Modern Sleep Medicine

 Abstract
of Sleep Medicine based on their long been engaged in theoretical research and clinical experience, from the sleep physiology, psychology, sleep, sleep disorders, sleep apnea and sleep medicine, the military chapter 5 describes the physiological changes in sleep, sleep, and Awakening of the physiological mechanisms, psychological assessment of insomnia, insomnia, sleep disorder women, the elderly sleep disorder, sleep disorders, sleep and epilepsy, sleep and cardiovascular disease, sleep apnea syndrome, and military operations personnel to sleep research. comprehensive book discusses the detailed guidance on good clinical function and reference value, for the majority of clinicians and researchers in the sleep study and reference.
Introduction Although sleep a long history of medical research, but development is slower. the progress of science, technology and medical science, the 20th century, 50 years, sleep medicine before entering a new period of development. So far, registered sleep disorders and related diseases, 87 species. sleep disorders and brain dysfunction, mental disorders, physical disorders and a variety of other diseases, there is a close mutual contact. sleep disorders is not only a health problem, and coordination with social stability and economic development are closely related. in Europe and the United States each year due to injuries caused by sleep-related disorders and operational errors caused by the economic losses of up to tens of billions of dollars. late start of modern sleep medicine, people have sleep disorders and related diseases still lack sufficient knowledge of the hazards; medical workers on the lack of sleep medicine expertise to understand the system , for the diagnosis and treatment of sleep disorders outstanding specifications; social economic development of sleep disorders caused by the negative impact of lack of sufficient attention. In view of this, we organized a national engaged in basic and clinical sleep researchers, has prepared this Medicine, for medical students, graduate students, clinicians, sleep medicine, and other related personnel engaged in reading, for reference.'s 1 / 3 of the time is spent in sleep, sleep and diet, reproductive belong to the basic physiological needs of human survival, health sleep on the importance of physical, mental and social development is self-evident. Some people say lack of sufficient awareness of the importance of also. have a healthy sleep is to build human and social harmony, one of the factors. we talk about healthy sleep, bear with healthy sleep awareness, good health, good lifestyle, health, psychology and scientific management of sleep, etc. content. In most cases, the subjective factors in the occurrence of sleep disorders and plays a decisive role in the development process. Fortunately, each of us is no stranger to sleep and sleep disorders. Therefore, this book is also suitable for the general public to read, wish to contribute to raising public awareness of their own sleep health. Sleep Medicine is a new interdisciplinary, many of the issues should be further research, such as regulation of sleep physiology, pathophysiology of sleep disorders, sleep disorders and other diseases as well as the relationship. the development of drug treatment fairly quickly. Therefore, some of the arguments in this book appears to be correct, a number of years and then will continue to be revised, coupled with our limited, errors and omissions urge readers to criticize correction.
Zhang Xi Table of Contents a sleep physiology
Chapter 1 Introduction Section I sleep and wake hhhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh II study of history hhhhhhhhhhhhhhhhhhhhhhhhhhhh sleep Chapter 2 Section of sleep physiology hhhhhhhhhhhhhhhhhhhhhhhhhhhh physiological sleep in the motor system of sleep breathing hhhhhhhhhhhhhhhhhhhhhhhh II Section sleep physiology hhhhhhhhhhhhhhhhhhhhhhhhhhh endocrine and immune system changes hhhhhhhhhhhhhhhhhhhh IV sleep hhhhhhhhhhhhhhhhhhhhhhh other physiological changes in Chapter 3, the physiological functions of sleep, sleep deprivation hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhhh Section II the general physiological functions of sleep and sleep hhhhhhhhhhhhhhhhhhhhhhhhh III Chapter 4 Learning and Memory hhhhhhhhhhhhhhhhhhhhhhhhhhh neural mechanisms of sleep and awakening Overview hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh
