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Journal of Clinical Sleep Medicine :... Aug 2014To review systematically medical-legal cases of sleep-related violence (SRV) and sexual behavior in sleep (SBS). (Review)
Review
OBJECTIVE
To review systematically medical-legal cases of sleep-related violence (SRV) and sexual behavior in sleep (SBS).
SEARCH METHODS
We searched Pubmed and PsychINFO (from 1980 to 2012) with pre-specified terms. We also searched reference lists of relevant articles.
SELECTION CRITERIA
Case reports in which a sleep disorder was purported as the defense during a criminal trial and in which information about the forensic evaluation of the defendant was provided.
DATA EXTRACTION AND ANALYSIS
Information about legal issues, defendant and victim characteristics, circumstantial factors, and forensic evaluation was extracted from each case. A qualitative-comparative assessment of cases was performed.
RESULTS
Eighteen cases (9 SRV and 9 SBS) were included. The charge was murder or attempted murder in all SRV cases, while in SBS cases the charge ranged from sexual touching to rape. The defense was based on sleepwalking in 11 of 18 cases. The trial outcome was in favor of the defendant in 14 of 18 cases. Defendants were relatively young males in all cases. Victims were usually adult relatives of the defendants in SRV cases and unrelated young girls or adolescents in SBS cases. In most cases the criminal events occurred 1-2 hours after the defendant's sleep onset, and both proximity and other potential triggering factors were reported. The forensic evaluations widely differed from case to case.
CONCLUSION
SRV and SBS medical-legal cases did not show apparent differences, except for the severity of the charges and the victim characteristics. An international multidisciplinary consensus for the forensic evaluation of SRV and SBS should be developed as an urgent priority.
Topics: Adolescent; Adult; Criminal Law; Female; Forensic Medicine; Homicide; Humans; Male; Night Terrors; Rape; Sex Offenses; Sleep Wake Disorders; Somnambulism; Violence; Young Adult
PubMed: 25126042
DOI: 10.5664/jcsm.3976 -
The Cochrane Database of Systematic... Mar 2017Restless legs syndrome (RLS) is a common disease affecting about 5% to 15% of the population. Symptoms of RLS can be severe in a minority of and can have a major impact... (Review)
Review
BACKGROUND
Restless legs syndrome (RLS) is a common disease affecting about 5% to 15% of the population. Symptoms of RLS can be severe in a minority of and can have a major impact on sleep, mostly sleep initiation, and quality of life. Benzodiazepines are drugs that can induce and maintain sleep and, hence, intuitively are thought to be beneficial to people with RLS. Altough benzodiazepines, particularly clonazepam, are used to treat RLS symptoms, a systematic review done by the American Academy of Sleep Medicine stated that benzodiazepines should not be used as a first-line treatment, although could be used as a coadjuvant therapy.
OBJECTIVES
To evaluate the efficacy and safety of benzodiazepine compared to placebo or other treatment for idiopathic RLS, including unconfounded trials comparing benzodiazepines versus open control.
SEARCH METHODS
In March 2016 we searched CENTRAL, MEDLINE, Embase and LILACS We checked the references of each study and contacted study authors to identify any additional studies. We considered studies published in any language.
SELECTION CRITERIA
Randomised clinical trials of benzodiazepine treatment in idiopathic RLS.
DATA COLLECTION AND ANALYSIS
We did not perform data collection and analysis, since we did not include any studies, MAIN RESULTS: We did not identify any studies that met the inclusion criteria of the review. Two cross-over studies are awaiting classification because the cross-over trials did not give data at the end of the first cross-over period.
AUTHORS' CONCLUSIONS
The effectiveness of benzodiazepines for RLS treatment is currently unknown.
