READING_CASE3.

 SLEEP–WAKE DISORDERS  Description and classification of sleep–wake disorders have been expanded in DSM-5 to reflect the important diagnostic overlay of medical conditions that affect normal sleep patterns. Of particular importance to primary care are insomnia disorder, obstructive sleep apnea hypopnea (OSAH) (see Chapter 29), substance/medication induced disorder (see Chapter 65), and restless legs syndrome (RLS). Insomnia disorder is presented in detail because it is an underpinning of each of these disorders. The criteria and important contributing factors for insomnia disorder and RLS are discussed.  Box 70.5 Education and Referral for Patients With Eating Disorders  • Provide information on eating disorder programs  • Review nutritional information and recommended dietary program and offer referral to a registered dietician  • Teach stress management and relaxation techniques for persons and families, to be used especially at mealtimes  • Provide education on health effects of laxatives and diuretics  • Reinforce the long-term nature of these disorders and the need for follow-up and treatment  • Point out that under stress, regressive behaviors can occur  • Involve the family in identifying symptoms to identify and report  • Encourage regular dental care for those who purge  • Teach strategies for managing self-destructive behaviors in ways that do not reinforce them  • Provide referral for individual or family therapy  Source: Vitousek KB, Orimoto L. Cognitive-behavioral models of anorexia nervosa, bulimia nervosa, and obesity. In: Kendall P, Dobson KS, eds. Psychopathology and cognition. San Diego, CA: Academic Press; 1993:191.