hhhhhhhhhhhhhhhhhhhhhhhhh Section II Section III awakening NREM sleep maintenance mechanism hhhhhhhhhhhhhhhhhhhhhhhhhhhh mechanism of REM sleep, the mechanism hhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhh IV V sleep - wake cycle Chapter 5 of the mechanism hhhhhhhhhhhhhhhhhhhhhhhh Phylogeny of sleep and sleep ontogeny hhhhhhhhhhhhhhhhhhhhhhh Phylogeny of Section II of sleep ontogeny hhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhh
second
psychology of sleep Sleep Chapter 6 physiological and psychological mechanisms of the pathogenesis of sleep hhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhh Section II hhhhhhhhhhhhhhhhhhhhhhhhh mental activity during sleep, sleep function and III experimental sleep deprivation research hhhhhhhhhhhhhhhhhhh Chapter 7 insomnia sleep psychological diagnostic assessments measure hhhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhh Section Section insomnia insomnia psychological assessment psychological dimension hhhhhhhhhhhhhhhhhhhhhhhhh Assessment Section in Chapter 8 hhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhhhh psychoanalytic therapy psychoanalytic theory hhhhhhhhhhhhhhhhhhhhhhhhhhh Section II technical methods of psychoanalytic therapy hhhhhhhhhhhhhhhhhhhhhhh Chapter 9 of cognitive behavioral therapy hhhhhhhhhhhhhhhhhhhhhhhhhhhhh first section the basic theory of cognitive behavior therapy cognitive model of insomnia hhhhhhhhhhhhhhhhhhhhhhh Section II of hhhhhhhhhhhhhhhhhhhhhhhhh the basic steps of cognitive behavioral therapy hhhhhhhhhhhhhhhhhhhhhhh Chapter 10, Section hhhhhhhhhhhhhhhhhhhhhhhhhhhhh biofeedback therapy biofeedback technology theory hhhhhhhhhhhhhhhhhhhhhhh Biofeedback treatment of Section II biofeedback hhhhhhhhhhhhhhhhhhhhhhhhh basic steps hhhhhhhhhhhhhhhhhhhhhhh Chapter 11, section I, Morita therapy hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhh the basic theory of Morita therapy Morita therapy is the principle of Section III hhhhhhhhhhhhhhhhhhhhhhhhh Morita therapy treatment hhhhhhhhhhhhhhhhhhhhhhhhh
third
sleep disorders and related disorders of sleep disorders Chapter 12 international and national classifications hhhhhhhhhhhhhhhhhhhhhhh Chapter 13, Section I of sleep and insomnia Insomnia hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh the concept of the epidemiology of sleep disorders II hhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhh Section IV hhhhhhhhhhhhhhhhhhhhhhhhhhh the etiology of insomnia Insomnia Insomnia clinical diagnosis hhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhh V VI Insomnia hhhhhhhhhhhhhhhhhhhhhhhhhhhh Chapter 14 of the phase associated with sleep sleep - wake cycle of day and night dysrhythmia hhhhhhhhhhhhh Section II outlines hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh
delayed sleep phase disorder sleep phase advance hhhhhhhhhhhhhhhhhhhhhhhhhh Section IV disorders hhhhhhhhhhhhhhhhhhhhhhhhhh non-24h sleep - wake syndrome hhhhhhhhhhhhhhhhhhhhhhhh V irregular sleep - wake rhythm hhhhhhhhhhhhhhhhhhhhhhhhh section VI, VII, shift work sleep disorder hhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhh time zone change in sleep disorders excessive daytime sleepiness Chapter 15 reasons for learning hhhhhhhhhhhhhhhhhhhhhhhhhhhhh
hhhhhhhhhhhhhhhhhhhhhhhhhhhhh Section II Section III clinical hhhhhhhhhhhhhhhhhhhhhhhhhhhhh
excessive daytime sleepiness inspection methods hhhhhhhhhhhhhhhhhhhhhhh IV excessive daytime sleepiness in the diagnosis and differential diagnosis of excessive daytime sleepiness hhhhhhhhhhhhhhhhhhhh V principles hhhhhhhhhhhhhhhhhhhhhhh Chapter 16 Prevention of childhood sleep disorders sleep behavior disorder hhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhhh Section II narcolepsy (narcolepsy) hhhhhhhhhhhhhhhhhhhhhhh sleep apnea hhhhhhhhhhhhhhhhhhhhhhhhhhhh III IV V meet in children with snoring disease hhhhhhhhhhhhhhhhhhhhhhhhhhhhh
hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh sleep myoclonus hhhhhhhhhhhhhhhhhhhhhhhhhhhhh VI VII VIII, rhythmic movement disorder hhhhhhhhhhhhhhhhhhhhhhhhhhh nocturnal panic attacks (NPA) hhhhhhhhhhhhhhhhhhhhhhhhh section nine section X, Prader-Willi Syndrome Kleine-Levin syndrome hhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhh
