Lesson 1Sleep partner report and bed-partner questionnaire use: witness reports, bed partner sleep diaries, STOP-Bang components collected from partnerExplains how to integrate sleep partner observations, including snoring, apneas, movements, vocalisations, and parasomnias. Reviews use of partner questionnaires, sleep diaries, and STOP-Bang items obtained from the bed partner to enhance diagnosis in local contexts.
Eliciting detailed partner observationsPartner reports of snoring and apneasNocturnal movements and parasomnia signsBed-partner sleep diaries and logsSTOP-Bang items from partner historyLesson 2Screening for other sleep disorders: RLS/PLMD screening, insomnia disorder questions, circadian rhythm disorder screening, REM behaviour screeningProvides a structured approach to screening for restless legs syndrome, periodic limb movement disorder, insomnia, circadian rhythm disorders, and REM sleep behaviour disorder, using key diagnostic questions to guide further testing or referral in resource-limited environments.
Key questions for restless legs syndromeClues to periodic limb movement disorderCore insomnia disorder interview itemsCircadian rhythm disorder screening pointsREM sleep behavior disorder red flagsLesson 3Focused symptom history: snoring, witnessed apneas, nocturnal choking, nocturia, morning headaches, non-restorative sleepDetails how to obtain a precise nocturnal symptom history, including snoring, witnessed apneas, choking, nocturia, gasping, and morning headaches, to differentiate obstructive sleep apnoea from other causes of non-restorative or fragmented sleep in adults.
Characterizing snoring pattern and severityWitnessed apneas and gasping descriptionsNocturnal choking, reflux, and positional factorsNocturia, sweating, and other autonomic signsMorning headaches and non-restorative sleepSymptom timelines and aggravating factorsLesson 4Comorbidities and medications: cardiovascular disease, psychiatric disorders, pain, nasal disease, antihypertensives, sedatives, alcohol and stimulant useFocuses on identifying medical, psychiatric, and medication contributors to sleep complaints, including cardiovascular and respiratory disease, pain, nasal issues, psychotropics, sedatives, alcohol, stimulants, and polypharmacy interactions prevalent in Kenyan patients.
Cardiometabolic and respiratory comorbiditiesPsychiatric disorders affecting sleepChronic pain and nasal or airway diseaseSedatives, opioids, and psychotropic agentsAlcohol, caffeine, and stimulant use patternsPolypharmacy and drug interaction reviewLesson 5Substance, lifestyle, and sleep hygiene assessment: alcohol timing/quantity, caffeine, smoking, exercise, weight historyOutlines assessment of alcohol, caffeine, nicotine, exercise, diet, and evening behaviours that affect sleep. Emphasises timing, quantity, chronic patterns, weight history, and how to translate findings into tailored sleep hygiene counselling adapted to local lifestyles.
Alcohol timing, dose, and nightcap effectsCaffeine sources, timing, and sensitivityNicotine, vaping, and other substancesExercise timing and light exposure habitsWeight history and recent weight changeTargeted sleep hygiene counseling pointsLesson 6Sleep timing and architecture: bedtime, wake time, sleep latency, awakenings, naps, shift work, variabilityReviews how to map sleep timing, regularity, and continuity, including bedtime, wake time, latency, awakenings, naps, and shift work common in Kenyan work patterns. Emphasises identifying circadian misalignment, social jet lag, and behavioural contributors to insomnia.
Bedtime, wake time, and time in bedSleep latency and nocturnal awakeningsNapping habits and unintended dozingShift work, jet lag, and social jet lagWeekday–weekend variability patternsUsing sleep diaries to clarify patternsLesson 7Red flags and safety assessment: unexplained weight loss, neurological signs, excessive daytime sleepiness with high accident risk, nocturnal seizures, psychiatric crisisCovers urgent sleep-related red flags that require rapid action, including safety risks from severe sleepiness, possible neurological disease, seizures, major weight loss, and psychiatric crisis, plus triage, documentation, and referral pathways in Kenyan clinics.
Identifying medical and neurological red flagsAssessing excessive sleepiness and accident riskScreening for nocturnal seizures and parasomniasRecognizing psychiatric crisis and suicidalityImmediate safety planning and urgent referralsLesson 8Daytime symptoms and function: Epworth Sleepiness Scale scoring, concentration, mood, occupational safety risksExplores structured assessment of daytime sleepiness, fatigue, cognition, mood, and safety. Includes Epworth Sleepiness Scale use, impact on work, driving, relationships, and how to distinguish sleepiness from low energy or depression in daily Kenyan life.
Using and interpreting the Epworth ScaleDifferentiating sleepiness from fatigueCognitive and mood impacts of poor sleepOccupational and driving safety assessmentEffects on relationships and quality of life
