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2.1
Sleep Disorders
Parasomnia

Presentation

As a child, the patient presented episodes of sleep talking and sleepwalking. [elsevier.es]

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]

Patients presenting with abnormal nocturnal behaviors often pose a diagnostic challenge. [sleepreviewmag.com]

Entire Body System

  • Nightmare

    They last from one to several minutes, and should be distinguished from nightmares. [psychnet-uk.com]

    […] or during awakenings Repetitive grinding of the teeth during sleep These are the 4 most common parasomnias: Nightmares and nightmare disorder Night terrors Bedwetting Sleepwalking Nightmares and nightmare disorder Nightmares are frightening dreams that [hopkinsmedicine.org]

    Nightmares and nightmare disorder Nightmares are frightening dreams that jolt the sleeper awake suddenly. People usually remember vivid details about their nightmares. Having the same nightmare over and over is called a nightmare disorder. [stanfordchildrens.org]

    Nightmares vs Night Terrors We’ve all had nightmares, and it’s pretty clear what they are: vivid dreams that cause feelings of fear, terror, anxiety, etc. [info.ancsleep.com]

  • Movement Disorder

    Rhythmic-movement Disorder Rhythmic-movement disorder is seen most often in younger children, yet can also occur in adults. The movements usually consist of recurrent headbanging, headrolling and body rocking. [psychnet-uk.com]

    See REM Sleep Behavior Disorder. Restless legs syndrome and periodic limb movement disorder Restless legs syndrome and periodic limb movement disorder are classified as Sleep Related Movement Disorders. [emedicinehealth.com]

    Other specific disorders include sleepeating, sleep sex, teeth grinding, rhythmic movement disorder, restless legs syndrome, [ citation needed ] and somniloquy. [en.wikipedia.org]

    MORE>>Periodic Limb Movements This sleep movement disorder involves a series of uncontrollable repetitive muscle movements that severely disrupt your sleep during the night. These movements occur most often in the lower legs. [sleepeducation.org]

  • Fever

    They can be triggered in certain individuals, by alcohol, sleep deprivation, physical activity, emotional stress, depression, medications, or a fevered illness. [en.wikipedia.org]

    High temperatures from fever may sometimes mess up the brain during sleep, leading to unpleasant experiences of parasomnia. Some people also experience fever dreams when their body temperature is elevated during sleep. [amerisleep.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]

  • Hypersomnia

    Hypersomnia Not Due to Substance Use or Known Physiological Condition (Nonorganic Hypersomnia, NOS) 12. Physiological (Organic) Hypersomnia, Unspecified (Organic Hypersomnia, N OS) IV. Circadian Rhythm Sleep Disorders 1. [slideshare.net]

    Haley Hill, PA-C, CCSH Erica Casselman, PA-C Scottsdale Office Gilbert Office Patient Forms Insurance Plans Physician Referrals Policies Sleep Health Adult & Pediatric Sleep Disorders Sleep Apnea Insomnia Sleep Related Movement Disorders Narcolepsy & Hypersomnia [sleeplessinarizona.com]

    She underwent a carefully conducted PSG and MSLT, which was negative for sleep disordered breathing or hypersomnia disorders. [academic.oup.com]

    This books covers all the parasomnias, including patient stories and vignettes, and also all the other categories of sleep disorders, including insomnia, sleep apnea, restless legs, hypersomnias and circadian rhythm disorders. Dr. [sleepfoundation.org]

    Parasomnias are different from insomnia, a number of conditions that affect people’s abilities to fall asleep or stay asleep, and hypersomnia, conditions that cause extreme tiredness. [sleepjunkies.com]

  • Nocturnal Leg Cramp

    For example, a mouth plate may be helpful for those who grind their teeth while stretching and certain vitamins may help those struggling with nocturnal leg cramps. [luxury.rehabs.com]

    Nocturnal Leg Cramps Nocturnal leg cramps are sudden, uncontrolled muscle contractions during rest. They usually happen in your calves. The cramping feeling may last from a few seconds to 10 minutes, but the pain may linger. [webmd.com]

    The cause of nocturnal leg cramps is not known. [onhealth.com]

