Institute for Continuing Education

Sleep Disorder

Course Objectives

Upon successful completion of this module, you will be able to:

• Define major sleep disorders using current ICSD-3-TR diagnostic criteria.
• Identify indications for polysomnography, home sleep apnea testing, MSLT, and MWT.
• Describe OSA treatments including PAP therapy, oral appliances, hypoglossal nerve stimulation, and tirzepatide.
• Explain narcolepsy treatment strategies including extended-release sodium oxybate and pitolisant.
• Differentiate between chronic insomnia subtypes and apply appropriate diagnostic tools.
• Recommend CBT-I as first-line insomnia treatment and identify when pharmacotherapy is appropriate.
• Apply pediatric sleep assessment tools including BEARS and CSHQ.
• Describe sleep disorder presentations across pediatric age groups.
• Explain 2024 guideline changes for restless legs syndrome management.
• Identify factors affecting PAP therapy adherence and strategies to improve outcomes.

Course Information

Over the past two decades, awareness and appreciation of sleep disorders and their effects have virtually exploded. Sleep is of the brain and for the brain. Although the functions of sleep remain unknown, it is clear that the organ responsible for generating sleep and the only organ served by sleep is the brain. Another indisputable fact is that sleep is vital for existence.

Much has been learned about the nature of sleep and wakefulness, and a wide variety of sleep disorders have been identified. When these disorders go unrecognized or untreated, the personal and societal consequences can be catastrophic. Therefore, it is important for practicing physicians to be aware of these disorders and to take sleep-wake complaints very seriously, particularly given the prevalence of sleep complaints among the general population.

In the first part of this four-part course, we underscore the serious nature of excessive daytime sleepiness, with emphasis on practical differential diagnosis and treatment. In the second part, we discuss how the ubiquitous complaint of insomnia can usually be managed in the primary care setting with gratifying results. In the third part, we try to demystify the fascinating conditions known as parasomnias, focusing on the fact that, contrary to popular opinion; these phenomena are usually not caused by underlying psychiatric or psychological problems. In the fourth and final part of the course, we examine the fact that sleep-wake complaints are far more prevalent in children than previously suspected and that proper diagnosis and treatment result in marked benefits for the patient and the entire family.

The take-home message from the combination of these sections of the course is that sleep-wake complaints are almost always caused by specific, identifiable, and--most important--treatable conditions. In most cases, patients do not have to suffer from hypersomnia, insomnia, or unusual behaviors arising from the sleep period, because help is at hand. Sleep disorder centers are a resource that can aid community physicians and patients. Many sleep-related complaints do not require formal sleep studies and can be managed quickly and economically with simple phone consultation between the primary care physician and the sleep medicine specialist.

Gratifyingly, most sleep-wake disorders are readily diagnosable and treatable. We hope that this course familiarizes healthcare professionals with the fundamentals of normal sleep and sleep disorders and provides guidance in recognizing and managing these common complaints.