Topics: Benzodiazepines; Humans; Restless Legs Syndrome
PubMed: 28319266
DOI: 10.1002/14651858.CD006939.pub2 -
Pediatric Dentistry Jan 2022The prevalence of bruxism in children varies considerably. The purpose of this study was to synthesize evidence of the prevalence of bruxism in Brazilian children and... (Meta-Analysis)
Meta-Analysis
The prevalence of bruxism in children varies considerably. The purpose of this study was to synthesize evidence of the prevalence of bruxism in Brazilian children and consider how proportions differ between genders, assessment approaches, and geographical regions. A search was conducted using five databases and in gray literature. Two independent investigators selected the studies and extracted data. The risk of bias was assessed via the Joanna Briggs Institute tool for studies on prevalence. The certainty of the evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Twenty-two cross-sectional studies were included after a two-step selection. Overall, 13,076 children from all regions of the country were assessed. The risk of bias ranged from high to low. Data were pooled in a random-effect model and resulted in an overall prevalence of sleep and awake bruxism of 25.8 percent (95 percent confidence interval [95% CI] equals 22.2 to 29.4; I2 equals 96 percent; prediction interval equals 0.07 to 0.44) and 20.1 percent (95% CI equals 18.0 to 22.3; I2 equals 30 percent; prediction interval equals 0.18 to 0.22), respectively. Subgroup and sensibility analysis showed distribution similarity between genders (P=0.96), assessment approaches (P=0.88), and geographical regions (P=0.44). "Possible" and "probable" sleep bruxism affects one in four Brazilian children, and there is evidence with a low level of certainty that its prevalence does not vary between genders, assessment approaches, or geographical regions. The distribution of bruxism is still an unknown subject and presumably occurs because of individual rather than regional or collective factors.
Topics: Brazil; Child; Cross-Sectional Studies; Female; Humans; Male; Prevalence; Sleep Bruxism
PubMed: 35232529
DOI: No ID Found -
Multiple Sclerosis and Related Disorders Nov 2021Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable sensation felt in the lower extremity. The aim of this systematic review and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Restless legs syndrome (RLS) is a sensory-motor disorder characterized by an uncomfortable sensation felt in the lower extremity. The aim of this systematic review and meta-analyses was (i) to provide updated information on the prevalence and clinical characteristics of RLS amongst people with multiple sclerosis (PwMS) and (ii) clarify RLS-related factors in PwMS.
METHODS
MEDLINE (PubMed), Scopus, and EMBASE were searched from their inception through April 2021 for the following keywords: 'restless legs syndrome' or 'RLS' and 'multiple sclerosis' or 'MS'. For the analysis of RLS prevalence, we calculated the percentage of RLS sufferers amongst the PwMS and people without MS. The prevalence of RLS was pooled separately for PwMS and healthy controls, regardless of the heterogeneity between studies. The odds ratios (ORs) and 95% CIs were extracted from the data in order to analyze the association between MS and RLS.
RESULTS
Nineteen studies were included in the review (9 case-controlled and 10 cross-sectional).The mean prevalence of RLS in the MS population was 27.5%, ranging from 13.2% to 65.1%, higher than the healthy controls. Based on the case control studies, the pooled RLS prevalence was much higher in PwMS than in healthy controls (OR 4.535, 95% CI 3.043-6.759, p<0.001). The majority of studies found no significant relationship between the presence of RLS in PwMS with disability, disease duration, type of MS, age, or gender.
CONCLUSIONS
Our updated systematic review strengthens the evidence of the increased risk of RLS amongst PwMS. Nevertheless, significant data reporting on characteristics of the MS disease, which increases the risk of suffering from RLS, is still lacking.
Topics: Case-Control Studies; Cross-Sectional Studies; Humans; Multiple Sclerosis; Odds Ratio; Prevalence; Restless Legs Syndrome
PubMed: 34592631
DOI: 10.1016/j.msard.2021.103275 -
Journal of Clinical Sleep Medicine :... Nov 2022This study aims to explore the polysomnographically measured sleep and leg movement differences between idiopathic restless legs syndrome (RLS) patients and healthy... (Meta-Analysis)
Meta-Analysis
STUDY OBJECTIVES
This study aims to explore the polysomnographically measured sleep and leg movement differences between idiopathic restless legs syndrome (RLS) patients and healthy controls.
METHODS
An electronic literature search was conducted in EMBASE, MEDLINE, all EBM databases, CINAHL, and PsycINFO. Only observational case-control studies were included in the meta-analysis. The differences in 13 sleep parameters and 23 leg movement parameters between RLS patients and healthy controls were explored.