Chapter 17 of the women's sleep disorders hhhhhhhhhhhhhhhhhhhhhhhhhhhhh Section menstrual-related sleep disorder hhhhhhhhhhhhhhhhhhhhhhh II Chapter 18 women insomnia hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh senile insomnia Restless legs syndrome Chapter 19 Chapter 20 hhhhhhhhhhhhhhhhhhhhhhhhhhhh night periodic leg move hhhhhhhhhhhhhhhhhhhhhhhhhhhh Chapter 21, Section hhhhhhhhhhhhhhhhhhhhhhhhhhhhh sleep behavior disorder sleep disorder hhhhhhhhhhhhhhhhhhhhhhhhhhhhh
II line of rapid eye movement sleep behavior disorder hhhhhhhhhhhhhhhhhhhhhhh Section enuresis sleep panic disorder hhhhhhhhhhhhhhhhhhhhhhhhhhhhh
hhhhhhhhhhhhhhhhhhhhhhhhhhhhh
IV V VI daydream nightmare hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh
hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh
Chapter 22 narcolepsy hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh Chapter 23 common diseases, nervous system and sleep disorders hhhhhhhhhhhhhhhhhhhhhh s a cerebral vascular disease and sleep disorders hhhhhhhhhhhhhhhhhhhhhhhh II brain degeneration associated with Parkinson syndrome, sleep disorders hhhhhhhhhhhhhhhhhhhhhhh III hhhhhhhhhhhhhhhhhhhhh IV sleep disorders related fatal familial insomnia, sleep-related headache hhhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhh V 24 Chapter neurodegenerative diseases and abnormal REM sleep behavior hhhhhhhhhhhhhhhhh Chapter 25, Section I of sleep and epilepsy hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh the concept and classification of epilepsy, polysomnography hhhhhhhhhhhhhhhhhhhhhhhhhh II Application of epilepsy hhhhhhhhhhhhhhhhhhhhhh
Section sleep epilepsy-like discharges IV epilepsy pathophysiology hhhhhhhhhhhhhhhhhhh circadian biological rhythms of sleep deprivation and epilepsy hhhhhhhhhhhhhhhhhhhhhhhhh hhhhhhhhhhhhhhhhhhhhhhhhhhh V VI VII sleep induced sleep and wake up hhhhhhhhhhhhhhhhhhhhhhhhhhhhhh relationship between epileptic discharges of epilepsy seizures hhhhhhhhhhhhhhhhhhhhhhh VIII, the relationship between sleep and the first hhhhhhhhhhhhhhhhhhhhhhhh nine epilepsy with sleep disorders hhhhhhhhhhhhhhhhhhhhhhhhhh thereto antiepileptic drugs on the role of sleep hhhhhhhhhhhhhhhhhhhhhhh Chapter 26 Sleep Disorders and cardio-cerebral vascular diseases induced sleep hhhhhhhhhhhhhhhhhhhhhhhh Section cerebrovascular diseases and processing center of the mechanism of sleep-related heart hhhhhhhhhhhhhhhhhh II Section of Cardiovascular and cerebrovascular diseases hhhhhhhhhhhhhhhhhhhhhhh impact of drugs on sleep, sleep-disordered breathing hhhhhhhhhhhhhhhhhhhhhhh
Part IV Chapter 27
disorders sleep apnea syndrome hhhhhhhhhhhhhhhhhhhhhhhhhh Chapter 28 risk factors of sleep apnea hhhhhhhhhhhhhhhhhhhhhhhh Chapter 29 the pathogenesis of sleep apnea hhhhhhhhhhhhhhhhhhhhhhhhh Chapter 30 sleep apnea syndrome among hhhhhhhhhhhhhhhhhhhhh Chapter 31 excessive daytime sleepiness and its evaluation hhhhhhhhhhhhhhhhhhhhhhhhh Chapter 32 of the multi-channel physiological recorder to monitor sleep apnea in sleep-disordered breathing disorders of hhhhhhhh Chapter 33 portable (Family) monitor the clinical diagnosis of sleep apnea application hhhhhhhhhhhhh Chapter 34 Technology and Development of sleep monitoring hhhhhhhhhhhhhhhhhhhhhhhhhh Chapter 35 sleep-disordered breathing and cardiovascular disease relationship hhhhhhhhhhhhhhhhhh Chapter 36 sleep apnea hypopnea syndrome metabolic disorders and prevention hhhhhhhhhhhhhhh Chapter 37 of chronic obstructive pulmonary disease and sleep hypoxemia hhhhhhhhhhhhhhhhhhhh Chapter 38 of upper airway resistance syndrome hhhhhhhhhhhhhhhhhhhhhhhhhhh Chapter 39 neuromuscular diseases and sleep-disordered breathing hhhhhhhhhhhhhhhhhhhhhh Chapter 40 central sleep apnea hypopnea syndrome hhhhhhhhhhhhhhhhhhhh Chapter 41 of the surgical treatment of OSAHS and technological progress of hhhhhhhhhhhhhhhhhhhhh Section tongue mmm hyoid suspension for traction and upper airway obstruction tongue derived minimally invasive surgical technology hhhhh II laser-assisted palatal flat fan shape mmm oropharyngeal obstruction surgery for new technology hhhhhhhhh Chapter 42 obstructive sleep apnea hypopnea syndrome in orthognathic surgery hhhhhhhhhhhhhhh Chapter 43 oral appliance treatment of obstructive sleep apnea syndrome by nasal hhhhhhhhhhhhhhhh Chapter 44 continuous positive airway pressure treatment of sleep disordered breathing methodology hhhhhhhhhhhhh Chapter 45 positive airway pressure treatment compliance hhhhhhhhhhhhhhhhhhhhhhh Chapter 46 Traditional Chinese Medicine to treat sleep apnea syndrome Profile hhhhhhhhhhhhhhhhhhh Chapter 47 sleep-disordered breathing and accident hhhhhhhhhhhhhhhhhhhhhhhh Military Sleep Medicine
