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[PMID]: 29412983
[Au] Autor:Iranzo A
[Ad] Address:Neurology Service, Multidisciplinary Sleep Unit, Hospital Clinic de Barcelona, C/ Villarroel 180, Barcelona 08036, Spain. Electronic address: AIRANZO@clinic.cat.
[Ti] Title:Parasomnias and Sleep-Related Movement Disorders in Older Adults.
[So] Source:Sleep Med Clin;13(1):51-61, 2018 Mar.
[Is] ISSN:1556-4088
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Parasomnias and sleep-related movement disorders are important problems in older adults. Sleep paralysis is rare, but may occur in families. In a minority of patients with disorders of arousal, the episodes persist until the age of 70. Zolpidem and other medications may induce sleepwalking and sleep-related eating. Most patients with idiopathic rapid eye movement (REM) sleep behavior disorder eventually develop Parkinson's disease or dementia with Lewy bodies. Anti-IgLON5 disease includes abnormal behaviors in NREM and REM sleep. Restless legs syndrome prevalence increases with age. A severe form of periodic limb movements in sleep may mimic REM sleep behavior disorder.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180207
[Lr] Last revision date:180207
[St] Status:In-Process

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[PMID]: 29038950
[Au] Autor:Ingravallo F; Schenck CH; D'Aloja E; Puligheddu M
[Ad] Address:Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via Irnerio 49, Bologna, Italy.
[Ti] Title:Firing a loaded gun during sleep in an elderly man with a "perfect storm" of risk factors including severe obstructive sleep apnea.
[So] Source:Sleep Breath;, 2017 Oct 16.
[Is] ISSN:1522-1709
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: We report a case of firing a loaded gun during sleep in a geriatric patient with undiagnosed major sleep disorders and multiple risk factors for sleep violence. Polysomnographic findings, diagnostic challenges, and forensic implications in this unprecedented geriatric case are discussed. METHODS: A 75-year-old employed man, married for 32 years, presented to a sleep center reporting to having fired a shot in his bedroom during sleep while his wife was away, without memory of hearing the gunshot. The day before the event, the patient had a normal life, apart from serious worries about recent nearby burglaries that prompted his sleeping with a loaded gun placed behind his bed. The patient underwent a sleep medicine workup, including nocturnal video polysomnography (vPSG). RESULTS: The patient and his wife were unaware of any sleep problems. Upon careful questioning, only mild daytime sleepiness and rare episodes of minor abnormal motor behavior were reported. At vPSG, sleep structure was markedly disrupted with only one clear sleep cycle with REM sleep that had preserved REM-atonia; severe obstructive sleep apnea and moderately severe periodic limb movement activity were documented. Brief abnormal movements from REM sleep without apparent precipitant were recorded. CPAP therapy was effective. CONCLUSIONS: In this case, there was a "perfect storm" of sleep and psychological risk factors that converged to strongly promote precipitous arousals with sleep-related violence in a patient with documented sleep motor dyscontrol. Primary care physicians, including geriatric specialists, should question patients and their spouses about any symptoms of sleep disorders.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171017
[Lr] Last revision date:171017
[St] Status:Publisher
[do] DOI:10.1007/s11325-017-1577-3

