Karl Doghramji, MD

A 40-year-old man complains of daytime sleepiness that is getting progressively worse. His concentration and memory are failing. Results of labs are normal. Which evaluation tool would you choose?

After an argument with a colleague, a 28-year-old graduate student appears "drunk" in class. What happened on the way to the lecture?

Results of this sleep study help diagnose the specific type of sleep apnea. Evidence of 5 or more predominantly obstructive respiratory events per hour of sleep suggests obstructive disease.

During his annual physical examination, a 54-year-old man has no major complaints, reports restful sleep, and is not tired during the day. Is he at risk for obstructive sleep apnea?

A 17-year-old student can't fall asleep, can't wake up, and is falling behind in school. Which of the therapies suggested here do you think would help reset his diurnal rhythms?

Shortly after he falls asleep, the child sits up in bed and shrieks, then cries and cannot be wakened when touched. His parents are very concerned. What do you suspect?

Iron deficiency seen in restless leg syndrome is identified as an important secondary cause and supplementation helps relieve symptoms.

What is single most appropriate diagnostic test when you suspect restless leg syndrome?

Restless leg syndrome is characterized by an urge to move the upper or lower extremities that is usually induced by rest.

RLS has several diagnostic features that distinguish it from other sleep-related disorders.

CPAP is first-line therapy for severe OSA but when patients complain about mask-related discomfort, what to do?

Shiftwork disorder, a pattern of daytime sleepiness and insomnia that is a result of working during the usual time for sleep, is just one of the negative sequelae.

Shiftwork disorder is a prolonged pattern of daytime sleepiness and insomnia that is a result of working during hours that overlap the usual time for sleep.

Snoring is a hallmark symptom of OSA and so serves as an early warning sign of potential morbidiy and mortality.

Maladaptive behavior can produce poor sleep and worsen insomnia complaints.