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Zeitschrift Fur Gerontologie Und... Mar 2020Parasomnias are characterized by abnormal experiences, dreams, movements and behavior during sleep. They may occur in the middle of the sleep during REM (rapid eye... (Review)
Review
Parasomnias are characterized by abnormal experiences, dreams, movements and behavior during sleep. They may occur in the middle of the sleep during REM (rapid eye movement) or NREM (non-rapid eye movement), during falling asleep or waking up. Characteristically for REM behavior disorder is an increased muscle tone although usually REM is defined by an absence of muscle tone. For these forms aggressive dreams may lead to violating bed partners or self-injury of the sleeping person. Even killing bed partners has been described. Many of the patients develop a kind of Parkinson's disease (synucleinopathies). The rate of phenoconversion is more than 30% in 5 years and nearly 100% after 15 years. There are several recommendations regarding a safe sleeping environment. Medicinal treatment consists of either melatonin or clonazepam.
Topics: Humans; Movement; Parasomnias; Parkinson Disease; REM Sleep Behavior Disorder; Sleep, REM; Synucleinopathies
PubMed: 32140765
DOI: 10.1007/s00391-020-01714-5 -
Postgraduate Medicine Jan 2020Parasomnias are abnormal behaviors that occur during sleep and can be associated, in particular during adulthood, with impaired sleep quality, daytime dysfunction, and... (Review)
Review
Parasomnias are abnormal behaviors that occur during sleep and can be associated, in particular during adulthood, with impaired sleep quality, daytime dysfunction, and occasionally with violent and harmful nocturnal behaviors. In these cases, therapies are often considered. Longterm pharmacological treatments are not always well tolerated and often have limited efficacy. Therefore, behavioral approaches remain an important treatment option for several types of parasomnias. However, the evidence-based approaches are limited. In the current review, we highlight results from various nonpharmacological techniques on different types of parasomnias and provide a glimpse into the future of nonpharmacological treatments in this field.
Topics: Behavior Therapy; Humans; Night Terrors; Parasomnias; REM Sleep Behavior Disorder; Sleep Arousal Disorders; Somnambulism
PubMed: 31760836
DOI: 10.1080/00325481.2019.1697119 -
Handbook of Clinical Neurology 2011Considerable progress has been made in the systematic study of nonrapid eye movement (NREM) sleep parasomnias. This chapter focuses on the clinical features, prevalence,...
Considerable progress has been made in the systematic study of nonrapid eye movement (NREM) sleep parasomnias. This chapter focuses on the clinical features, prevalence, pathophysiology, associated sleep parameters, and clinical variants of the prototypic NREM sleep parasomnias, namely confusional arousals, sleepwalking, and sleep terrors. Whereas the occurrence of NREM parasomnias in children is frequently viewed as relatively benign, these disorders often pose greater problems, including sleep-related injuries, in affected adults. Most episodes arise from sudden but incomplete arousal from slow-wave sleep and sometimes from stage 2 sleep. Factors that deepen or fragment sleep can facilitate or precipitate NREM parasomnias in predisposed individuals. NREM parasomnias can be associated with various primary sleep disorders or with medical conditions. Diagnosis of NREM parasomnias can often be made based on a detailed history, although some patients may require more extensive evaluations, including polysomnographic study with an expanded EEG montage. Sleep deprivation and the presentation of auditory stimuli during slow-wave sleep are two techniques that can increase the occurrence of behavioral manifestations under laboratory conditions. A variety of nonpharmacological treatments have been recommended for long-term management of NREM parasomnias, whereas pharmacological agents should be considered only if the behaviors are hazardous or extremely disruptive.
Topics: Animals; Electroencephalography; Humans; Parasomnias; Polysomnography; Serotonin; Sexual Dysfunction, Physiological; Sleep Stages; Somnambulism
PubMed: 21056232
DOI: 10.1016/B978-0-444-52007-4.00011-4 -
The Journal of Clinical Psychiatry Sep 2008Epidemiologic studies from general population and clinical case series suggest association of parasomnias with mental illnesses and psychotropic medications. This...
OBJECTIVE
Epidemiologic studies from general population and clinical case series suggest association of parasomnias with mental illnesses and psychotropic medications. This cross-sectional study aimed at determining the prevalence rate of sleepwalking, sleep-related eating disorder (SRED), rapid eye movement sleep behavior-like disorder (RSBD-like disorder), and sleep-related injury (SRI) and their associated factors in an adult psychiatric outpatient clinic.
