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Zhurnal Nevrologii I Psikhiatrii Imeni... 2021Exploding head syndrome (EHS) is a paroxysmal sensory parasomnia characterized by the sensation of a loud noise or «explosion in the head» during the... (Review)
Review
Exploding head syndrome (EHS) is a paroxysmal sensory parasomnia characterized by the sensation of a loud noise or «explosion in the head» during the wake-sleep/sleep-wake cycle. The most popular explanation for this condition is the decrease of reticular formation activity during the transition between wakefulness and sleep. The authors present a review of literature on the diagnosis and treatment of EHS and clinical observations of patients with classical signs.
Topics: Humans; Parasomnias; Reticular Formation; Sleep; Sleep Wake Disorders; Wakefulness
PubMed: 34693698
DOI: 10.17116/jnevro2021121091111 -
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 -
Nature Communications May 2024Sleepwalking and related parasomnias result from incomplete awakenings out of non-rapid eye movement sleep. Behavioral episodes can occur without consciousness or...
Sleepwalking and related parasomnias result from incomplete awakenings out of non-rapid eye movement sleep. Behavioral episodes can occur without consciousness or recollection, or in relation to dream-like experiences. To understand what accounts for these differences in consciousness and recall, here we recorded parasomnia episodes with high-density electroencephalography (EEG) and interviewed participants immediately afterward about their experiences. Compared to reports of no experience (19%), reports of conscious experience (56%) were preceded by high-amplitude EEG slow waves in anterior cortical regions and activation of posterior cortical regions, similar to previously described EEG correlates of dreaming. Recall of the content of the experience (56%), compared to no recall (25%), was associated with higher EEG activation in the right medial temporal region before movement onset. Our work suggests that the EEG correlates of parasomnia experiences are similar to those reported for dreams and may thus reflect core physiological processes involved in sleep consciousness.
Topics: Humans; Dreams; Electroencephalography; Male; Female; Adult; Parasomnias; Young Adult; Consciousness; Mental Recall; Sleep, REM; Middle Aged; Sleep
PubMed: 38724511
DOI: 10.1038/s41467-024-48337-7 -
Journal of Clinical Sleep Medicine :... May 2018A case is reported of recurrent, injurious self-biting during sleep, requiring surgical interventions, in a 55-year-old obese man with a 20-year history of violent...
A case is reported of recurrent, injurious self-biting during sleep, requiring surgical interventions, in a 55-year-old obese man with a 20-year history of violent complex parasomnia, with greatly increased frequency and severity of episodes induced by work stress during the preceding 3 years. After clinical evaluation and overnight, hospital-based video-polysomnography, the cause of the chronic injurious parasomnia was deemed to be a non-rapid eye movement (NREM) sleep parasomnia comorbid with severe obstructive sleep apnea. Therapy with bedtime clonazepam and bilevel positive airway pressure was effective, with injurious parasomnia relapse occurring with cessation of either or both of these therapies. The differential diagnosis of sleep-related biting should now include NREM sleep parasomnia (with or without comorbid obstructive sleep apnea), besides previously reported cases of REM sleep behavior disorder (RBD), sleep-related dissociative disorder, sleep-related rhythmic movement disorder and anticipated cases of parasomnia overlap disorder (RBD + NREM sleep parasomnia), sleep-related biting seizures, and sleep-related eating disorder.
Topics: Bites, Human; Clonazepam; Combined Modality Therapy; Continuous Positive Airway Pressure; Diagnosis, Differential; GABA Modulators; Humans; Male; Middle Aged; Parasomnias; Polysomnography; Recurrence; Self-Injurious Behavior; Sleep Apnea, Obstructive
PubMed: 29734991
DOI: 10.5664/jcsm.7134 -
European Journal of Paediatric... Nov 2013Childhood parasomnias are believed to be a benign disorder due to immaturity of some neural circuits, synapses and receptors. The aim of our study was to explore a...
BACKGROUND
Childhood parasomnias are believed to be a benign disorder due to immaturity of some neural circuits, synapses and receptors. The aim of our study was to explore a possible connection with other neurological developmental disorders.
