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Parasomnia

Sleep Disorders


Presentation

  • METHODS: We present 7 consecutive patients presenting with catathrenia over a 5-year period. They were all young women, ranging in age from 20 to 34 years with a body mass index (BMI) RESULTS: Groaning was present throughout all stages of sleep.[ncbi.nlm.nih.gov]
  • The frequency of events and distribution throughout the night presented as a continuous status of parasomnia ('status parasomnicus').[ncbi.nlm.nih.gov]
  • Treatment guidelines, within the context of forensic medicine, are presented.[ncbi.nlm.nih.gov]
  • Pruritus (itching) during the sleep period can present as a symptom of dermatological or systemic disease, or as a parasomnia.[ncbi.nlm.nih.gov]
  • Symptoms and Causes of Parasomnias The exact causes of the sleep disorder are going to vary depending on the particular type of parasomnia present, but there are some common elements.[gomentor.com]
Nightmare
  • Nightmares: Childhood nightmares are normal but, for some kids, there may be a psychological reason for their bad dreams. Interventions such as behavioral cognitive therapy, relaxation and hypnosis may help children with nightmares.[childrens.com]
  • Painful sleep-related erections Nocturnal paroxysmal dystonia (NPD) Nightmares and Night Terrors Threats to safety and/or self-esteem are often the theme of nightmares that are disruptive to sleep.[luxury.rehabs.com]
  • Some research has suggested a genetic basis for nightmares. Personality and emotional factors predispose to nightmares. Nightmares can be triggered by certain medications, illicit substances and alcohol.[snoreaustralia.com.au]
  • Nightmares : Nightmares are vivid dreams during sleep that can cause feelings of fear, terror, and/or anxiety.[my.clevelandclinic.org]
  • Nightmares Nightmares differ from night terrors in that they are usually psychologically based, are more often remembered, and aren't usually dangerous. Nightmares also occur only during REM (rapid eye movement) sleep.[m.rossa-editorial.kidshealth.org]
Nocturnal Awakening
  • NES is characterized by consumption of excessive amounts of food either before bed or during nocturnal awakenings.[emedicine.com]
Tinnitus
  • Nocturnal panic attacks, depressive or psychotic episodes Muscle cramps and spasms Paraesthesiae (tingling, numbness, 'pins and needles' sensations) Seizures, convulsions, fits and 'funny turns' Headaches/migraines/exploding head syndrome/cluster headaches Tinnitus[snoreaustralia.com.au]
Restless Legs Syndrome
  • Restless legs syndrome and periodic limb movement disorder Restless legs syndrome and periodic limb movement disorder are treated with 3 classes of medications.[emedicinehealth.com]
  • Patients who have Restless Legs Syndrome experience periodic limb movement, though few with Periodic Limb Movement Disorder have Restless Legs Syndrome.[hackensacksleep.com]
  • Other sleep disorders such as obstructive sleep apnea and restless leg syndrome can be triggers, as can gastroesophageal reflux, fever, and sleep deprivation.[clinicaladvisor.com]
  • Restless Legs Syndrome Restless legs syndrome (RLS), a sensory and motor abnormality that seems to have a genetic basis. In RLS, the child's legs move repeatedly.[psychnet-uk.com]
  • Restless Legs Syndrome Restless legs syndrome (RLS), a sensory and motor abnormality that seems to have a genetic basis. In RLS, the child’s legs move repeatedly.[nithra.com]
Fear
  • MORE Sleep Terrors Sleep terrors (or night terrors) cause you to wake up in intense fear with barely any memory, if any, of a terrifying dream.[sleepeducation.org]
  • People typically clearly remember the dream and the source of the fear.[gomentor.com]
  • People experiencing sleep paralysis often are fearful because they do not know what is happening, but an episode may be stopped by sound or touch.[hospitals.jefferson.edu]
  • Sleep terrors are like severe nightmares but with intense fear often accompanied by screaming and fighting. Fifteen per cent of children experience night terrors after general anesthesia, occurring anywhere up to 2 weeks after surgery.[medicinenet.com]
  • Patrícia Portela (Portugal) 2-6/5 Wednesday to Sunday 20:00 (2-4/5) 15:00, 18:00, 21:00 (5, 6/5) MOP 150 Mandarin's House “[E]ven the most unexpected dream is a rebus that conceals a desire or, its reverse, a fear.” – Italo Calvino, Invisible Cities Experience[icm.gov.mo]
Night Terrors