    ‘Nocturnal head banging, sleep talking and nocturnal leg cramps are other rare forms of parasomnia.’ ‘Almost 20-40 percent of all normal kids have parasomnia at least once in their lifetimes.’ [lexico.com]

    Nocturnal leg cramps are sudden, involuntary contractions of the muscles in the calf or foot, that happen during sleep. They can usually be relieved by stretching the cramped muscle. [therecoveryvillage.com]

Musculoskeletal

  • Fracture

    Severe injuries including fractures, subdural effusions and eye injures are reported. Repeated tongue injuries have not been described as a consequence of RMD. [ncbi.nlm.nih.gov]

    This allows the individual to act out their dreams and may result in repeated injury — bruises, lacerations, and fractures —to themselves or others. [en.wikipedia.org]

    Here is presented a patient with right temporoparietal bone fracture, pneumocephalus and hemotympanum in right ear due to head trauma during a parasomnia attack. [avesis.istanbulc.edu.tr]

    This allows the individual to act out their dreams and may result in repeated injury—bruises, lacerations, and fractures—to themselves or others. [sleepdisordersresource.com]

Psychiatrical

  • 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]

    Nightmares are vivid dreams that contain frightening images or cause negative feelings such as fear, terror, and/or extreme anxiety. [stanfordhealthcare.org]

    Nightmares: Vivid nighttime events that can cause feelings of fear, terror, and/or anxiety. Usually the person wakes from REM sleep and experiences fear and anxiety making it difficult to return to sleep. [sleepmed.com]

    Night terrors—These severe attacks cause people, usually children, to appear to wake up and scream in fear or panic. However, these individuals are typically inconsolable, and tend to have no recollection of the event the following day. [brighamandwomens.org]

Neurologic

  • Night Terrors

    More than one episode a night is rare, as is the likelihood of complex manoeuvres. Night/Sleep Terrors Night terrors usually start with a terrifying scream, increased heart and breathing rates, sweating and a frightened expression. [psychnet-uk.com]

    These disorders of arousal can range from confusional arousals, somnambulism, to night terrors. [en.wikipedia.org]

    Night terrors Night terrors, also known as sleep terrors, are episodes of fear, confusion, and screaming during sleep. [hopkinsmedicine.org]

  • Screaming

    They can cause the sleeper to cry, scream, walk, move about and or curse. These seizures can be treated with medications. REM Behavior Disorder REM Behavior Disorder is the ability to act out your dreams. [psychnet-uk.com]

    Some individuals also talk while in their sleep, saying meaningless words and even having arguments with people who are not there. [6] Sleep terrors (night terrors) [ edit ] Sleep terror is the most disruptive arousal disorder since it may involve loud screams [en.wikipedia.org]

    Reviewed by: Mercedes Bello, MD This page was last updated on: January 28, 2021 04:19 PM Learn more about Night Terrors Night terrors are episodes of screaming, flailing and intense fear that occur during sleep. [nicklauschildrens.org]

  • Seizure

    Nocturnal Seizures Nocturnal seizures occur during sleep and are commonly diagnosed by undergoing a overnight sleep study (PSG). They can cause the sleeper to cry, scream, walk, move about and or curse. [psychnet-uk.com]

    […] of frank convulsive episodes, and lack of significant seizure risk factors. [sleepreviewmag.com]

    There are some patients who only have nocturnal seizures without experiencing seizures during the day, but most patients will have a history. Patients can minimize seizures by getting adequate rest. [neurologyadvisor.com]

    March 16, 2018 If childhood parasomnias are excessive or there is concern for nighttime seizure, a sleep professional or neurologist should be consulted. No parent wants to hear their child scream in the night. [clinicaladvisor.com]

  • Insomnia

    Treatment: Acute insomnia is common and easily treated by your primary care practitioner. Insomnia accompanying depression needs psychiatric treatment. [psychnet-uk.com]

    Many sleep disorders manifest with insomnia and usually excessive daytime sleepiness (EDS). Insomnia is difficulty falling or staying asleep, early awakening, or a sensation of unrefreshing sleep. [merckmanuals.com]

