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Continuum (Minneapolis, Minn.) Aug 2017Sleep-wake disorders occur in 10% to 28% of children and differ somewhat in pathophysiology and management from sleep-wake disorders in adults. This article discusses... (Review)
Review
PURPOSE OF REVIEW
Sleep-wake disorders occur in 10% to 28% of children and differ somewhat in pathophysiology and management from sleep-wake disorders in adults. This article discusses the diagnosis and management of key childhood sleep disorders.
RECENT FINDINGS
The role of sleep in memory consolidation and in the facilitation of learning has been increasingly recognized, even at the toddler stage. Cataplexy, a key feature of narcolepsy type 1, may be subtle in childhood and characterized by transient muscle weakness isolated to the face. Children with obstructive sleep apnea and restless legs syndrome display prominent neurobehavioral symptoms such as daytime inattentiveness and hyperactivity, so it is important to elicit a sleep history when these symptoms are encountered. Systemic iron deficiency occurs in about two-thirds of children with restless legs syndrome and is easily treatable. Parasomnias arising out of non-rapid eye movement (REM) sleep, such as confusional arousals and sleepwalking, may be difficult to distinguish from nocturnal seizures, and, in many cases, video-EEG polysomnography is required to differentiate between causes.
SUMMARY
Clinicians should routinely integrate the assessment of sleep-wake function into their practices of neurology and child neurology because of the opportunity to improve the quality of life of their patients.
Topics: Child; Humans; Parasomnias; Quality of Life; Restless Legs Syndrome; Sleep; Sleep Wake Disorders
PubMed: 28777180
DOI: 10.1212/CON.0000000000000504 -
Current Opinion in Pulmonary Medicine Nov 2016The purpose of this review is to help further the understanding of the clinical profile of patients with sexsomnia and to better understand the spectrum of the clinical... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to help further the understanding of the clinical profile of patients with sexsomnia and to better understand the spectrum of the clinical manifestations of sexsomnia. We will review the literature from the past decade on the subject and then compare it with our own clinical experience from patients who were retrospectively identified with sexsomnia at a tertiary sleep clinic over a 6-year period.
RECENT FINDINGS
The prevalence of sexual behaviours in sleep remains unknown, but it seems to involve predominantly younger male adults who also frequently exhibit other non-rapid eye movement-related parasomnias. Medication-induced cases have been reported and treatment approach of sexsomnia greatly varies.Of 41 individuals with sexsomnia from our centre with a mean age of 32 (37 men), manifestations of sexsomnia were variable; sexual intercourse was most frequently reported overall, but the majority of women carried out masturbation. Violence and aggression were described on 11 occasions. All patients were amnesic of events. 73% had a history of another parasomnia.
SUMMARY
Sexsomnia is frequently associated with concurrent sleep conditions or drugs initiation. It is a real clinical disorder which should be properly diagnosed and managed.
Topics: Humans; Male; Parasomnias; Prevalence; Sexual Behavior; Sleep; Sleep Wake Disorders
PubMed: 27607155
DOI: 10.1097/MCP.0000000000000321 -
Sleep Medicine Jul 2015The International Classification of Sleep Disorders-Third Edition (ICSD-3) classifies catathrenia among the respiratory disorders and not as a parasomnia as in ICSD-2.... (Review)
Review
BACKGROUND
The International Classification of Sleep Disorders-Third Edition (ICSD-3) classifies catathrenia among the respiratory disorders and not as a parasomnia as in ICSD-2. Few patients have been reported during these years, and the clinical description of the sound is different from group to group. In fact, there is no full agreement about its nature, origin, meaning, and treatment.
METHODS AND RESULTS
In this paper we review the literature on catathrenia focusing on the characteristics of the sound, demographics of the patients, aetiology, response to treatment, etc., in order to support its classification as a respiratory disorder or a parasomnia. We also discuss the possibility of Catathrenia being not one disorder but two variants or two different disorders.