METHOD
Subjects aged 18 to 65 years who were attending an outpatient clinic in Hong Kong from May 2006 through June 2006 were included in this cross-sectional study. A 3-phase design was employed, including a structured questionnaire on parasomnias, followed by clinical interviews of both questionnaire-positive and -negative groups, and polysomnography for subjects having active parasomnias in recent 1 year. In addition, the principal psychiatric diagnoses, medical illnesses, and detailed drug history over recent 1 year were retrieved from the computerized records.
RESULTS
Twelve hundred thirty-five subjects completed the phase 1 interview. The estimated prevalence of the lifetime diagnoses of sleepwalking, SRED, SRI, sleep violence, and RSBD-like disorder were 8.5%, 4.0%, 21.0%, 3.6%, and 5.8%, respectively, while the 1-year prevalence of these conditions were 2.9%, 2.4%, 8.8%, 2.5%, and 3.8%, respectively. These conditions were associated with depression and a constellation of sleep disturbances. Specific combinations of psychotropics were found to pose risk in particular parasomnias: sedative antidepressants and nonbenzodiazapine hypnotics in sleepwalking, regular zolpidem and antidepressants in SRED, and selective serotonin reuptake inhibitors in RSBD-like disorder.
CONCLUSIONS
Sleepwalking, SRED, RSBD-like disorder, and SRI were common and underrecognized among the psychiatric population in this study. Their occurrences were likely contributed by interacting effect of mental illnesses, sleep disturbances, and specific psychotropic medications. Further prospective study is warranted for clarification of the etiology and clinical management of these potentially dangerous and "hidden" parasomnias.
Topics: Adolescent; Adult; Aged; Ambulatory Care; Comorbidity; Cross-Sectional Studies; Drug Interactions; Female; Health Surveys; Hong Kong; Humans; Incidence; Male; Mental Disorders; Middle Aged; Parasomnias; Polysomnography; Psychotropic Drugs; Risk Factors; Young Adult
PubMed: 19193338
DOI: 10.4088/jcp.v69n0904 -
Current Opinion in Pulmonary Medicine Nov 2016The purpose of this review is to help further the understanding of the clinical profile of patients with sexsomnia and to better understand the spectrum of the clinical... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to help further the understanding of the clinical profile of patients with sexsomnia and to better understand the spectrum of the clinical manifestations of sexsomnia. We will review the literature from the past decade on the subject and then compare it with our own clinical experience from patients who were retrospectively identified with sexsomnia at a tertiary sleep clinic over a 6-year period.
RECENT FINDINGS
The prevalence of sexual behaviours in sleep remains unknown, but it seems to involve predominantly younger male adults who also frequently exhibit other non-rapid eye movement-related parasomnias. Medication-induced cases have been reported and treatment approach of sexsomnia greatly varies.Of 41 individuals with sexsomnia from our centre with a mean age of 32 (37 men), manifestations of sexsomnia were variable; sexual intercourse was most frequently reported overall, but the majority of women carried out masturbation. Violence and aggression were described on 11 occasions. All patients were amnesic of events. 73% had a history of another parasomnia.
SUMMARY
Sexsomnia is frequently associated with concurrent sleep conditions or drugs initiation. It is a real clinical disorder which should be properly diagnosed and managed.
Topics: Humans; Male; Parasomnias; Prevalence; Sexual Behavior; Sleep; Sleep Wake Disorders
PubMed: 27607155
DOI: 10.1097/MCP.0000000000000321 -
Pediatrics International : Official... Oct 2016
Topics: Adolescent; Child; Female; Humans; Incidence; Male; Parasomnias; Prevalence; Risk Factors; Sleep; Sleep Initiation and Maintenance Disorders; Students; Surveys and Questionnaires; Turkey
PubMed: 26895098
DOI: 10.1111/ped.12954 -
Neurology(R) Neuroimmunology &... Sep 2024Encephalitis with anti-N-methyl-d-aspartate receptor antibodies (anti-NMDARe) is a rare disorder characterized by cognitive impairment, psychosis, seizures, and abnormal...
OBJECTIVES
Encephalitis with anti-N-methyl-d-aspartate receptor antibodies (anti-NMDARe) is a rare disorder characterized by cognitive impairment, psychosis, seizures, and abnormal movements. Abnormal behaviors during REM sleep have not been described in anti-NMDARe.
METHODS
Patients were monitored by video-polysomnography on a first night followed by multiple sleep latency tests and 18 hours of bed rest.
RESULTS
Two patients with anti-NMDARe developed during the acute and postacute phase parasomnias including REM sleep behavior disorder and continuous finalistic quiet gesturing during a mixed N2/R sleep. The parasomnia disorder was improved by gabapentin and clonazepam.
