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The Psychiatric Clinics of North America Sep 2023Women have increased risks for both sleep disturbances and disorders and for mental health issues throughout their lives, starting in adolescence. Women have a higher... (Review)
Review
Women have increased risks for both sleep disturbances and disorders and for mental health issues throughout their lives, starting in adolescence. Women have a higher prevalence of insomnia disorder and restless legs syndrome (RLS) versus men, and obstructive sleep apnea (OSA) is more likely as women age. Hormonal transitions are important to consider in women's sleep. For women, insomnia, OSA, and RLS are predictive of depression, and insomnia and sleep-disordered breathing are predictive of Alzheimer disease. These findings underscore the importance of assessment, treatment, and future research examining sleep and mental health in women, given their unique and increased vulnerability.
Topics: Male; Adolescent; Humans; Female; Sleep Initiation and Maintenance Disorders; Mental Health; Sleep; Sleep Apnea, Obstructive; Women's Health; Restless Legs Syndrome; Prevalence; Sleep Wake Disorders
PubMed: 37500248
DOI: 10.1016/j.psc.2023.04.008 -
Sleep Medicine Clinics Mar 2024Sleep terrors, categorized under disorders of arousal, more prevalent in pediatric population, generally are self-limited but sometimes can persist or occur in... (Review)
Review
Sleep terrors, categorized under disorders of arousal, more prevalent in pediatric population, generally are self-limited but sometimes can persist or occur in adulthood. These are primed by factors enhancing homeostatic drive on backdrop of developmental predisposition and are precipitated by factors increasing sleep fragmentation resulting in dissociated state of sleep with some cerebral regions showing abnormal slow wave activity and others fast activity. This phenotypically evolves into abrupt partial arousal with individual arousing from N3 or N2 sleep with behaviors representing intense fear such as crying with autonomic hyperactivity. There is no recollection of the event, and lack of vivid dream mentation although fragmented imagery may be noted. Behavioral management is of prime importance including addressing precipitating factors, family reassurance, safety measures, and scheduled awakenings. Pharmacologic agents such as clonazepam and antidepressants are used infrequently in case of disruptive episodes.
Topics: Humans; Child; Night Terrors; Somnambulism; Parasomnias; Sleep; Sleep Stages; Sleep Wake Disorders
PubMed: 38368070
DOI: 10.1016/j.jsmc.2023.12.004 -
Sleep Medicine Clinics Mar 2024This article reports on the epidemiology, prevalence, and physiopathology of sleep-related urinary dysfunction, a new syndromic category proposed by the recently revised... (Review)
Review
This article reports on the epidemiology, prevalence, and physiopathology of sleep-related urinary dysfunction, a new syndromic category proposed by the recently revised ICSD-3-TR classification. Sleep enuresis, whether primary or secondary, monosymptomatic or plurisymptomatic, will be reviewed in terms of risk factors, comorbidity, and diagnostic and therapeutic indications. A definition of nocturia and its impact on patients' health, quality of life, and mortality will follow. Finally, the impact of urge incontinence on various medical and neurologic disorders will be discussed. Special emphasis will be placed on the possible association of this parasomnia with several sleep disorders and poor, fragmented sleep.
Topics: Humans; Quality of Life; Nocturnal Enuresis; Sleep Wake Disorders; Nocturia; Sleep
PubMed: 38368063
DOI: 10.1016/j.jsmc.2023.10.009 -
Current Neurology and Neuroscience... Jul 2023Patients with different types of choreic syndromes, specially those with Huntington's (HD) and Wilson's (WD) diseases, report frequent sleep complaints. This review... (Review)
Review
PURPOSE OF REVIEW
Patients with different types of choreic syndromes, specially those with Huntington's (HD) and Wilson's (WD) diseases, report frequent sleep complaints. This review focuses on the main findings of studies addressing the sleep features in these diseases, and other less frequent causes of chorea associated with sleep disorders, including a new syndrome described in the last decade associated with IgLON5 antibodies.
