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Otolaryngologists Must Be at the Forefront of Diagnosing Sleep Disorders

by Pell Ann Wardrop, MD •

Children, adolescents, and young adults are particularly at risk for sleep deprivation. While adults need 7.5 to eight hours of sleep, school-age children need 10 hours of sleep each night. In children, short sleep time has been shown to be associated with cognitive dysfunction, behavior disorders, and increased anxiety. Adolescents and young adults need about 9.2 hours of sleep each night, according to studies conducted by Mary Carskadon at Brown University. Unfortunately, sleep duration in this age group averages about seven hours a night, so many high school and college students are significantly sleep-deprived. This contributes to the high rate of motor vehicle accidents and fatalities in teens and young adults. In addition to sleepiness, sleep deprivation in this age group has been correlated with school dysfunction, risk-taking behavior, poor dietary choices, and disciplinary problems.

As otolaryngologists serve as the gateway for diagnosis and treatment of many patients with sleep disorders, increased knowledge of sleep medicine will enhance our ability to provide comprehensive care for our patients. The airway plays a major role in sleep disorders, so otolaryngologists have a major role to play in management of sleep disorders. Failure to adequately educate ourselves about these disorders will narrow the treatment options available to our patients.

ENT Sleep Questionnaire

The one-page questionnaire includes the following:

  • Previous evaluation/treatment for OSAS
  • Results of CPAP treatment-if cannot tolerate, why?
  • Snoring severity
  • Witnessed apneas
  • Awaken gasping for air
  • Nasal obstruction at night
  • Sleepwalking, talking, dream enacting
  • Difficulty falling/staying asleep
  • Hours in bed/asleep each night
  • School/work performance issues
  • Leg symptoms-urge to move, kicking
  • Caffeine, ETOH intake
  • Epworth Sleepiness Scale

Diagnostic Criteria for RLS

  • Urge to move the legs, with uncomfortable sensations in the legs
  • These symptoms are worse during periods of rest
  • Urge to move or uncomfortable sensations are relieved by walking/stretching
  • Symptoms are worse in the evening or at night
  • Not caused by another sleep or medical disorder

Resources

Institute of Medicine. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington DC: National Academies Press, April 2006.

American Academy of Sleep Medicine. International Classification of Sleep Disorders, 2nd Ed. (ICSD 2). Chicago: American Academy of Sleep Medicine, 2005.

National Sleep Foundation: www.nationalsleepfoundation.org

©2008 The Triological Society