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

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