RECENT FINDINGS
Patients with HD and WD showed a bad quality of sleep and high frequency of insomnia and excessive daytime somnolence. WD patients also showed high scores on a specific scale for rapid eye movement sleep behavior disorders. HD and WD share decreased sleep efficiency and increased REM sleep latencies, percentage of sleep stage N1, and wake after sleep onset (WASO) among their polysomnographic features. Patients with HD and WD showed a high prevalence of different sleep disorders. Patients with other causes of chorea, including neuroacanthocytosis, parasomnia with sleep breathing disorder associated with antibodies to IgLON5, Sydenham's chorea, and choreic syndromes associated to certain genetic mutations show sleep disorders as well.
Topics: Humans; Syndrome; Chorea; Sleep; REM Sleep Behavior Disorder; Sleep Wake Disorders; Cell Adhesion Molecules, Neuronal
PubMed: 37269451
DOI: 10.1007/s11910-023-01274-2 -
Sleep Medicine Clinics Mar 2024Trauma-associated sleep disorder (TASD) is a recently described parasomnia that develops following a traumatic event. It consists of trauma-related nightmares,... (Review)
Review
Trauma-associated sleep disorder (TASD) is a recently described parasomnia that develops following a traumatic event. It consists of trauma-related nightmares, disruptive nocturnal behaviors, and autonomic disturbances, and shares similarities with post-traumatic stress disorder and rapid eye movement behavior disorder. The underlying pathophysiology of TASD and how it relates to other parasomnias are still not entirely understood; proposed treatment is similarly nebulous, with prazosin at the forefront along with management of comorbid sleep disorders. The purpose of this article is to characterize and highlight the clinical features of this condition.
Topics: Humans; Polysomnography; Sleep Wake Disorders; Parasomnias; Stress Disorders, Post-Traumatic; Dreams
PubMed: 38368073
DOI: 10.1016/j.jsmc.2023.10.005 -
Sleep Medicine Clinics Mar 2024Sleep-related eating disorder is a non-rapid-eye movement parasomnia typified by recurrent episodes of eating/drinking following arousals, with associated... (Review)
Review
Sleep-related eating disorder is a non-rapid-eye movement parasomnia typified by recurrent episodes of eating/drinking following arousals, with associated partial/complete amnesia. Adverse health consequences and quality of life impairments are common. The condition can be idiopathic but most often accompanies unrecognized/untreated comorbid sleep disorders and/or is induced by psychoactive medications. As such, management consists of addressing comorbidities and removing potentially offending medications. While a thorough clinical history is often sufficient, additional sleep testing may help identify coexisting sleep disorders and/or other phenomena that may cause arousals. Limited data suggest benefit from topiramate and other medications in idiopathic or otherwise refractory cases.
Topics: Humans; Quality of Life; Parasomnias; Feeding and Eating Disorders; Sleep Wake Disorders; Sleep
PubMed: 38368069
DOI: 10.1016/j.jsmc.2023.10.013 -
Brain : a Journal of Neurology Aug 2023The neurodegenerative synucleinopathies, including Parkinson's disease and dementia with Lewy bodies, are characterized by a typically lengthy prodromal period of...
The neurodegenerative synucleinopathies, including Parkinson's disease and dementia with Lewy bodies, are characterized by a typically lengthy prodromal period of progressive subclinical motor and non-motor manifestations. Among these, idiopathic REM sleep behaviour disorder is a powerful early predictor of eventual phenoconversion, and therefore represents a critical opportunity to intervene with neuroprotective therapy. To inform the design of randomized trials, it is essential to study the natural progression of clinical markers during the prodromal stages of disease in order to establish optimal clinical end points. In this study, we combined prospective follow-up data from 28 centres of the International REM Sleep Behavior Disorder Study Group representing 12 countries. Polysomnogram-confirmed REM sleep behaviour disorder subjects were assessed for prodromal Parkinson's disease using the Movement Disorder Society criteria and underwent periodic structured sleep, motor, cognitive, autonomic and olfactory testing. We used linear mixed-effect modelling to estimate annual rates of clinical marker progression stratified by disease subtype, including prodromal Parkinson's disease and prodromal dementia with Lewy bodies. In addition, we calculated sample size requirements to demonstrate slowing of progression under different anticipated treatment effects. Overall, 1160 subjects were followed over an average of 3.3 ± 2.2 years. Among clinical variables assessed continuously, motor variables tended to progress faster and required the lowest sample sizes, ranging from 151 to 560 per group (at 50% drug efficacy and 2-year follow-up). By contrast, cognitive, olfactory and autonomic variables showed modest progression with higher variability, resulting in high sample sizes. The most efficient design was a time-to-event analysis using combined milestones of motor and cognitive decline, estimating 117 per group at 50% drug efficacy and 2-year trial duration. Finally, while phenoconverters showed overall greater progression than non-converters in motor, olfactory, cognitive and certain autonomic markers, the only robust difference in progression between Parkinson's disease and dementia with Lewy bodies phenoconverters was in cognitive testing. This large multicentre study demonstrates the evolution of motor and non-motor manifestations in prodromal synucleinopathy. These findings provide optimized clinical end points and sample size estimates to inform future neuroprotective trials.
