ABC of sleep disorders. Sleep problems in patients with medical illness.

Abstract

Sleep complaints are ubiquitous in patients with medical illness. A recent survey of outpatients attending hospital clinics indicated that the vast majority of patients reported sleep disruption concomitant with their condition. The proportion with complaints (> 70%) was more than twice that among control subjects. Doctors rarely ask about sleep problems in the Factors that may indicate a context of medical illness despite the fact that the patient's first complaint disruption of sleep architecture in may be that a particular symptom caused sleep disruption. medically ill patients There are specific reasons for sleep disruptions in patients with medical . Movement arousals (number) illness-for example, people are often deprived of sleep before an 0Feunchgsislesae(eh. operation. Polysomnography has shown that there is a preoperative of sleep) reduction in slow wave sleep and that this is related to the anticipated * Awakenings in first six hours of sleep importance of surgery. The increase in deep sleep that occurs after an (number) operation is thought to facilitate the healing process. * Sleep efficiency (A variety of sleep variables may be influenced by specific disorders and * Apnoea index particular treatments and each of these effects is likely to differ. A decrease * Leg kicks (total number) in deep (slow wave) sleep, for example, may lead to a sensation of having low energy, whereas repeated interruption of sleep may lead to daytime * Abnormal REM latency * Reduced slow wave sleep corrected for sleepiness. age (% below normal) Drugs may also disrupt sleep architecture by suppressing rapid eye . Total sleep time movement (REM) sleep or by causing a withdrawal effect during the night. * Total sleep time In both cases the drug clearly alters sleep, but the impact on health and * Long awakenings (10 min) recovery may differ. L a. Patterns on electroencephalogram Fatigue is common in several medical conditions. Clinicians, researchers, and patients themselves claim that the fatigue experienced in certain medical conditions differs qualitatively from the experience oftiredness or sleepiness. However, there have been few attempts to separate these states. In this article we provide an overview of the impact of medical disorders on sleep.