METHODS
72 children (mean age 9.9 ± 5.0 years, 47 boys) were clinically examined and 88 nocturnal v-PSG and 22 v-EEG recordings were evaluated. The most frequent diagnostic findings were: sleepwalking in 24 children, confusional arousal in 21, sleep terror in 8, groaning and enuresis each in 7, non-specific arousal disorder in 4 patients, and REM-related parasomnia in only one child. For statistical evaluation chi-square test, the two-sample t-test and Mann-Whitney rank test were used.
RESULTS
Perinatal risk history was found in 38% of the cohort. Developmental disorders were diagnosed in 30 children (41.7%), more frequently in combinations with: attention-hyperactivity disorder (30.6%), dyslexia and dysgraphia (13.9%), developmental dysphasia (9.7%), mild motor and/or intellectual dysfunction (6.9%). Abnormal movements in sleep, some of them also regarded as developmental, were diagnosed in 37 children (51.4%). Sleep-related breathing disorders were found in 29 patients (40.3%) -snoring (29.2%) and/or sleep apnea (11.1%). Only 16.7% had no comorbidity. Most of the children (60%) showed 2 or 3, exceptionally up to 5 comorbidities. Children, in whom no parasomnia was found in close relatives, had a mild but non-significant earlier onset of the disease (4.4 ± 4.0 against 6.3 ± 4.3 years).
CONCLUSION
Childhood parasomnias are frequently associated with perinatal risk factors and developmental comorbidities, and can be regarded as a disorder of sleep maturation.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Child, Preschool; Cohort Studies; Developmental Disabilities; Female; Humans; Male; Parasomnias; Retrospective Studies; Sex Factors
PubMed: 23778306
DOI: 10.1016/j.ejpn.2013.05.004 -
Psychologie & Neuropsychiatrie Du... Jun 2010Parasomnias are sleep-related abnormal behaviors. They are frequent and overlooked causes of nocturnal disruptive behavior in the elderly, especially when patients are... (Review)
Review
Parasomnias are sleep-related abnormal behaviors. They are frequent and overlooked causes of nocturnal disruptive behavior in the elderly, especially when patients are cognitively impaired. Confusion and violence can result in sleep disruption, injuries for the patients or their bed partners, caregivers distress, and they can be a motive for institutionalization. Parasomnias include the NonREM sleep disorders of arousal (sleepwalking, sleep terrors, confusional arousals and sleep-related eating disorder), the REM sleep behavior disorder (RBD) and more rarely the parasomnia overlap syndrome, which associates both NREM and REM parasomnias. Patients with NREM sleep parasomnias are confused, eyes open, with a glazed look during their nocturnal behaviors, and they have a post-episode amnesia. They shout and bolt from the bed (night terrors), look about in a confused manner, walk and speak (sleepwalking), and eat peculiar or inedible food (sleep-related eating disorders). These behaviors, which are frequent in young adults, may be triggered by short-half live hypnotics in elderly. During the parasomnia, the brain is partially awake (enough to perform complex motor and verbal action), and partially asleep (without conscious awareness or responsibility). RBD is characterized by a loss of the normal muscle atonia that accompanies REM sleep. Patients have excessive motor activity such as punching, kicking, or crying out in association with dream content. RBD are frequent in Parkinson's disease and dementia with Lewy bodies and may precede the cognitive or motor symptoms of these diseases by 5 to 10 years. RBD can also be promoted by antidepressants. When combined with thorough clinical interviews, the video-polysomnography is a powerful tool, especially for discriminating the parasomnia from nocturnal frontal lobe epilepsy, sleep apneas and periodic leg movements. Ensuring safety and withdrawing deleterious treatments are useful in patients with violent activities, potential injurious or bothersome to other household members. Clonazepam and melatonin (3-12 mg) are highly effective for treating RBD.
