-
Sleep Medicine Clinics Mar 2024Although many sleep-related behaviors are benign, others can result in physical or sexual aggression toward bed partners or others. Individuals who engage in... (Review)
Review
Although many sleep-related behaviors are benign, others can result in physical or sexual aggression toward bed partners or others. Individuals who engage in sleep-related violence (SRV) and sexual behavior in sleep (SBS) may face legal sanctions for their behavior. Attorneys or legal decision-makers may call on an expert to evaluate a defendant and opine about the veracity of an alleged parasomnia diagnosis, the criminal responsibility of the defendant, and his risk of violence to others. This article reviews the phenomena of SRV and SBS and guides evaluators in the forensic considerations relevant to parasomnias.
Topics: Humans; Parasomnias; Sexual Behavior; Sleep
PubMed: 38368065
DOI: 10.1016/j.jsmc.2023.10.010 -
Sleep Medicine Reviews Dec 2014Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear... (Review)
Review
Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear and distress. In spite of the fact that its characteristic symptomatology was first described approximately 150 y ago, exploding head syndrome has received relatively little empirical and clinical attention. Therefore, a comprehensive review of the scientific literature using Medline, PsycINFO, Google Scholar, and PubMed was undertaken. After first discussing the history, prevalence, and associated features, the available polysomnography data and five main etiological theories for exploding head syndrome are summarized. None of these theories has yet reached dominance in the field. Next, the various methods used to assess and treat exploding head syndrome are discussed, as well as the limited outcome data. Finally, recommendations for future measure construction, treatment options, and differential diagnosis are provided.
Topics: Auditory Perception; Diagnosis, Differential; Humans; Polysomnography; Sleep-Wake Transition Disorders; Syndrome
PubMed: 24703829
DOI: 10.1016/j.smrv.2014.03.001 -
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 Clinics Mar 2024COVID-19 had a massive impact on sleep, resulting in overall increase of sleep disturbances. During lockdown many factors contributed to sleep disturbances, in... (Review)
Review
COVID-19 had a massive impact on sleep, resulting in overall increase of sleep disturbances. During lockdown many factors contributed to sleep disturbances, in particular changes in sleep-wake habits and stress. This article will describe the frequency and features of the principal parasomnias and the impact of the pandemic and the government restriction measures on sleep. Among different pathophysiological hypotheses, we will discuss the role of stress, considered as an expression of the allostatic load. Finally, during the pandemic, parasomnias were mainly investigated by questionnaires, with controversial results; video-polysomnographic studies are crucial to obtain a definitive diagnosis, even in critical conditions.
Topics: Humans; COVID-19; Pandemics; Communicable Disease Control; Parasomnias; Sleep Wake Disorders
PubMed: 38368064
DOI: 10.1016/j.jsmc.2023.10.012 -
Current Pain and Headache Reports Jul 2018To explain our current understanding of exploding head syndrome (EHS), an unusual and underreported sensory parasomnia. (Review)
Review
PURPOSE OF REVIEW
To explain our current understanding of exploding head syndrome (EHS), an unusual and underreported sensory parasomnia.
RECENT FINDINGS
Based on findings from recent studies of EHS, the prevalence is higher than previously suggested by the literature, which historically has consisted mostly of case reports. The typical presentation also has been better illustrated by recent case series, and diagnostic criteria have been defined. Its pathophysiology is still unclear. EHS is underrecognized and its symptoms are alarming, but a review of our current state of knowledge will allow physicians to make a diagnosis of this benign condition with greater confidence.
Topics: Humans; Parasomnias; Prevalence; Sleep; Sleep Wake Disorders; Syndrome
PubMed: 30062616
DOI: 10.1007/s11916-018-0717-1 -
Journal of Child and Adolescent... 2018Parasomnias are common in childhood but there is no established treatment for parasomnias. The aim of this study was to (1) report on the outcome of using L-tryptophan...
OBJECTIVE
Parasomnias are common in childhood but there is no established treatment for parasomnias. The aim of this study was to (1) report on the outcome of using L-tryptophan to manage parasomnias in children and (2) examine sleep architecture and subjective psychological/sleep symptoms in children with parasomnia.
METHOD
A retrospective analysis was conducted of charts of children (3-18 years old) who underwent polysomnographic testing and were diagnosed with primary parasomnia. Study patients were either prescribed L-tryptophan (daily dose range: 500-4500 mg, mean dose of 2400 mg) to manage their parasomnias or administered no treatment whereby parents/guardians declined treatment. Questionnaires assessing sleep and psychosocial symptoms were administered at the initial clinical consultation and a follow-up parasomnia outcome questionnaire was administered over the phone to parents/guardians.
RESULTS
One hundred and sixty-five children (106 boys, 59 girls) received a sleep diagnosis of primary parasomnia. A significantly (p < 0.001) higher proportion (84%) of children taking L-tryptophan experienced improvements in their parasomnia symptoms compared with those (47%) who chose not to use L-tryptophan. Polysomnography revealed that children with parasomnias had an altered sleep architecture based on age-related normative values. Children with a diagnosis of parasomnia were also subjectively more fatigued and endorsed more depressive symptoms.