    Insomnia 1. Adjustment Insomnia 2. Psychophysiological Insomnia 3. Paradoxical lnsomnia 4. Idiopathic Insomnia 5. Insomnia Due to Mental Disorder 6. Inadequate Sleep Hygiene 7. Behavioral Insomnia of Childhood 8. Insomnia Due to Drug or Substance 9. [slideshare.net]

    Dhannia Torres-Rincon, PhD Bret Ringdahl, PhD Haley Hill, PA-C, CCSH Erica Casselman, PA-C Scottsdale Office Gilbert Office Patient Forms Insurance Plans Physician Referrals Policies Sleep Health Adult & Pediatric Sleep Disorders Sleep Apnea Insomnia [sleeplessinarizona.com]

  • Agitation

    After the agitation ceases, the sleeper may awaken for a short time and then return to sleep. [psychnet-uk.com]

    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]

    Children may become more agitated when you try to comfort them. Most episodes last from five to fifteen minutes. But they may last as long as thirty to forty minutes in some youth. Overall, confusional arousals are fairly harmless in children. [sleepeducation.org]

    The more she tries to soothe him, the more agitated he becomes. A college student walks into her parents' bedroom while they are sleeping and pours a glass of water into her mother's dresser drawer. [winchesterhospital.org]

    Sleep terrors occur with a loud scream and cause behavior suggesting extreme terror including rapid breathing, increased heartbeat, and agitation. During a sleep terror, the child may jump out of bed and run around the room or even out of the house. [nicklauschildrens.org]

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]

In this article, the authors describe the characteristics of the most frequent parasomnias, suggesting the key points for a decisive diagnostic workup. [medlink.com]

A complete sleep history and diagnostic workup including polysomnography is important to rule out the differentials and reach a conclusive diagnosis of parasomnia. [cureus.com]

Treatment

Treatment: Acute insomnia is common and easily treated by your primary care practitioner. Insomnia accompanying depression needs psychiatric treatment. [psychnet-uk.com]

Treatment Treatment for sleep terrors is with benzodiazepines (eg, diazepam, 5-20 mg at bedtime), since it will suppress stage 3 and stage 4 sleep. [sleep.health.am]

This article aims to draw attention to RBD, allowing early recognition and treatment. [ncbi.nlm.nih.gov]

For children, parental reassurance is often the mainstay of treatment. [msdmanuals.com]

Parasomnia Treatment The broad expertise of our sleep doctors allows parasomnia treatment to be individualized. [sleepmed.com]

Prognosis

Prognosis Virtually all children grow out of night terrors before adolescence. Adult night terrors tend to be more chronic with a waxing and waning course. [patient.info]

[33] The prognosis for other parasomnias seems promising. [en.wikipedia.org]

Etiology

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]

Later, etiologies included prion, neurodegeneration, 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]

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

Epidemiology Prevalence of RLS could be as high as 10-20% in the older age group and it is increasingly common with age. [patient.info]

OBJECTIVE: Epidemiologic studies from general population and clinical case series suggest association of parasomnias with mental illnesses and psychotropic medications. [ncbi.nlm.nih.gov]

Genetic aspects and genetic epidemiology of parasomnias. Sleep Med. Rev. 7: 413-421, 2003. [PubMed: 14573377] [Full Text: https://linkinghub.elsevier.com/retrieve/pii/S1087079201902473] Kato, T., Montplaisir, J. Y., Blanchet, P. J., Lund, J. [omim.org]

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]

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]

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]

Somnambulism: clinical aspects and pathophysiological hypotheses. Lancet Neurol. 12, 285–294 (2013). This review addresses pathophysiological hypotheses and promising research perspectives in the field of DOAs. 51. [nature.com]

Prevention

Prevention Sleepwalking may be prevented by the following: Do not use alcohol or anti-depressant medicines if you sleepwalk. Avoid sleep deprivation, and try to prevent insomnia, because these can trigger sleepwalking. [sleepcenterga.com]

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]

Installing window and door locks can help prevent injury to people whose parasomnia involves sleepwalking or other behaviors. [whitneysleepcenter.com]

To prevent these cramps, people should stretch the affected muscles for several minutes before going to sleep. Usually, stretching as soon as cramps occur relieves symptoms promptly and is preferred to drug treatment. [merckmanuals.com]

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