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CMAJ : Canadian Medical Association... May 2014
Review
Topics: Diagnosis, Differential; Electroencephalography; Female; Humans; Incidence; Male; Neuropsychological Tests; Night Terrors; Parasomnias; Physical Examination; Prognosis; REM Sleep Parasomnias; Rare Diseases; Severity of Illness Index
PubMed: 24799552
DOI: 10.1503/cmaj.120808 -
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 Aug 2021
Topics: Epilepsy; Gastroesophageal Reflux; Humans; Parasomnias; Polysomnography; Sleep
PubMed: 34153797
DOI: 10.1016/j.sleep.2021.05.035 -
Sleep Medicine Clinics Jun 2021Restless sleep disorder is (RSD) a condition characterized by frequent large movements during sleep associated with daytime impairment. RSD has been studied in children... (Review)
Review
Restless sleep disorder is (RSD) a condition characterized by frequent large movements during sleep associated with daytime impairment. RSD has been studied in children aged 6 to 18 years. Polysomnography is necessary for the diagnosis of RSD. The current diagnostic criteria include more than 5 large movements per hour of sleep documented by PSG. The pathophysiology is not known yet, but iron deficiency and sleep instability and increased sympathetic activation are suspected to play a role. Iron supplementation is the only treatment option studied so far.
Topics: Humans; Parasomnias; Polysomnography
PubMed: 33985662
DOI: 10.1016/j.jsmc.2021.03.003 -
Sleep Feb 2017To describe patients with sexsomnia and to contrast their clinical and sleep measures with those of healthy controls and sleepwalkers.
INTRODUCTION
To describe patients with sexsomnia and to contrast their clinical and sleep measures with those of healthy controls and sleepwalkers.
AIMS AND METHODS
Subjects referred for sexsomnia and for sleepwalking/night terror were interviewed, completed the Paris Arousal Disorder Severity Scale (PADSS), and were monitored 1-2 nights with video-polysomnography.
RESULTS
Seventeen patients (70.6% male, aged 17-76 years) had sexsomnia, with amnestic fondling of the bed partner (n = 11), complete sexual intercourse (n = 8), masturbation (n = 8), and spontaneous orgasm (n = 1). The sexual behaviors were more direct during sleep than during wakefulness (n = 12), leading to 6 sexual assaults, including intra-conjugal rape (n = 3), assault of a family member (n = 2), rape of a friend (n = 1), and forensic consequences (n = 2). In 47% of sexsomnia patients, there was a history or current occurrences of sleepwalking/night terrors. Patients with sexsomnia had more N3 awakenings than healthy matched controls and the same amount as regular sleepwalkers. Half of them presented evidence of cortico-cortical dissociation, including concomitant slow (mostly frontal) and rapid (mostly temporal and occipital) electroencephalography (EEG) rhythms, with concomitant N3 penile erection in 1 case. Of 89 sleepwalkers, 10% had previous episodes of amnestic sexual behaviors, with a higher PADSS-A score and a trend of a higher total PADSS score than the 80 sleepwalkers without sexsomnia.
CONCLUSION
In this single-center series, we confirmed the male predominance of sexsomnias and its potential for severe clinical and forensic consequences. The results suggest a continuum of regular sleepwalking, sleepwalking with occasional sexsomnia, and quasi-exclusive sexsomnia.
Topics: Adolescent; Adult; Aged; Case-Control Studies; Electroencephalography; Female; Humans; Male; Middle Aged; Night Terrors; Parasomnias; Polysomnography; Sex Offenses; Sexual Behavior; Sleep, REM; Somnambulism; Young Adult
PubMed: 28364495
DOI: 10.1093/sleep/zsw043 -
Journal of Clinical Sleep Medicine :... Jun 2020Unpleasant dreamlike mentation can occur during non-rapid eye movement parasomnias, leading to associated panic attacks. The mentations are rarely remembered and are...