RESULTS
Thirty-eight studies were identified for systematic review, 31 of which were used for meta-analysis. Meta-analyses revealed significant reductions in total sleep time, sleep efficiency, stage N2 and rapid eye movement (REM) sleep percentages, and increases in wake time after sleep onset, stage shifts per hour, stage N1 percentage, REM latency, arousal index, and apnea-hypopnea index. Some leg movement parameters, such as periodic limb movement during sleep (PLMS) index, PLMS sequence duration, number of PLMS sequence, and periodicity index, were higher in RLS patients compared with healthy controls. Further, our meta-analysis revealed a higher PLMS index during non-REM sleep compared with that during REM sleep.
CONCLUSIONS
RLS patients manifest a lightening of sleep, increased sleep fragmentation, and greater sleep-related breathing disruption and limb movements during sleep relative to healthy normal individuals. The distributions of PLMS during a night's sleep may provide more information to clarify the specific characteristics of leg movements in RLS. PLMS in RLS are concentrated in non-REM sleep. The periodicity index may be a more sensitive and specific marker of RLS than the PLMS index.
CITATION
Zhang H, Zhang Y, Ren R, et al. Polysomnographic features of idiopathic restless legs syndrome: a systematic review and meta-analysis of 13 sleep parameters and 23 leg movement parameters. . 2022;18(11):2561-2575.
Topics: Humans; Restless Legs Syndrome; Leg; Sleep; Polysomnography; Movement
PubMed: 35903949
DOI: 10.5664/jcsm.10160 -
Sleep Medicine Reviews Feb 2018Medications that trigger sleepwalking may inadvertently put the patient at risk of injury to themselves and/or others, and contribute to poor treatment adherence. The... (Review)
Review
Medications that trigger sleepwalking may inadvertently put the patient at risk of injury to themselves and/or others, and contribute to poor treatment adherence. The aim of this study was to systematically review the literature to identify drugs that may increase the risk of sleepwalking. A search of CINAHL, EMBASE, PsycINFO, PubMed, and ScienceDirect was conducted with the keywords 'sleepwalking' OR 'somnambulism'. Of the original 83 sourced papers, 62 met the inclusion criteria and were subsequently included for review. Twenty-nine drugs, primarily in four classes-benzodiazepine receptor agonists and other gamma aminobutyric acid (GABA) modulators, antidepressants and other serotonergic agents, antipsychotics, and β-blockers-were identified as possible triggers for sleepwalking. The strongest evidence for medication-induced sleepwalking was for zolpidem and sodium oxybate. All other associations were based on case reports. This research highlights the importance of considering sleepwalking in risk profiles in clinical trials, particularly for drugs that enhance GABA activity at the GABA receptor, enhance serotonergic activity, or block the activity of noradrenaline at β receptors. The results also have implications for prescribers to consider sleepwalking as a potential adverse effect and ensure that: 1) the patient is educated about a safe sleep environment; 2) they are encouraged to report the onset or exacerbation of sleepwalking, and 3) alternative treatments are considered if sleepwalking occurs.
Topics: Antidepressive Agents; GABA-A Receptor Agonists; Humans; Pyridines; Somnambulism; Zolpidem
PubMed: 28363449
DOI: 10.1016/j.smrv.2017.01.005 -
BMJ Clinical Evidence Sep 2007Sleep disorders may affect 20-30% of young children, and include excessive daytime sleepiness, problems getting to sleep (dysomnias), or undesirable phenomena during... (Review)
Review
INTRODUCTION
Sleep disorders may affect 20-30% of young children, and include excessive daytime sleepiness, problems getting to sleep (dysomnias), or undesirable phenomena during sleep (parasomnias), such as sleep terrors, and sleepwalking. Children with physical or learning disabilities are at increased risk of sleep disorders.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for dysomnias in children? What are the effects of treatments for parasomnias in children? We searched: Medline, Embase, The Cochrane Library and other important databases up to September 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 14 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antihistamines, behavioural therapy plus benzodiazepines, or plus chloral and derivates, exercise, extinction and graduated extinction, light therapy, melatonin, safety/protective interventions for parasomnias, scheduled waking (for parasomnias), sleep hygiene, and sleep restriction.