DISCUSSION
Video-polysomnography avoids misdiagnosing these parasomnia behaviors for seizure or movement disorders and allows adequate treatment.
Topics: Humans; Anti-N-Methyl-D-Aspartate Receptor Encephalitis; Female; Adult; Male; Polysomnography; REM Sleep Parasomnias; REM Sleep Behavior Disorder; Parasomnias; Sleep, Slow-Wave; Clonazepam
PubMed: 38917379
DOI: 10.1212/NXI.0000000000200203 -
Continuum (Minneapolis, Minn.) Aug 2017Sleep-wake disorders occur in 10% to 28% of children and differ somewhat in pathophysiology and management from sleep-wake disorders in adults. This article discusses... (Review)
Review
PURPOSE OF REVIEW
Sleep-wake disorders occur in 10% to 28% of children and differ somewhat in pathophysiology and management from sleep-wake disorders in adults. This article discusses the diagnosis and management of key childhood sleep disorders.
RECENT FINDINGS
The role of sleep in memory consolidation and in the facilitation of learning has been increasingly recognized, even at the toddler stage. Cataplexy, a key feature of narcolepsy type 1, may be subtle in childhood and characterized by transient muscle weakness isolated to the face. Children with obstructive sleep apnea and restless legs syndrome display prominent neurobehavioral symptoms such as daytime inattentiveness and hyperactivity, so it is important to elicit a sleep history when these symptoms are encountered. Systemic iron deficiency occurs in about two-thirds of children with restless legs syndrome and is easily treatable. Parasomnias arising out of non-rapid eye movement (REM) sleep, such as confusional arousals and sleepwalking, may be difficult to distinguish from nocturnal seizures, and, in many cases, video-EEG polysomnography is required to differentiate between causes.
SUMMARY
Clinicians should routinely integrate the assessment of sleep-wake function into their practices of neurology and child neurology because of the opportunity to improve the quality of life of their patients.
Topics: Child; Humans; Parasomnias; Quality of Life; Restless Legs Syndrome; Sleep; Sleep Wake Disorders
PubMed: 28777180
DOI: 10.1212/CON.0000000000000504 -
Handbook of Clinical Neurology 2019The nonrapid eye movement (NREM) parasomnias range from age-related developmental phenomena in children to aggressive and injurious motor behaviors in all age groups.... (Review)
Review
The nonrapid eye movement (NREM) parasomnias range from age-related developmental phenomena in children to aggressive and injurious motor behaviors in all age groups. These parasomnias are commonly referred to as disorders of arousal and are an important cause of sleep-related injury. Genetic predisposition plays a role in the disorders of arousal, most evident in sleepwalking. Important concepts guiding our current understanding of the pathophysiology of the NREM parasomnias include sleep state instability (a propensity for arousal during NREM sleep), sleep inertia (incomplete awakening from NREM sleep), state dissociation (an ability to simultaneously straddle both NREM sleep and wakefulness), and activation of central pattern generators (permitting expression of subcortically determined motor behaviors without conscious higher cortical input). Management is multifaceted with an emphasis on education and nonpharmacologic measures. The purpose of this chapter is to review wake and NREM neurobiology and update our current understanding of NREM parasomnia pathophysiology, epidemiology, genetics, clinical features, precipitating factors, neurophysiologic evaluation, diagnosis, and clinical management.
Topics: Humans; Sleep Arousal Disorders; Sleep, Slow-Wave
PubMed: 31307616
DOI: 10.1016/B978-0-444-64142-7.00063-1 -
Revue Neurologique Oct 2023The interaction between sleep and epilepsy is complex. A better understanding of the mechanisms linking sleep and epilepsy appears increasingly important as it may... (Review)
Review
The interaction between sleep and epilepsy is complex. A better understanding of the mechanisms linking sleep and epilepsy appears increasingly important as it may improve diagnosis and therapeutic strategies in patients with epilepsy. In this narrative review, we aim to (i) provide an overview of the physiological and pathophysiological processes linking sleep and epilepsy; (ii) present common sleep disorders in patients with epilepsy; (iii) discuss how sleep and sleep disorders should be considered in new therapeutic approaches to epilepsy such as neurostimulation; and (iv) present the overall nocturnal manifestations and differential diagnosis between epileptic seizures and parasomnia.
Topics: Humans; Electroencephalography; Sleep; Epilepsy; Parasomnias; Sleep Wake Disorders
PubMed: 37598088
DOI: 10.1016/j.neurol.2023.07.006