Unpleasant dreamlike mentation can occur during non-rapid eye movement parasomnias, leading to associated panic attacks. The mentations are rarely remembered and are likely underreported. However, they may lead to significant personal distress and, if not addressed, may contribute to poorer clinical outcomes. Cotard le délire de negation are very rare nihilistic delusions, historically described with psychotic disorders. Their association with a variety of neurologic disorders, including migraine and cluster-headache, has also been reported. Here we present three cases of Cotard parasomnia during which distinct states of consciousness defined by nihilistic ideation occurred. Patients described believing they are dead or dying, while unable to perceive or experience their bodies in whole, or in part, as their own. A source analysis of the electroencephalographic fingerprint of these mentations suggests right-hemispheric hypoactivity subsequent to confusional arousals. Mechanistically, an aberrant activation of two major intrinsic brain networks of wakefulness, the salience network and the default mode network, is argued.
Topics: Brain; Dreams; Electroencephalography; Humans; Parasomnias; Sleep Arousal Disorders
PubMed: 32195661
DOI: 10.5664/jcsm.8430 -
Journal of Clinical Sleep Medicine :... Apr 2016Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only.
STUDY OBJECTIVES
Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only.
METHODS
We retrospectively analyzed clinical, polysomnographic, and HLA findings of 74 adults (37 men) with NREM parasomnia gathered from four neurological sleep centers. Parasomniac events were classified according to ICSD-2 criteria. HLA DQB1 genotyping was compared to regional-matched reference allele-frequencies.
RESULTS
Fifty-six patients had more than 2 different parasomnia type: 11 sleepwalking, 4 sleep terrors, 3 confusional arousals only. Parasomniac events were documented during video-polysomnography (V-PSG) in 70% (49/70) of subjects (71.4% confusional arousals, 8.2% sleep terrors, 4.1% sleepwalking, 16.3% ≥ 2 NREM parasomnia types). Violent behavior during V-PSG occurred in 8.5% (6/71). NREM parasomnia onset was reported after the age of 30 years in 6.8% (5/74). The HLA DQB1*05:01 allele was present in 41% (29/71) compared to 24.2% in the regional-matched reference allele group (p < 0.05). This haplotype prevalence did not differ within the NREM parasomnia type. Epworth Sleepiness Score was 10 or higher in 28.6%.
CONCLUSIONS
This is a large polysomnography-based case series of patients with NREM parasomnia. In patients with suspected sleepwalking or sleep terrors, polysomnography is highly useful in detecting arousals from NREM sleep as a marker of NREM parasomnia. We confirmed previous findings by demonstrating a high prevalence of the HLA DQB1*05:01 genotype for different types of NREM parasomnias. Our findings therefore support a common genetic background, and corroborate the importance of video-polysomnography in the work-up of parasomnia.
Topics: Adolescent; Adult; Aged; Female; Genetic Predisposition to Disease; HLA-DQ beta-Chains; Humans; Male; Middle Aged; Parasomnias; Retrospective Studies; Sleep Arousal Disorders; Sleep Stages; Somnambulism; Videotape Recording; Young Adult
PubMed: 26951409
DOI: 10.5664/jcsm.5692 -
Journal of Psychopharmacology (Oxford,... Aug 2019This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A... (Meta-Analysis)
Meta-Analysis
This British Association for Psychopharmacology guideline replaces the original version published in 2010, and contains updated information and recommendations. A consensus meeting was held in London in October 2017 attended by recognised experts and advocates in the field. They were asked to provide a review of the literature and identification of the standard of evidence in their area, with an emphasis on meta-analyses, systematic reviews and randomised controlled trials where available, plus updates on current clinical practice. Each presentation was followed by discussion, aiming to reach consensus where the evidence and/or clinical experience was considered adequate, or otherwise to flag the area as a direction for future research. A draft of the proceedings was circulated to all speakers for comments, which were incorporated into the final statement.
Topics: Chronobiology Disorders; Consensus; Evidence-Based Medicine; Humans; London; Parasomnias; Psychopharmacology; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders
PubMed: 31271339
DOI: 10.1177/0269881119855343 -
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 -
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