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[PMID]: 29029239
[Au] Autor:Arnulf I; Uguccioni G; Gay F; Baldayrou E; Golmard JL; Gayraud F; Devevey A
[Ad] Address:Sleep Disorders Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
[Ti] Title:What Does the Sleeping Brain Say? Syntax and Semantics of Sleep Talking in Healthy Subjects and in Parasomnia Patients.
[So] Source:Sleep;40(11), 2017 Nov 01.
[Is] ISSN:1550-9109
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Objectives: Speech is a complex function in humans, but the linguistic characteristics of sleep talking are unknown. We analyzed sleep-associated speech in adults, mostly (92%) during parasomnias. Methods: The utterances recorded during night-time video-polysomnography were analyzed for number of words, propositions and speech episodes, frequency, gaps and pauses (denoting turn-taking in the conversation), lemmatization, verbosity, negative/imperative/interrogative tone, first/second person, politeness, and abuse. Results: Two hundred thirty-two subjects (aged 49.5 ± 20 years old; 41% women; 129 with rapid eye movement [REM] sleep behavior disorder and 87 with sleepwalking/sleep terrors, 15 healthy subjects, and 1 patient with sleep apnea speaking in non-REM sleep) uttered 883 speech episodes, containing 59% nonverbal utterance (mumbles, shouts, whispers, and laughs) and 3349 understandable words. The most frequent word was "No": negations represented 21.4% of clauses (more in non-REM sleep). Interrogations were found in 26% of speech episodes (more in non-REM sleep), and subordinate clauses were found in 12.9% of speech episodes. As many as 9.7% of clauses contained profanities (more in non-REM sleep). Verbal abuse lasted longer in REM sleep and was mostly directed toward insulting or condemning someone, whereas swearing predominated in non-REM sleep. Men sleep-talked more than women and used a higher proportion of profanities. Apparent turn-taking in the conversation respected the usual language gaps. Conclusions: Sleep talking parallels awake talking for syntax, semantics, and turn-taking in conversation, suggesting that the sleeping brain can function at a high level. Language during sleep is mostly a familiar, tensed conversation with inaudible others, suggestive of conflicts.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171120
[Lr] Last revision date:171120
[St] Status:In-Process
[do] DOI:10.1093/sleep/zsx159

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[PMID]: 28892547
[Au] Autor:Ekambaram V; Maski K
[Ti] Title:Non-Rapid Eye Movement Arousal Parasomnias in Children.
[So] Source:Pediatr Ann;46(9):e327-e331, 2017 Sep 01.
[Is] ISSN:1938-2359
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Parasomnia is a common pediatric sleep disorder that can cause parents or caregivers distress when experienced by their children. Based on the International Classification of Sleep Disorders, parasomnias can be divided into two subgroups: non-rapid eye movement (NREM) parasomnias and rapid eye movement (REM) parasomnias. REM sleep parasomnias include nightmares, REM behavior disorder, and sleep paralysis, whereas NREM sleep parasomnias include disorders of arousal such as confusional arousals, sleepwalking, sleep talking, night terrors, and sleep-related eating disorder. This review focuses on the epidemiology, clinical presentation, diagnosis, and treatment of the most common form of parasomnias-NREM arousal parasomnias. Additionally, this review aims to help clinicians distinguish NREM parasomnias from nocturnal frontal lobe seizures, as this distinction is important to avoid diagnostic delays and inappropriate medication exposure. [Pediatr Ann. 2017;46(9):e327-e331.].
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 170911
[Lr] Last revision date:170911
[St] Status:In-Process
[do] DOI:10.3928/19382359-20170814-01

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[PMID]: 28777180
[Au] Autor:Kotagal S
[Ti] Title:Sleep-Wake Disorders of Childhood.
[So] Source:Continuum (Minneap Minn);23(4, Sleep Neurology):1132-1150, 2017 Aug.
[Is] ISSN:1538-6899
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract: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.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170929
[Lr] Last revision date:170929
[St] Status:In-Process
[do] DOI:10.1212/CON.0000000000000504