Topics: Aged; Attention Deficit and Disruptive Behavior Disorders; Dissociative Disorders; Female; Humans; Male; Neurodegenerative Diseases; Parasomnias; Prognosis; Sleep, REM
PubMed: 20525541
DOI: 10.1684/pnv.2010.0210 -
Journal of Clinical Neurophysiology :... Mar 2023Non-REM parasomnias are often observed during childhood and adolescence, by which time they typically remit. For a small percentage, these nocturnal behaviors can... (Review)
Review
Non-REM parasomnias are often observed during childhood and adolescence, by which time they typically remit. For a small percentage, these nocturnal behaviors can persist into adulthood, or in some cases, present as a new onset in adults. Non-REM parasomnias (also known as disorders of arousal) can offer a diagnostic challenge in patients who have an atypical presentation where REM sleep parasomnias, nocturnal frontal lobe epilepsy, and overlap parasomnia should be considered as part of the differential. The purpose of this review is to discuss the clinical presentation, evaluation, and management of non-REM parasomnias. The neurophysiology behind non-REM parasomnias is considered, and this gives insights into their cause and the potential for treatment.
Topics: Adolescent; Adult; Humans; Eye Movements; Neurophysiology; Parasomnias
PubMed: 36872501
DOI: 10.1097/WNP.0000000000000945 -
BMC Neurology Jul 2017Parasomnia overlap disorder (POD) is a distinct parasomnia and characterized by concomitant manifestation of rapid-eye-movement (REM)- and non-REM (NREM)-parasomnias....
BACKGROUND
Parasomnia overlap disorder (POD) is a distinct parasomnia and characterized by concomitant manifestation of rapid-eye-movement (REM)- and non-REM (NREM)-parasomnias. Although not uncommon among patients with Parkinson's disease, POD is often under-investigated.
CASE PRESENTATION
This is the first report of patients with PD and features of POD that underwent deep brain stimulation. Our patients exhibited different outcomes of POD features after subthalamic deep brain stimulation.
CONCLUSIONS
We expect that the reporting of these first patients will open the discussion about the need for more detailed and broad-spectrum assessments regarding parasomnias in PD patients that undergo deep brain stimulation. The implications of our observations are both clinical and neurobiological.
Topics: Aged; Deep Brain Stimulation; Female; Humans; Male; Middle Aged; Parasomnias; Parkinson Disease
PubMed: 28720127
DOI: 10.1186/s12883-017-0916-0 -
Sleep Medicine Jun 2021
Topics: Humans; Night Terrors; Parasomnias; Sleep; Somnambulism
PubMed: 33895494
DOI: 10.1016/j.sleep.2021.03.032 -
Sleep Medicine May 2019It is now recognized that the vast majority of individuals with typical RBD will develop a synucleinopathy; usually 11-16 years after symptom onset. Parasomnia Overlap...
BACKGROUND
It is now recognized that the vast majority of individuals with typical RBD will develop a synucleinopathy; usually 11-16 years after symptom onset. Parasomnia Overlap Disorder (POD) with adolescent-onset dream enactment behavior with phenoconversion to neurodegenerative disease after a long latency has not been previously described.
PATIENT
We present a case of a 65-year-old man with presumptive POD who had co-morbid childhood onset sleep walking and adolescent-onset dream enactment behavior beginning at age 17, with subsequent evolution to an increasingly troublesome REM sleep behavior disorder (RBD) at age 64 with Parkinson's Disease (PD) developing a year later.
RESULTS
Polysomnography performed at age 64 was consistent with a diagnosis of RBD. Dream enactment behavior preceded PD diagnosis by at least 48 years. Our case represents the youngest reported RBD case who developed PD.
CONCLUSIONS
We report the first case of adolescent onset, presumed RBD in the context of presumptive POD developing neurodegenerative disease. Adolescent-onset RBD may have similar prognostic implications as typical RBD, where future phenoconversion to a synucleinopathy is expected.
Topics: Adolescent; Aged; Humans; Levodopa; Male; Parasomnias; Parkinson Disease; Polysomnography; REM Sleep Behavior Disorder; Somnambulism
PubMed: 30954790
DOI: 10.1016/j.sleep.2019.01.041