  • They include night terrors, nightmares, sleepwalking, and bedwetting. Night Terrors Night terrors (also known as Pavor Nocturnus) are characterized by a sudden arousal from sleep with a piercing scream or cry.[m.rossa-editorial.kidshealth.org]
  • Night Terrors: When the individual wakes up from sleep abruptly in an unstable and confused state, unable to communicate what had occurred, it is called night terror, a type of parasomnia.[epainassist.com]
  • Sleep terrors/night terrors : Night terrors or sleep terrors are considered to be a type of disorder of arousal.[my.clevelandclinic.org]
  • Painful sleep-related erections Nocturnal paroxysmal dystonia (NPD) Nightmares and Night Terrors Threats to safety and/or self-esteem are often the theme of nightmares that are disruptive to sleep.[luxury.rehabs.com]
  • Night Terrors A person experiencing a night terror abruptly awakes from sleep in a terrified state, but is confused and unable to communicate. They do not respond to voices and are difficult to fully awaken.[webmd.com]
Screaming
  • If you have ever been told by friends or a bed partner that you talk or scream in your sleep, thrash around, kick your legs about, or sleepwalk, then you may have a sleep disorder called a parasomnia.[sweetsleepstudio.com]
  • Sleep terrors are like severe nightmares but with intense fear often accompanied by screaming and fighting. Fifteen per cent of children experience night terrors after general anesthesia, occurring anywhere up to 2 weeks after surgery.[medicinenet.com]
  • "I spent Sunday screaming for help, but no help came," she said. She kept on screaming, and help finally came on Tuesday after a woman living nearby heard her. Vincenti was shaken by the incident but otherwise uninjured.[abcnews.go.com]
  • Sleep terrors Also called night terrors, this is an arousal disorder that causes panic and loud screaming and even bodily harm if the person gets up and runs about. No attempt should be made to comfort the person as this can intensify the terror.[news-medical.net]
  • They include sleep walking, becoming violent during sleep, fighting in sleep, or fearful screaming. Contact Dr. R Bart Sangal at the Sleep & Attention Disorders Institute in Sterling Heights, Mich. He is a certified Sleep Medicine doctor.[sleepandattentiondisorders.com]
Agitation
  • Thirty-four participants (mean [ /-SD] age 22.7 [ /-12.9] years) noting nocturnal motor agitation or behaviors and 12 healthy controls (mean age 24.1 [ /-3.1] years) underwent nocturnal polysomnography with video-tape recording and motor behaviors analysis[ncbi.nlm.nih.gov]
  • Sleep terrors often begin with a "bloodcurdling" scream or shout, and cause behavior suggesting extreme terror, such as dilated pupils, rapid breathing, racing heart, sweating and extreme agitation.[chop.edu]
  • Confusional arousals occur mainly in infants and toddlers and may begin with movements and moaning, then evolve to agitated behavior by calling out or crying. The child may appear confused with eyes open or closed.[hospitals.jefferson.edu]
  • Avoidance of sleep deprivation and agitation of co-morbid disorders in patients often reduce the instances. Psychotherapy, hypnosis, and relaxation exercises can be helpful depending on the other factors that might be triggering the unrest.[countingsheep.net]
  • After the agitation ceases, the sleeper may awaken for a short time and then return to sleep.[psychnet-uk.com]
Sleep Disturbance
  • These conditions were associated with depression and a constellation of sleep disturbances.[ncbi.nlm.nih.gov]
  • Types of parasomnias include: Nightmares Night terrors Sleepwalking Sleep drunkenness Sleep paralysis Bedwetting Symptoms The common symptom of all parasomnias is sleep disturbance.[cedars-sinai.edu]
  • The usual sleep disturbance suspects — alcohol, caffeine, recreational drugs, and smoking — can also contribute.[bustle.com]
  • 2015 ICD-9-CM Diagnosis Code 780.59 Other sleep disturbances 2015 Billable Thru Sept 30/2015 Non-Billable On/After Oct 1/2015 ICD-9-CM 780.59 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 780.59[icd9data.com]
  • Sleep disturbances and correlates of children with autism spectrum disorders . Child Psychiatry Hum Dev. 2007 ; 37: 179 – 191 . Google Scholar ISI 23. Patzold, L.M. Richdale, A.L. Tonge, B.L.[journals.sagepub.com]
Neglect
  • Somnambulism responds to the same treatment for the same reason, but simple safety measures should not be neglected.[sleep.health.am]

