physiology
- Clinical review questions
- Answers
- Suggested reading
- References
- 39. Sleep in medical disorders and pregnancy
- Introduction
- Acromegaly
- Cancer
- Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS)
- Fibromyalgia
- Chronic kidney disease (CKD)
- Human immunodeficiency virus (HIV)
- Pregnancy
- Effect of COVID-19 on sleep and alertness
- Clinical review questions
- Answers
- Suggested reading
- References
- 40. Sleep and neurological disorders
- Introduction
- Neurodegenerative disorders and sleep
- Dementias
- Parkinsonism syndromes (PD, PD+)
- Other neurodegenerative disorders
- Sleep disturbances in stroke
- Traumatic brain injury (TBI)
- Hypersomnia and TBI
- Insomnia and TBI
- Clinical review questions
- Answers
- Selected readings
- References
- Glossary
- Index
- Edition: 2
- Published: June 30, 2024
- Imprint: Elsevier
- No. of pages: 928
- Language: English
- Hardback ISBN: 9780323810814
- eBook ISBN: 9780323810821
RB
Richard B. Berry
Dr. Richard B. Berry is a professor of medicine at the University of Florida in Gainesville. He has been honored with the American Academy of Sleep Medicine awards for Excellence in Education (2010) and Distinguished Service to the Field of Sleep Medicine (2020). Dr. Berry is a fellow of the American Academy of Sleep Medicine.
Affiliations and expertise
Professor of Medicine, University of Florida in Gainesville; Fellow of American Academy of Sleep MedicineMW
Mary H. Wagner
Dr. Mary H. Wagner is Director of the Pediatric Sleep Program at UF Health Sleep Disorders Center at Magnolia Parke, while also serving as Professor of Pediatrics in the Pediatric Pulmonary Division at the University of Florida (UF). She is board certified in Sleep Medicine, Pediatric Pulmonary and Pediatrics, and also serves as Director of the Pediatric Pulmonary Center Training Grant. Dr. Wagner received her MD from UF, where she also completed postgraduate training in Pediatrics and Pediatric Pulmonology. Before joining the faculty at UF she was Assistant Professor of Pediatrics at the Johns Hopkins Hospital in Baltimore, MD. Dr. Wagner brings over 20 years of experience to the Pediatric Sleep Clinic at Magnolia Parke, where the medical team helps patients with a multidisciplinary approach including nutrition, social work, respiratory therapy, nursing and clinical psychology.
Affiliations and expertise
Director of the Pediatric Sleep Program at University of Florida Health Sleep Disorders Center; Professor of Pediatrics in the Pediatric Pulmonary Division at the University of Florida in GainesvilleSR
Scott M. Ryals
Dr. Scott M. Ryals is a sleep physician at Atrium Health in Charlotte, NC. He is board certified in Sleep Medicine and Internal Medicine by the ABIM. He received his undergraduate degree in biology from Emory University and his medical degree from Tulane University. He completed a residency and chief residency in Internal Medicine, followed by a Sleep Medicine fellowship at the University of Florida. Dr. Ryals is a Fellow of the American Academy of Sleep Medicine (FAASM).
Affiliations and expertise
Sleep Physician at Atrium Health in Charlotte, NC; Fellow of the American Academy of Sleep Medicine