Sleep disorder

About: Sleep disorder is a research topic. Over the lifetime, 19380 publications have been published within this topic receiving 884281 citations. The topic is also known as: somnipathy & non-organic sleep disorder.

A parasomnia overlap disorder involving sleepwalking, sleep terrors, and REM sleep behavior disorder in 33 polysomnographically confirmed cases.

Abstract: A series of 33 patients with combined (injurious) sleepwalking, sleep terrors, and rapid eye movement (REM) sleep behavior disorder (viz. "parasomnia overlap disorder") was gathered over an 8-year period. Patients underwent clinical and polysomnographic evaluations. Mean age was 34 +/- 14 (SD) years; mean age of parasomnia onset was 15 +/- 16 years (range 1-66); 70% (n = 23) were males. An idiopathic subgroup (n = 22) had a significantly earlier mean age of parasomnia onset (9 +/- 7 years) than a symptomatic subgroup (n = 11) (27 +/- 23 years, p = 0.002), whose parasomnia began with either of the following: neurologic disorders, n = 6 [congenital Mobius syndrome, narcolepsy, multiple sclerosis, brain tumor (and treatment), brain trauma, indeterminate disorder (exaggerated startle response/atypical cataplexy)]; nocturnal paroxysmal atrial fibrillation, n = 1; posttraumatic stress disorder/major depression, n = 1; chronic ethanol/amphetamine abuse and withdrawal, n = 1; or mixed disorders (schizophrenia, brain trauma, substance abuse), n = 2. The rate of DSM-III-R (Diagnostic and Statistical Manual, 3rd edition, revised) Axis 1 psychiatric disorders was not elevated; group scores on various psychometric tests were not elevated. Forty-five percent (n = 15) had previously received psychologic or psychiatric therapy for their parasomnia, without benefit. Treatment outcome was available for n = 20 patients; 90% (n = 18) had substantial parasomnia control with bedtime clonazepam (n = 13), alprazolam and/or carbamazepine (n = 4), or self-hypnosis (n = 1). Thus, "parasomnia overlap disorder" is a treatable condition that emerges in various clinical settings and can be understood within the context of current knowledge on parasomnias and motor control/dyscontrol during sleep.

Sleep and Its Disorders

Abstract: Sleep disorders are very prevalent in the general population and are associated with significant medical, psychological, and social disturbances. Insomnia is the most common. When chronic, it usually reflects psychological/behavioral disturbances. Most insomniacs can be evaluated in an office setting, and a multidimensional approach is recommended, including sleep hygiene measures, psychotherapy, and medication. The parasomnias, including sleepwalking, night terrors, and nightmares, have benign implications in childhood but often reflect psychopathology or significant stress in adolescents and adults and organicity in the elderly. Excessive daytime sleepiness is typically the most frequent complaint and often reflects organic dysfunction. Narcolepsy and idiopathic hypersomnia are chronic brain disorders with an onset at a young age, whereas sleep apnea is more common in middle age and is associated with obesity and cardiovascular problems. Therapeutic naps, medications, and supportive therapy are recommended for narcolepsy and hypersomnia; continuous positive airway pressure, weight loss, surgery, and oral devices are the common treatments for sleep apnea.

Postoperative sleep disturbances: mechanisms and clinical implications.

Abstract: Major surgery is beset by complications such as pulmonary, cardiac, thromboembolic and cerebral dysfunction, which cannot be attributed solely to inadequate surgical and anaesthetic techniques, but rather to increased organ demands caused by the endocrine metabolic response to surgical trauma [33]. Postoperative cerebral dysfunction comprises delirium, confusion and milder degrees of mental dysfunction [1, 48, 53, 62], and disturbances in the normal sleep pattern [4, 7, 9, 13, 17, 34, 39, 42, 65]. Changes in early postoperative sleep [4, 7, 8, 13, 17, 34, 39, 42, 65] and sleep after non-surgical stress [10, 20, 24, 26, 27, 29, 60] are characterized by a decrease in total sleep time, elimination of rapid eye movement (REM) sleep, a marked reduction in the amount of slow wave sleep (SWS) and increased amounts of non-REM (N-REM) sleep stage 2. Recent data have suggested that postoperative sleep disturbances may be involved in the development of altered mental function [27], postoperative episodic hypoxaemia [38, 65] and haemodynamic instability [40]. The aim of this article, therefore, is to review the incidence and duration of postoperative sleep disturbances, and to evaluate possible mechanisms and potential implications for postoperative outcome.

Improving Sleep Quality in Older Adults with Moderate Sleep Complaints: A Randomized Controlled Trial of Tai Chi Chih

Abstract: participants: Volunteer sample of 112 healthy older adults, aged 59 to 86 years. intervention: Random allocation to Tai Chi Chih or health education for 25 weeks. results: Among adults with moderate sleep complaints, as defined by PSQI global score of 5 or greater, subjects in the Tai Chi Chih condition were more likely to achieve a treatment response, as defined by PSQI less than 5, compared to those in health education (P < 0.05). Subjects in the Tai Chi Chih condition with poor sleep quality also showed significant improvements in PSQI global score (P < 0.001) as well as in the sleep parameters of rated sleep quality (P < 0.05), habitual sleep efficiency (P < 0.05), sleep duration (P < 0.01), and sleep disturbance (P < 0.01). Conclusions: Tai Chi Chih can be considered a useful nonpharmacologic approach to improve sleep quality in older adults with moderate complaints and, thereby, has the potential to ameliorate sleep complaints possibly before syndromal insomnia develops. Clinical Trials registration: ClinicalTrials.gov Identifier: NCT00118885

Validation of a Cataplexy Questionnaire in 983 Sleep-disorders Patients

Abstract: Our goal was to validate a self-administered narcolepsy questionnaire focusing on cataplexy. Nine hundred and eight three consecutive subjects entering the Stanford Sleep Disorder Clinic completed the questionnaire. Clinic physicians reported on the presence or absence of "clear-cut" cataplexy. Responses to 51 cataplexy-related questionnaire items were compared between subjects with clear-cut cataplexy (n = 63) and all other patients (n = 920). As previously reported, a large portion of the non-narcoleptic population was found to experience muscle weakness with various intense emotions (1.8% to 18.0%) or athletic activities (26.2% to 28.8%). Factor analysis and Receiver Operating Characteristic Curve (ROC) analysis were used to determine the most predictive items for clear-cut cataplexy. Most strikingly, cataplexy was best differentiated from other types of muscle weakness when triggered by only three typical situations: "when hearing and telling a joke," "while laughing," or "when angry." Face or neck, rather than limbs, were also more specifically involved in clear-cut cataplexy. Other items, such as length of attacks, bilaterality, and alteration in consciousness, were poorly predictive. A simple decision tree was constructed to isolate high-(91.7%) and low-(0.6%) risk groups for cataplexy. This questionnaire will be used to increase diagnostic consistency across clinical centers, thus providing more homogenous subject pools for clinical and basic research studies.