Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Jan 1995
[Clinical diagnosis in sleep laboratory patients based on ICD-10, DSM-III-R and ICSD classification criteria].
For the diagnosis of sleep disorders, 3 different standardized classification systems are available: the International Statistical Classification of Diseases and Related Health Problems (ICD-10), the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R/DSM-IV) and the International Classification of Sleep Disorders (ICSD). These 3 classification schemata were comparatively evaluated in 50 sleep-disturbed patients who were admitted within 1 year to a non-specialized sleep laboratory for diagnostic evaluation and treatment. 17 female and 33 male sleep-disturbed patients, aged 54 +/- 12 years, were recorded polysomnographically in 3 subsequent nights (adaptation night, baseline/diagnosis night, treatment night) for measuring objective sleep quality. The subjective sleep quality as well as the subjective and objective awakening quality was assessed by means of rating scales, as well as psychometric and psychophysiological test battery. ⋯ Based on the DSM-III-R, 46% of the patients were diagnosed as insomnias based on another mental disorder, 38% as organic hypersomnias and 14% as parasomnias. Based on the ICSD Classification, sleep disorders associated with anxiety disorders were leading (30%), followed by sleep disorders based on affective disorders (16%), obstructive snoring (14%), primary snoring (8%) and sleep disorders based on neurological disorders (6%). While the broader ICD-10 and DSM-III-R diagnoses are syndrome-etiologically oriented and may be easily utilized by the practicing physician, the more narrowly defined, extensive, pathogenetically oriented polysomnographic features including ICSD diagnoses are suited better for the specialist.
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Wien Med Wochenschr · Jan 1995
[Polysomnographic structure of subjective "awake" and "asleep" nocturnal segments].
8 patients being diagnosed as having periodic limb movements in sleep and 14 patients with the diagnosis of psychophysiological insomnia (PI) were studied. They indicated their subjective time of sleep onset, final awakening and wake episodes during the night in a time scale. ⋯ There were no significant differences--concerning the polysomnographic structure--between sections indicated as "wake" or "sleep" or between the 2 groups. Patients with PI had less frequent awakenings but of longer duration, which can be seen as a reason for the negative subjective judgement of the night quality.