Osler observed that patients will often
tell physicians what is wrong with them, if they will simply
listen. Such
is nearly true in sleep medicine, but not quite--for one must
listen particularly to others who have observed the patient
in
wakefulness and sleep.
Sleep is the one state in which
we cannot know what befalls us.
Furthermore, many patients cannot reliably judge when they
are asleep or awake!
The
dilemma?
--Obtaining those crucial observations,
when patients are all the more likely to come to their appointments
alone...and when we as physicians have diminishing time to devote
to the care for each patient.
The
solutions.
--Maintenance
of a high index of suspicion...focussing
upon common indicators, as outlined in the case
vignette, and in the
summaries of clues and associated
conditions that
followed.
--Creation
of an enhanced awareness of sleep apnea and other sleep-related
illnesses among your staff, your patients, their family members
and their employers. To
do so may save lives and health.
--Use
of screening questionnaires on a routine basis, whenever
the possibility of a significant problem exists.
Insist
that both are completed: Questionnaire
I by the
patient, and Questionnaire
II by the
spouse, bedpartner, family member or friend who has
had an opportunity to observe the patient's sleep
and levels of alertness. (Click to download)
A
guide tø the interpretation
of completed questionnaires is found within The Sleep
Site. The differential diagnosis and/or significance
of both patient and observer responses can be accessed by
simply entering them on the following pages of The Sleep
Site:
For Questionnaire II:
go to https://members.tripod.com/~sleephealth/3q2.html
Or,
if
preferred, contact us at (614) 443-7800 or by e
mail to request
free postage-paid screening questionnaires. The completed
screening questionnaires can be forwarded directly to us
by your office or the patient for review at no charge.
We will mail a summary of our impressions after that review
both to yourself and to your patient.
--Obtain
additional information and assistance when necessary to resolve
the problems of your individual patients:
OUR PATIENTS SPEND
NEARLY ONE-THIRD OF THEIR LIVES IN SLEEP.
IT IS NOT FOR US TO
CHOOSE TO PROTECT THEIR HEALTH
ONLY DURING THE OTHER TWO-THIRDS OF THEIR LIVES.
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