Topics: Diagnosis, Differential; Humans; Parasomnias; REM Sleep Parasomnias; Respiration Disorders; Respiratory Sounds
PubMed: 26004681
DOI: 10.1016/j.sleep.2014.12.026 -
Sleep Medicine Apr 2017
Topics: Arousal; Humans; Parasomnias; Polysomnography; Sleep Wake Disorders
PubMed: 28131614
DOI: 10.1016/j.sleep.2016.11.008 -
Handbook of Clinical Neurology 2019The nonrapid eye movement (NREM) parasomnias range from age-related developmental phenomena in children to aggressive and injurious motor behaviors in all age groups.... (Review)
Review
The nonrapid eye movement (NREM) parasomnias range from age-related developmental phenomena in children to aggressive and injurious motor behaviors in all age groups. These parasomnias are commonly referred to as disorders of arousal and are an important cause of sleep-related injury. Genetic predisposition plays a role in the disorders of arousal, most evident in sleepwalking. Important concepts guiding our current understanding of the pathophysiology of the NREM parasomnias include sleep state instability (a propensity for arousal during NREM sleep), sleep inertia (incomplete awakening from NREM sleep), state dissociation (an ability to simultaneously straddle both NREM sleep and wakefulness), and activation of central pattern generators (permitting expression of subcortically determined motor behaviors without conscious higher cortical input). Management is multifaceted with an emphasis on education and nonpharmacologic measures. The purpose of this chapter is to review wake and NREM neurobiology and update our current understanding of NREM parasomnia pathophysiology, epidemiology, genetics, clinical features, precipitating factors, neurophysiologic evaluation, diagnosis, and clinical management.
Topics: Humans; Sleep Arousal Disorders; Sleep, Slow-Wave
PubMed: 31307616
DOI: 10.1016/B978-0-444-64142-7.00063-1 -
Molecular Neurobiology May 2017Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder characterized by enacting one's dreams during the REM sleep, with most of the dreams being... (Review)
Review
Rapid eye movement (REM) sleep behavior disorder (RBD) is a sleep disorder characterized by enacting one's dreams during the REM sleep, with most of the dreams being violent or aggressive, so that patients often come to see the doctor complaining hurting themselves or bed partners during sleep. Prevalence of RBD, based on population, is 0.38-2.01 %, but much higher in patients with neurodegenerative diseases, especially synucleinopathies. RBD may herald the emergence of synucleinopathies by decades, such that it may be used as an effective early marker of neurodegenerative diseases. Pharmaceutical treatment of RBD includes clonazepam, melatonin, pramipexole, and some newly reported medications. In this review, we summarized the clinical and PSG features of RBD, the pathophysiology and the therapy of it, focusing on the correlation between neurodegenerative diseases and RBD, in order to emphasize the significance of RBD as an early marker of neurodegenerative diseases.
Topics: Animals; Humans; Neurodegenerative Diseases; REM Sleep Behavior Disorder
PubMed: 27032389
DOI: 10.1007/s12035-016-9831-4 -
Pediatric Pulmonology Aug 2022Sleep terrors (STs) are sleep disorders characterized by abrupt arousal from sleep with autonomic hyperactivity and inappropriate behavior. Though a common condition in... (Review)
Review
Sleep terrors (STs) are sleep disorders characterized by abrupt arousal from sleep with autonomic hyperactivity and inappropriate behavior. Though a common condition in childhood that usually affects children between 4 and 12 years of age, STs, however, may be present even in adulthood. The exact etiology of STs is not known yet, however, several hypotheses have been proposed over the years, identifying some potential genetic, neurodevelopmental, or other causes. Nevertheless, a useful pathophysiological model identified a common cascade of predisposing, priming, and precipitating factors, which could help to explain and sometimes prevent STs. Establishing a correct diagnosis is mandatory for appropriate management, as several conditions (such as other parasomnias or nocturnal seizures) may mimic STs. Furthermore, we also described some conditions which can be comorbid to STs, like some medical or psychological disorders. A number of treatment options have been proposed, ranging from only sleep hygiene practices to pharmacological therapies; we reviewed some of the most prominent ones. In spite of the fact that STs have long been considered benign disorders, which tend to reduce spontaneously over the years, they may have unexpected consequences on the child but also on the caregivers.
