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STOP, THAT and One Hundred Other Sleep Scales (Hardcover, 2012)
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STOP, THAT and One Hundred Other Sleep Scales (Hardcover, 2012)
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There are at least four reasons why a sleep clinician should be
familiar with rating scales that evaluate different facets of
sleep. First, the use of scales facilitates a quick and accurate
assessment of a complex clinical problem. In three or four minutes
(the time to review ten standard scales), a clinician can come to a
broad understanding of the patient in question. For example, a
selection of scales might indicate that an individual is sleepy but
not fatigued; lacking alertness with no insomnia; presenting with
no symptoms of narcolepsy or restless legs but showing clear
features of apnea; exhibiting depression and a history of
significant alcohol problems. This information can be used to
direct the consultation to those issues perceived as most relevant,
and can even provide a springboard for explaining the benefits of
certain treatment approaches or the potential corollaries of
allowing the status quo to continue. Second, rating scales can
provide a clinician with an enhanced vocabulary or language,
improving his or her understanding of each patient. In the case of
the sleep specialist, a scale can help him to distinguish fatigue
from sleepiness in a patient, or elucidate the differences between
sleepiness and alertness (which is not merely the inverse of the
former). Sleep scales are developed by researchers and clinicians
who have spent years in their field, carefully honing their
preferred methods for assessing certain brain states or
characteristic features of a condition. Thus, scales provide
clinicians with a repertoire of questions, allowing them to draw
upon the extensive experience of their colleagues when attempting
to tease apart nuanced problems. Third, some scales are helpful for
tracking a patient's progress. A particular patient may not
remember how alert he felt on a series of different stimulant
medications. Scale assessments administered periodically over the
course of treatment provide an objective record of the
intervention, allowing the clinician to examine and possibly
reassess her approach to the patient. Finally, for individuals
conducting a double-blind crossover trial or a straightforward
clinical practice audit, those who are interested in research will
find that their own clinics become a source of great discovery.
Scales provide standardized measures that allow colleagues across
cities and countries to coordinate their practices. They enable the
replication of previous studies and facilitate the organization and
dissemination of new research in a way that is accessible and
rapid. As the emphasis placed on evidence-based care grows, a
clinician's ability to assess his or her own practice and its
relation to the wider medical community becomes invaluable. Scales
make this kind of standardization possible, just as they enable the
research efforts that help to formulate those standards. The
majority of Rating Scales in Sleep and Sleep Disorders: 100 Scales
for Clinical Practice is devoted to briefly discussing individual
scales. When possible, an example of the scale is provided so that
readers may gain a sense of the instrument's content.
Groundbreaking and the first of its kind to conceptualize and
organize the essential scales used in sleep medicine, Rating Scales
in Sleep and Sleep Disorders: 100 Scales for Clinical Practice is
an invaluable resource for all clinicians and researchers
interested in sleep disorders."
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