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[PMID]: 28777175
[Au] Autor:Irfan M; Schenck CH; Howell MJ
[Ti] Title:Non-Rapid Eye Movement Sleep and Overlap Parasomnias.
[So] Source:Continuum (Minneap Minn);23(4, Sleep Neurology):1035-1050, 2017 08.
[Is] ISSN:1538-6899
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE OF REVIEW: This article reviews the spectrum of non-rapid eye movement (non-REM) sleep parasomnias, including sleepwalking, confusional arousals, and sleep terrors, which represent the range of phenotypic disorders of arousal from non-REM sleep that occurs in children and adults. RECENT FINDINGS: The International Classification of Sleep Disorders, Third Edition (ICSD-3) classifies parasomnias according to the sleep stage they emerge from: REM, non-REM, or other. Demographics, clinical features, and diagnosis of non-REM parasomnias are reviewed in this article, and an up-to-date synopsis of guidelines for management strategies to assist in the treatment of these sleep disorders is provided. SUMMARY: The non-REM parasomnias are most common in children and adolescents but may persist into adulthood. They can be distinguishable from REM parasomnias and nocturnal epilepsies, and, importantly, may lead to injury. Additionally, other parasomnias in this spectrum include sleep-related eating disorder and sexsomnia. Overlap parasomnia disorder includes one or more manifestations of a non-REM parasomnia seen in combination with REM sleep behavior disorder, representing an apparent erosion of the normally distinct stages of non-REM and REM sleep. A similar yet much more extreme dissociation of states underlies agrypnia excitata and status dissociatus, which represent rare, severe dissociations between non-REM, REM, and wake states resulting clinically in oneiric behaviors and severe derangement of normal polysomnographic wake and sleep stage characteristics. Management of non-REM and overlap parasomnias and state dissociation disorders include ensuring bedroom safety and prescription of clonazepam or hypnosis, in select cases, although in children and adolescents with noninjurious behaviors, non-REM parasomnias are often age-limited developmental disorders, which may ultimately remit by adulthood, and, in these cases, counseling and education alone may suffice. Timely and accurate recognition of the non-REM and overlap parasomnias is crucial to limiting potential patient injury.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1708
[Cu] Class update date: 170929
[Lr] Last revision date:170929
[St] Status:In-Process
[do] DOI:10.1212/CON.0000000000000503

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[PMID]: 28777174
[Au] Autor:Högl B; Iranzo A
[Ti] Title:Rapid Eye Movement Sleep Behavior Disorder and Other Rapid Eye Movement Sleep Parasomnias.
[So] Source:Continuum (Minneap Minn);23(4, Sleep Neurology):1017-1034, 2017 Aug.
[Is] ISSN:1538-6899
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE OF REVIEW: The most common rapid eye movement (REM) parasomnia encountered by neurologists is REM sleep behavior disorder (RBD), and nightmares are so frequent that every neurologist should be able to differentiate them from the dream enactment of RBD. Isolated sleep paralysis is relatively common and is often mistaken for other neurologic disorders. This article summarizes the current state of the art in the diagnosis of RBD, discusses the role of specific questionnaires and polysomnography in the diagnosis of RBD, and reviews recent studies on idiopathic RBD as an early feature of a synucleinopathy, secondary RBD, and its management. Recent diagnostic criteria and implications of nightmares and isolated sleep paralysis are also reviewed. RECENT FINDINGS: Idiopathic RBD can now be considered as part of the prodromal stage of a synucleinopathy. Therefore, an accurate diagnosis is mandatory, and this implies detection of REM sleep without atonia. The polysomnography montage, including EMG of the submentalis and flexor digitorum superficialis muscles, provides a high sensitivity and specificity for the diagnosis. The exact diagnosis is important for patient counseling and for future neuroprotective trials. SUMMARY: REM parasomnias include RBD, sleep paralysis, and nightmares, which have distinct clinical characteristics and different implications regarding diagnostic procedures, management, and prognosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 170929
[Lr] Last revision date:170929
[St] Status:In-Process
[do] DOI:10.1212/CON.0000000000000489