fifth chapter Chapter 48 of the military operations staff of sleep hhhhhhhhhhhhhhhhhhhhhhhh
Section status of military operations staff of sleep deprivation on sleep II hhhhhhhhhhhhhhhhhhhhhhh ability of the military operation military operations personnel hhhhhhhhhhhhhhhhhhhh III sleep hygiene safeguards hhhhhhhhhhhhhhhhhhh Chapter 49 central stimulant - modafinil hhhhhhhhhhhhhhhhhhhhhhhhh
Chapter 4, the neural mechanisms of sleep and waking
sleep - wake cycle regulation is a very complex high-level physical activity, involving the central multi-site, at all levels, from the center of the cerebral cortex to the brain stem involved in the regulation; a variety of neurotransmitters and neurohormonal interactions of endogenous peptides and the impact of immune substances on sleep has been attached; the spirit of the limbic system, mood and sleep - wake relationship, can not be ignored. Sleep-depth study of brain mechanism in promoting natural sleep agents new development to provide conditions and to address the treatment of other sleep disorders provide a theoretical basis.
first section outlines how did sleep occurs of? sleep and wake and sleep - waking cycle mechanisms of how it? It has long been repeated through continuous exploration and research, formed a series of theories, the following were introduced.
a cerebral anemia theory
This is the first of modern medicine on the hypothesis that the mechanism of human sleep. the hypothesis that people after a day of intense activity, to the evening activity, the brain also reduces blood flow and lead to and the brain cell activity does not even slow activity, and so it was a sleep. historical circumstances at the time, many people agree with this theory.
Second, sleep hormone theory
With the deepening of scientific practice, will produce one or more then injected into the cerebrospinal fluid of normal dogs of the fourth ventricle, the results of normal dogs will sleep for several hours. Since then many scientists repeated the experiment, all get the same results. The research suggests that, in the awakening period, the brain may produce a metabolite that promotes sleep. So far, there are still many scientists in this area continue the exploration. For example, the 1965-1975 Harvard University physiologist Papanhaimo on the 48h of the goats sleep deprivation, cerebrospinal fluid, injected into awake cat or rabbit ventricle, the results of the cat and rabbit were asleep 7h. we all know, rats are nocturnal activities, laws contrary to human activities. there experiments confirmed that the cerebrospinal fluid of sleep deprivation after the goats were injected into a large 0.1ml rat in vivo, the results of these rats reduced the activities of the night 63%. In addition, some scholars have found in cerebrospinal fluid from goats, a sleep hormone may, after the determination of molecular weight of the substance is a polypeptide of 350 to 500 substances. but possible sleep hormone levels in the brain tissue is very low, so recently many scientists are skeptical of this theory. However. there are still many scholars continue to study in this area was reported 80 .20 century's urine there may be a sleep hormone, is found by the determination of a peptide, the substance of the brain micro perfusion in the rabbit, rabbit's normal sleep can increase the half. In fact, the sleep hormone theory has gradually developed into the current mechanisms of homeostatic regulation of sleep (sleep homeostasis) of one of the main content. then we will be introduced, the process is the steady state of sleep, in waking, sleep pressure will gradually increase, in order to adjust the balance at the average level of sleep, the body will take the initiative to go to sleep. sleep state mechanism is a hot topic in the exploration and identification of endogenous sleep substances, these substances as part of sleep, may be used to call the sleep factor. now found a lot of sleep-related substances such as glandular glycosides, some cytokines, neuropeptides, etc., but its role in promoting sleep and study remains to be further confirmed. scientists factors in sleep and sleep homeostasis theory study, once a reality, yet if such can be synthesized sleep factor great benefits.