Workup

  • […] and physical examination Electroencephalography (EEG) may be helpful; microarousals and sleep state disorganization are often noted on EEG done during nocturnal sleep See DDx and Workup for more detail.[emedicine.com]

Treatment

  • A person should seek treatment whenever there is risk for injury to oneself or another person from the parasomnia.[nm.org]
  • Abstract Patient education and behavioral management represent the first treatment approaches to the patient with parasomnia, especially in case of disorders of arousal (DOA).[ncbi.nlm.nih.gov]
  • The patient responded well to treatment typically administered for adult NREM parasomnias, and after careful review of the clinical presentation, objective findings and treatment outcome, sleep-related epilepsy was ruled out in favour of parasomnia.[ncbi.nlm.nih.gov]
  • Treatment is directed at eliminating the triggers for these episodes.[merckmanuals.com]
  • The sleep study will require the patient to stay overnight at the hospital so that the medical team can monitor the patient's: Brain waves Heart rate Breathing Body and limb movement Treatments For many patients no treatment is needed.[cedars-sinai.edu]

Prognosis

  • What Is the Prognosis (Outlook) for REM Sleep Disorder? The outlook of REM sleep behavior disorder (RBD) depends on the cause. In persons with RBD in whom no cause can be identified, the symptoms can be controlled with medications.[emedicinehealth.com]
  • What Is the Prognosis for Sleep Disorders? Nightmare disorder Most children outgrow this disorder. A small number of children report this disorder persisting into adulthood and becoming a lifelong problem.[emedicinehealth.com]
  • Prognosis The NREM parasomnias are rarely associated with any significant morbidity or long-term sequelae.[emedicine.com]

Etiology

  • Later, etiologies included prion, autoimmune disease, and various toxic etiologies ( Antelmi et al 2015 ). The content you are trying to view is available only to logged in, current MedLink Neurology subscribers .[medlink.com]
  • This study may help to better understand the etiology and mechanisms underlying the clinical enigma of the nociceptive dysregulation in NREM sleep parasomnias.[clinicaltrials.gov]
  • Further prospective study is warranted for clarification of the etiology and clinical management of these potentially dangerous and "hidden" parasomnias. Copyright 2008 Physicians Postgraduate Press, Inc.[ncbi.nlm.nih.gov]
  • Etiology Genetic factors Sleepwalking occurs more frequently in monozygotic twins and is 10 times more likely if a first-degree relative has a history of sleepwalking. An increased frequency of DQB1*04 and *05 alleles is reported.[emedicine.com]

Epidemiology

  • OBJECTIVE: Epidemiologic studies from general population and clinical case series suggest association of parasomnias with mental illnesses and psychotropic medications.[ncbi.nlm.nih.gov]
  • The epidemiology, etiology, investigation, and management of this condition are summarized, as well as a review of status dissociatus, a severe motor parasomnia in which features of wake and sleep states coexist.[medlink.com]
  • Epidemiological investigation of sleep disorders for children at ages of 2–12 years in Changsha City . Zhongguo Dangdai Erke Zazhi. 2008 ; 10(3): 353 – 6 . Google Scholar 22. Liu, X. Hubbard, J.A. Fabes, R.A. .[journals.sagepub.com]
  • Genetic aspects and genetic epidemiology of parasomnias. Sleep Med. Rev. 7: 413-421, 2003. [PubMed: 14573377] [Full Text: ] Kato, T., Montplaisir, J. Y., Blanchet, P. J., Lund, J. P., Lavigne, G. J.[omim.org]
  • Genetic aspects and genetic epidemiology of parasomnias. Sleep Medicine Reviews 2003;7(5):413-421.[child-encyclopedia.com]
Sex distribution
Age distribution

Pathophysiology

  • POD pathophysiology is not clear to date. METHODS: The authors report 5 cases of POD, review the literature, and analyze previously published cases of POD.[ncbi.nlm.nih.gov]
  • This case series describes three such patients, and discusses potentially relevant pathophysiology that can underlie itching or pain.[ncbi.nlm.nih.gov]
  • […] summarize the known cases and clinical findings supporting TSD, 2) differentiate TSD from clinical disorders with which it has overlapping features, 3) propose criteria for the diagnosis of TSD, and 4) present a hypothetical neurobiological model for the pathophysiology[ncbi.nlm.nih.gov]
  • The pathophysiology of sleep paralysis is still mostly unknown. Irregular sleep-wake schedules, jet lag, sleep deprivation and high levels of stress can contribute to sleep paralysis.[countingsheep.net]
  • The clinical and pathophysiological relevance of REM sleep behavior disorder in neurodegenerative diseases. Sleep Med Rev 2009;13:385–401. Arnulf I. REM sleep behavior disorder: motor manifestations and pathophysiology. Mov Disord 2012;27:677–89.[racgp.org.au]

Prevention

  • They may also prevent you from falling back to sleep. Sleep terrors — Also called night terrors, during these episodes the sleeping person abruptly awakes and appears terrified. They may also sleepwalk and talk.[iuhealth.org]
  • A purposive interdental plate was placed to prevent jaw closings during sleep: masticatory myoclonus still persisted, but it did not provoke arousals; insomnia disappeared and night hypnograms improved.[ncbi.nlm.nih.gov]
  • In some cases, grinding can be prevented with the use of a mouth guard. The mouth guard, supplied by a dentist, can fit over the teeth to prevent them from grinding against each other.[webmd.com]
  • CONCLUSIONS AND HYPOTHESIS: Sleep related violence needs thorough diagnostic evaluation for preventing life-threatening consequences. Violent somnambulism appears to be a distinct NREM sleep-related overlap parasomnia. Copyright 2014 Elsevier Ltd.[ncbi.nlm.nih.gov]
  • Prevention includes stretching the affected muscles for several minutes before sleep. Stretching as soon as cramps occur relieves symptoms promptly and is preferable to drug treatment.[merckmanuals.com]

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