A Clinical Casebook of Sleep Disorders in Women

Sleep disorders are very common among women during their lifespan, presenting in isolation or in combination with other illnesses particularly psychiatric and neurologic disorders. Pregnancy-related sleep disorders pose an interesting dilemma as this is a transient phase; these are associated with potential long-term effects on maternal and fetal health. Menopause and pre-menopausal stages lead to a significant change in sleep architecture, sometimes associated with insomnia with or without sleep related breathing disorder. Sleep architecture in men and women varies due to significant hormonal differences between the genders. However, sleep complaints are disproportionately higher among women. 

This book presents 20 clinical cases to understand the differences in presentation of symptoms and treatment options for various sleep disorders that are more commonly noted among women. These cases cover a spectrum of sleep related breathing disorders, sleep related movement disorders, hypersomnias, parasomnias, issues of sleep fragmentation leading to insomnia in association with hormonal changes and some unique cases encountered in our clinical practices.

 

This compilation of interesting clinical cases presents trainees and experienced physicians with a useful guide to assist in their clinical practices and will stimulate further research and studies.

 

Part I : Menstrual Cycle and Sleep Changes.- 1. Sleep changes with menarche.- 2. Insomnia in pregnancy; a review.- 3. Restless legs syndrome in women: a case report.- 4. Sleep deprivation in a postpartum woman with short sleeper syndrome.- Part II : Sleep-related Disorders of Breathing in Women.- 5. Can snoring cause me to be tired and sleepy? Upper airway resistance syndrome in women.- 6. Is it snoring or sleep apnea; should I be worried?.- 7. Case of obesity hypoventilation in an African American lady with underlying hypertension, diabetes and mood disorder.- Part III : Hypersomnias in Women.- 8. Idiopathic hypersomnia.- 9. Complicated delayed sleep wake phase disorder in a 59-year-old woman.- 10. Medication management of patient with narcolepsy during pregnancy and lactation.- Part IV :  Menopause related sleep disorders.- 11. Sleep disturbances due to hot flashes in the post-menopausal state.- 12. Hypoglossal nerve stimulator in the treatmentof obstructive sleep apnea in a menopausal woman with CPAP intolerance.- 13. Onset of chronic insomnia due to COVID-19 pandemic in the setting of severe anxiety in an elderly widow.- Part V : Sleep and Psychiatric Disorders in Women.- 14. Bipolar disorder related sleep disturbances in women.- Part VI : Special topics.- 15. Intractable insomnia in a woman with otherwise successful treatment of breast cancer.- 16. Parasomnias in women.- 17. Fatigue in a transgender man.- Part VII : Neurologic disorders with sleep disturbance.- 18. Parkinson disease and REM sleep behavior disorder in women.- 19. Disordered sleep in a female caregiver.- 20. Poor sleep in a cancer patient receiving palliative care.

Safia S. Khan, MD

Departments of Family and Community Medicine and Neurology

University of Texas Southwestern Medical Center

5323 Harry Hines Blvd

Dallas, TX 75390

 

Imran S. Khawaja, MD

Department of Psychiatry

MD TruCare 

Fort Worth, TX 

USA