CONCLUSIONS
This study finds that parasomnias in children are not benign and that treatment with L-tryptophan provides a favorable outcome. Children diagnosed with parasomnia had altered sleep architecture, were more fatigued, and endorsed depressive symptoms. This study supports the need to diagnose and treat parasomnias in children.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Male; Parasomnias; Polysomnography; Retrospective Studies; Sleep; Sleep Stages; Surveys and Questionnaires; Tryptophan
PubMed: 29741922
DOI: 10.1089/cap.2017.0164 -
Neurologia (Barcelona, Spain) Apr 2014The purpose of our study is to describe 4 cases of sexsomnia, a form of parasomnia characterised by sexual behaviour during sleep.
INTRODUCTION
The purpose of our study is to describe 4 cases of sexsomnia, a form of parasomnia characterised by sexual behaviour during sleep.
METHODS
Clinical history and video-polysomnography recordings from patients diagnosed with sexsomnia in the Multidisciplinary Sleep Unit at Hospital Clínic in Barcelona.
RESULTS
Three men and one woman between 28 and 43 years of age reported sexual behaviours during sleep with progression times ranging from 9 months to 7 years. Episodes consisted of masturbation without seeking the participation of a sleeping partner (2 cases) and attempts at sexual intercourse with inappropriate and uncharacteristic vocalizations and behaviours (3 cases). The frequency of the episodes ranged from 4 isolated episodes to 2-3 per week. Patients were amnestic of these events and surprised by their partners' accounts of their behaviour. Medical histories revealed that 1 patient was a somnambulist, 2 had confusional arousals, and 1 experienced somniloquy. Video-polysomnography did not disclose sexual behaviours during sleep but revealed sleep apnoea in 2 cases and periodic leg movements in sleep in another. The only patient treated with clonazepam reported decreased frequency of both confusional arousals and sexsomnia episodes.
CONCLUSIONS
Sexsomnia occurs in young adults and is characterised by masturbation and inappropriate attempts at achieving sexual intercourse followed by total amnesia of the events. It can be associated with other parasomnias such as sleepwalking and confusional arousals. Other sleep disorders, including sleep apnoea and periodic leg movement disorder, may trigger episodes of sexsomnia.
Topics: Adult; Female; Humans; Male; Parasomnias; Polysomnography; Sexual Behavior; Sleep Wake Disorders
PubMed: 23664055
DOI: 10.1016/j.nrl.2013.01.013 -
Journal of Clinical Sleep Medicine :... Aug 2014We report the case of a 30-year-old woman presenting with dangerous nocturnal NREM episodes with the clinical feature of lancinating throat pain. We hypothesize that the...
We report the case of a 30-year-old woman presenting with dangerous nocturnal NREM episodes with the clinical feature of lancinating throat pain. We hypothesize that the pain may have represented sensory hallucination analogous to commonly recognized visual images associated with NREM parasomnias. This case is also unusual for probable psychological triggers that could play a role in the pathogenesis of the disease, as evidenced by successful psychotherapy.
Topics: Adult; Female; Hallucinations; Humans; Pain; Parasomnias; Pharynx; Psychotherapy; Sleep Stages
PubMed: 25126041
DOI: 10.5664/jcsm.3974 -
Journal of Clinical Sleep Medicine :... Aug 2016Sleep-related abnormal sexual behaviors (sexsomnia) are classified as a subtype of NREM sleep parasomnias. Sexsomnia has been reported as part of parasomnia overlap...
Sleep-related abnormal sexual behaviors (sexsomnia) are classified as a subtype of NREM sleep parasomnias. Sexsomnia has been reported as part of parasomnia overlap disorder (POD) in two other patients. We present the case of a 42-year-old male patient with video-polysomnography (vPSG) documented POD. The patient had sleepwalking, sleep-related eating, confusional arousals, sexsomnia, sleeptalking, and REM sleep behavior disorder (RBD). Confusional arousals and RBD were documented during the vPSG. This case had the added complexity of obstructive sleep apnea (OSA) playing a role in sleepwalking and sleep related eating, with good response to nasal continuous positive airway pressure (nCPAP). The sexsomnia did not respond to nCPAP but responded substantially to bedtime clonazepam therapy.
Topics: Adult; Clonazepam; Continuous Positive Airway Pressure; GABA Modulators; Humans; Male; Parasomnias; Polysomnography; Sexual Behavior; Sleep Apnea, Obstructive; Sleep Arousal Disorders; Sleep-Wake Transition Disorders; Somnambulism
PubMed: 27166304
DOI: 10.5664/jcsm.6066 -
Disease-a-month : DM Jul 2011
Topics: Arousal; Dreams; Humans; Paralysis; Parasomnias; Sleep
PubMed: 21807161
DOI: 10.1016/j.disamonth.2011.04.007