Topics: Humans; Parkinson Disease; Lewy Body Disease; REM Sleep Behavior Disorder; Prospective Studies; Disease Progression; Biomarkers; Prodromal Symptoms
PubMed: 36881989
DOI: 10.1093/brain/awad072 -
Sleep Medicine Clinics Mar 2024In sleep-related dissociative disorders, phenomena of the psychiatrically defined dissociative disorders emerge during the sleep period. They occur during sustained... (Review)
Review
In sleep-related dissociative disorders, phenomena of the psychiatrically defined dissociative disorders emerge during the sleep period. They occur during sustained wakefulness, either in the transition to sleep or following an awakening from sleep. Behaviors during episodes vary widely, and can result in injury to self or others. Daytime dissociative episodes and a background of trauma are almost always present; there is typically major co-existing psychopathology. Diagnosis is based on both clinical history and polysomnography; differential diagnosis primarily involves other parasomnias and nocturnal seizures. Information available about treatment is limited; in a few reported cases, psychological interventions have proven effective.
Topics: Humans; Parasomnias; Sleep Wake Disorders; Dissociative Disorders; Sleep, REM; Sleep
PubMed: 38368062
DOI: 10.1016/j.jsmc.2023.10.003 -
Continuum (Minneapolis, Minn.) Aug 2023Non-rapid eye movement (non-REM) parasomnias are common across the lifespan. This article describes the manifestations, diagnosis, and management of non-REM parasomnias...
OBJECTIVE
Non-rapid eye movement (non-REM) parasomnias are common across the lifespan. This article describes the manifestations, diagnosis, and management of non-REM parasomnias in adults and discusses the social implications of these conditions.
LATEST DEVELOPMENTS
Non-REM parasomnias represent a hybrid state of wakefulness and sleep, often triggered by events that increase the frequency of arousals or make it more difficult to fully arouse from sleep. Sleep deprivation, certain medications, and untreated obstructive sleep apnea are known to provoke parasomnias, particularly in those who are genetically predisposed. Non-REM parasomnias include disorders of arousal (ie, sleepwalking, sleep terrors, and confusional arousals), sleep-related eating disorder, and exploding head syndrome. Clinical overlap exists between sleep-related eating disorder and disorders of arousal, suggesting that sleep-related eating disorder may be a fourth disorder of arousal or a manifestation of sleepwalking. Exploding head syndrome is a unique parasomnia of uncertain etiology.
ESSENTIAL POINTS
Non-REM parasomnias can range from minor nuisances to severe, life-altering events. While some patients with non-REM parasomnia experience significant consequences during sleep, wakefulness, or both, non-REM parasomnias do not pose a major risk to most patients. For all patients with non-REM parasomnias, safety should be explicitly discussed and addressed. Nonpharmacologic treatment should be prioritized, as increasing total sleep time, avoiding triggering substances, and treating comorbid sleep disorders is often sufficient for the management of non-REM parasomnias. If symptoms persist despite these interventions, treatment with clonazepam or other medications can be considered.
Topics: Adult; Humans; Somnambulism; Parasomnias; Sleep; Wakefulness; Sleep Duration
PubMed: 37590825
DOI: 10.1212/CON.0000000000001261