Sleep Matters - January 2022 - Vol 12 No 4

Introduction

Guidelines for diagnostic overnight testing for other sleep disorders or mild sleep-disordered breathing in South Africa

This summary follows on from the previous article which concentrated on patients who were suspected of having moderate to severe obstructive sleep apnea. This article will focus on those patients for whom an apnea diagnostic test is not appropriate or who, for some reason, are not managed by that process. Essentially these are the patients who may need a full overnight polysomnogram or who fill the home-based apnea specific process

How many sleep disorders do you have? (Case study)

It is usually quite easy to recognise single sleep disorders when patients present with classical symptoms. Sometimes, however, patients may have multiple sleep disorders and it can be complicated to unravel and find a management strategy. I had a 24-year-old male patient who has had sleeping problems since high school and who may have 4 sleep disorders. I present him here as a case study by creating a table with symptoms that he had as well as (in the second column) what sleep disorder(s) these symptoms may indicate. Then a brief discussion about these disorders and the start of management. I hope this may be useful.

Insomnia identity – do people know if they have insomnia?

This disconnect has been described before. Poor sleep as identified on polysomnography does not necessarily lead to a complaint of poor sleep and vice versa. Sleep misperception is a sleep disorder where patients significantly underestimate how much sleep they have even when verified on the same night by polysomnography – thus they identify as having insomnia without any real evidence that their sleep is disturbed.