Topics: Administration, Oral; Behavior Therapy; Child; Humans; Learning Disabilities; Melatonin; Parasomnias; Sleep; Sleep Wake Disorders
PubMed: 19450298
DOI: No ID Found -
Neurological Sciences : Official... Jan 2023The prevalence of restless legs syndrome (RLS) is reported to vary in patients with multiple sclerosis (MS) in studies which are conducted in different populations. The... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The prevalence of restless legs syndrome (RLS) is reported to vary in patients with multiple sclerosis (MS) in studies which are conducted in different populations. The goal of this systematic review and meta-analysis is to update the prevalence of RLS in MS cases.
METHODS
We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Google Scholar, and gray literature including references from identified studies and conference abstracts which were published up to June 2021. Data on the total number of participants, first author, country, disease duration, number of controls, mean patient age, male and female numbers, mean EDSS, and number of cases and/or controls with RLS were extracted from the included studies.
RESULTS
The literature search revealed 855 articles; after deleting duplicates, 530 remained. For the meta-analysis, 75 studies were included (Fig. 1). In six articles, the authors did not differentiate between CIS and MS cases when reporting RLS cases. In total, 15,411 MS/CIS patients were evaluated and 4309 had RLS. The pooled prevalence of RLS was 28% (95% CI: 24-33%). The pooled prevalence of RLS in men was 22% (95% CI: 17-26%), and the pooled prevalence of RLS in women was 30% (95% CI: 25-35%). The pooled prevalence of RLS in controls was 8% (95% CI: 6-10%).
CONCLUSION
The results of this systematic review and meta-analysis show that the pooled prevalence of RLS is 28% in MS cases and 8%. The pooled prevalence is higher in women than men (30% vs 22%).
Topics: Humans; Male; Female; Restless Legs Syndrome; Prevalence; Multiple Sclerosis; Motivation
PubMed: 36058956
DOI: 10.1007/s10072-022-06364-6 -
CNS Spectrums Feb 2022Parasomnias are involuntary behaviors or subjective experiences during sleep. Our objective was to review existing information on the presence of parasomnias in patients... (Review)
Review
Parasomnias are involuntary behaviors or subjective experiences during sleep. Our objective was to review existing information on the presence of parasomnias in patients with addictions or during treatment for addictions. Information about parasomnias related to rapid-eye-movement (REM) and non-REM sleep in patients with addictions, while using substances or in abstinence, was reviewed. A systematic search of published articles reporting parasomnias as a consequence of drug use or abuse was conducted in the PubMed and SciELO databases. The search for the studies was performed in three phases: (1) by title, (2) by abstract, and (3) by complete text. The search was performed independently by two researchers, who then compared their results from each screening phase. Seventeen articles were found. The consumption of alcohol was reported in association with arousal disorders, such as sexsomnia and sleep-related eating disorder; and REM sleep behavior disorder was reported during alcohol withdrawal. Cocaine abuse was associated with REM sleep behavior disorder with drug consumption dream content. Overall, we found that several types of parasomnias were very frequent in patients with addictions. To avoid accidents in bedroom, legal problems, and improve evolution and prognosis; must be mandatory to include security measures related to sleep period; avoid pharmacological therapy described as potential trigger factor; improve sleep hygiene; and give pharmacological and behavioral treatments for patients with these comorbid sleep disorders.
Topics: Alcoholism; Humans; Parasomnias; REM Sleep Behavior Disorder; Sleep; Substance Withdrawal Syndrome
PubMed: 33092679
DOI: 10.1017/S1092852920001911 -
Sleep Medicine Reviews Aug 2012Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is... (Review)
Review
Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.
Topics: Adrenal Gland Diseases; Adult; Cardiovascular Diseases; Diabetes Complications; Dyslipidemias; Humans; Hypertension; Metabolic Diseases; Obesity; Restless Legs Syndrome
PubMed: 21733722
DOI: 10.1016/j.smrv.2011.04.001