Topics: Adult; Child; Dreams; Humans; Night Terrors; Parasomnias; Parents; Sleep
PubMed: 33647192
DOI: 10.1002/ppul.25304 -
Sleep Medicine Clinics Mar 2024Recurrent isolated sleep paralysis has a 7.6% lifetime prevalence of at least one episode in the general population. Episodes resolve spontaneously and are benign. Sleep... (Review)
Review
Recurrent isolated sleep paralysis has a 7.6% lifetime prevalence of at least one episode in the general population. Episodes resolve spontaneously and are benign. Sleep paralysis represents a dissociate state, with persistence of the rapid eye movement (REM)-sleep muscle atonia in the waking state. The intrusion of alpha electroencephalogram into REM sleep is followed by an arousal response and then by persistence of REM atonia into wakefulness. Predisposing factors include irregular sleep-wake schedules, sleep deprivation, and jetlag. No drug treatment is required. Patients should be informed about sleep hygiene. Cognitive behavioral therapy may be useful in cases accompanied by anxiety and frightening hallucinations.
Topics: Humans; Sleep Paralysis; Sleep, REM; Sleep; Wakefulness; Arousal
PubMed: 38368058
DOI: 10.1016/j.jsmc.2023.10.006 -
Sleep Medicine Reviews Dec 2021Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia with dream-enactment behaviors occurring during REM sleep and associated with the lack of the... (Review)
Review
Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia with dream-enactment behaviors occurring during REM sleep and associated with the lack of the physiological REM sleep muscle atonia. It can be isolated and secondary to other neurological or medical conditions. Isolated RBD heralds in most cases a neurodegenerative condition due to an underlying synucleinopathy and consequently its recognition is crucial for prognostic implications. REM sleep without atonia on polysomnography is a mandatory diagnostic criterion. Different conditions may mimic RBD, the most frequent being obstructive sleep apnea during sleep, non-REM parasomnia, and sleep-related hypermotor epilepsy. These diseases might also be comorbid with RBD, challenging the evaluation of disease severity, the treatment choices and the response to treatment evaluation. Video-PSG is the gold standard for a correct diagnosis and will distinguish between different or comorbid sleep disorders. Careful history taking together with actigraphy may give important clues for the differential diagnosis. The extreme boundaries of RBD might also be seen in more severe and complex conditions like status dissociatus or in the sleep disorders' scenario of anti IgLON5 disease, but in the latter both clinical and neurophysiological features will differ. A step-by-step approach is suggested to guide the differential diagnosis.
Topics: Humans; Parasomnias; Polysomnography; REM Sleep Behavior Disorder; Sleep Apnea, Obstructive; Sleep, REM
PubMed: 34186416
DOI: 10.1016/j.smrv.2021.101515 -
The Psychiatric Clinics of North America Mar 2024Children with psychiatric comorbidities frequently are referred for evaluation of sleep complaints. Common sleep symptoms can include difficulty falling asleep, frequent... (Review)
Review
Children with psychiatric comorbidities frequently are referred for evaluation of sleep complaints. Common sleep symptoms can include difficulty falling asleep, frequent nocturnal awakening, restless sleep, and symptoms of restless legs syndrome (RLS). The understanding of the sleep condition in relation to the psychiatric comorbidity often is a challenge to the physician and often sleep disorders remain undiagnosed, untreated, or undertreated. Restless legs syndrome has been associated with psychiatric comorbidities and with certain medications, such as antidepressants, antihistamines, and antipsychotics. This article reviews the presentation of RLS and restless sleep, the association with psychiatric comorbidities, and treatment options.
Topics: Child; Humans; Adolescent; Restless Legs Syndrome; Comorbidity
PubMed: 38302203
DOI: 10.1016/j.psc.2023.06.010