three, suspension of activity, neurotransmitters are not flexible, and could no longer accept the external stimulus, arising from sleep. This doctrine of abstract, yet to be confirmed, some scholars are now exploring the ongoing research in this area.
IV sleep instinct theory < br> sleep instinct theory, also called the same. sleep is to stop the interest of all external stimuli, but also return to the womb before birth live inside the state, repeat this period warm, dark and all other features of life. Also that some people used to sleep the body curled into a ball, which is the position in the uterus is very similar to the daily morning like re-birth, to prove that this theory is reasonable. However, this theory as too abstract and can not explain many phenomena occur during sleep.
Five, the great Russian physiologist Ivan Pavlov made in the 20th century, 30 years, and is still a certain authority. The doctrine that the phenomenon of human sleep is due to the inhibition of brain power caused by the spread in the brain. He organisms reflex theory, in the process of conditioned reflex, the brain produces inhibition was observed, some animals will turn a blind eye nutation, muscles loosely hanging shelves in the experiment, also issued a snoring animal to sleep. conclude: Sleep is an active suppression process. When the inhibition spread widely in the cerebral cortex, spread to the subcortical center, it caused a sleep phenomenon. Pavlov its outstanding contribution in medicine, who had won the Nobel Prize, but he still can not sleep suppression theory to explain all phenomena of sleep.
six, theory proposed by scientists. purpose is inherent in the body's , work and study, sleep and waking life phenomena such as are carried out according to certain rhythms. soon deviated from the normal human life rhythm, the body's physiological function in disturbance, sleep disorders and other diseases as the pathological basis. This theory started developed into the current sleep - waking cycle mechanisms of central regulation of circadian rhythm. a large number of studies have found that different species exist in the circadian clock system in vivo. clock is generated by endogenous pacemaker rhythms, including sleep - wake cycle, including rhythmic activities are regulated by the biological clock. With the deepening of the study, many of the body's biological clock system has been identified. already know that the mammalian circadian center located in the suprachiasmatic nucleus, and its details will then be introduced. < br> July, sleep center sleep center
doctrine doctrine known by the Swiss physiologist Hess WR founded. He according to brain surgery, when the scalpel or current direct contact with the human brain (or animal brain) a part of the cell, would trigger the phenomenon of human or animal sleep, sleep, first proposed in 1929, the central doctrine. The doctrine that, in the middle of the brain may exist between a sleep center, sleep center of the nerve cell activity causes leading to sleep; if stimulation sleep center, the body will go to sleep. At the same time also believe that sleep is the sleep center To date, sleep has become a central doctrine of the mainstream of the field of sleep mechanism theory. However, in the early 20th century, although Hess WR and other very few scholars have been proposed sleep center there is the view, but it is still generally agreed that fatigue from sleep caused by slow brain activity; the same time that the incoming sensory information the brain to maintain wakefulness, and this information passed to stop production, led to sleep. This is the time flourishes mechanism of the passive theory of sleep. subsequently half a century of exploration, the body's sleep-related structure to be identified; while recognizing that the brain is through these structures to the active sleep-related sleep, and this is the mechanism of sleep active theory. The theory is the central doctrine of the concept of sleep further extension. VIII, Yin and Yang theory
country medical profound sleep, in sleep research in the field also has a long history. in the medicine man and nature is echoed, Heaven one, day is yang and night are negative. Sleep is the body to adapt to growth and decline of yin and yang balance of nature is a process. yang into the person is sleeping soundly in the shade, yin yang out of people that wake, that is, static and dynamic change yang when the sleep state, yang by the static Turn when awake. If Lin Peiqin (Treatment of Class CD), said: regular natural gas conversion results.
September, the central doctrine of the awakening
As mentioned earlier, arousal and sleep like belongs to the body with the most important physiological phenomenon. In addition, the latest surveys show that modern society More and more people sleep there at night, and then ...