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[PMID]: 28760912
[Au] Autor:Parrino L; Pavesi G
[Ad] Address:From the Sleep Disorders Center (L.P.) and Unit of Neurology (G.P.), Azienda Ospedaliero-Universitaria di Parma, Italy. liborio.parrino@unipr.it.
[Ti] Title:When sleep-related hypermotor epilepsy (SHE) met Charles Darwin and Francis Galton.
[So] Source:Neurology;89(5):502-505, 2017 Aug 01.
[Is] ISSN:1526-632X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Sleep-related hypermotor epilepsy (SHE) is characterized by short-lasting seizures patterned by repetitive and stereotyped motor events in the same person. In autosomal dominant SHE, genetic factors play a well-known key role. In Charles Darwin quotes a plausible example of SHE illustrated by his cousin Sir Francis Galton: "the gentleman…lay fast asleep on his back in bed, raising his right arm slowly in front of his face, up to his forehead, and then dropping it with a jerk, so that the wrist fell heavily on the bridge of his nose. The trick did not occur every night, but occasionally, and was independent of any ascertained cause. Sometimes it was repeated incessantly for an hour or more." Similar manifestations during sleep occurred also in the patient's son and granddaughter, suggesting an autosomal inheritance without sex relationship. Differential diagnosis with REM behavior disorder and other parasomnias is discussed. To our knowledge, this could be the first description of a stereotyped SHE pattern with genetic transmission.
[Mh] MeSH terms primary: Epilepsy, Partial, Motor/history
Sleep Wake Disorders/history
[Mh] MeSH terms secundary: Books/history
Epilepsy, Partial, Motor/genetics
Genetic Predisposition to Disease
History, 19th Century
History, 20th Century
Humans
Sleep Wake Disorders/genetics
United Kingdom
[Pt] Publication type:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Personal name as subject:Darwin C; Galton F
[Em] Entry month:1708
[Cu] Class update date: 170804
[Lr] Last revision date:170804
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170802
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004134

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[PMID]: 28720127
[Au] Autor:Bargiotas P; Muellner J; Schuepbach WMM; Bassetti CL
[Ad] Address:Department of Neurology, University Hospital (Inselspital) and University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland. panagiotis.bargiotas@insel.ch.
[Ti] Title:Parasomnia overlap disorder, Parkinson's disease and subthalamic deep brain stimulation: three case reports.
[So] Source:BMC Neurol;17(1):137, 2017 Jul 18.
[Is] ISSN:1471-2377
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Parasomnia overlap disorder (POD) is a distinct parasomnia and characterized by concomitant manifestation of rapid-eye-movement (REM)- and non-REM (NREM)-parasomnias. Although not uncommon among patients with Parkinson's disease, POD is often under-investigated. CASE PRESENTATION: This is the first report of patients with PD and features of POD that underwent deep brain stimulation. Our patients exhibited different outcomes of POD features after subthalamic deep brain stimulation. CONCLUSIONS: We expect that the reporting of these first patients will open the discussion about the need for more detailed and broad-spectrum assessments regarding parasomnias in PD patients that undergo deep brain stimulation. The implications of our observations are both clinical and neurobiological.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170723
[Lr] Last revision date:170723
[St] Status:In-Process
[do] DOI:10.1186/s12883-017-0916-0

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[PMID]: 28651358
[Au] Autor:Marquis LP; Paquette T; Blanchette-Carrière C; Dumel G; Nielsen T
[Ad] Address:Department of Psychology, Université de Montréal, Québec, Canada.
[Ti] Title:REM Sleep Theta Changes in Frequent Nightmare Recallers.
[So] Source:Sleep;40(9), 2017 Sep 01.
[Is] ISSN:1550-9109
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Study Objectives: To replicate and expand upon past research by evaluating sleep and wake electroencephalographic spectral activity in samples of frequent nightmare (NM) recallers and healthy controls. Methods: Computation of spectral activity for sleep (non-REM and REM) and wake electroencephalogram recordings from 18 frequent NM recallers and 15 control participants. Results: There was higher "slow-theta" (2-5 Hz) for NM recallers than for controls during wake, non-REM sleep and REM sleep. Differences were clearest for frontal and central derivations and for REM sleep cycles 2-4. There was also higher beta activity during NREM sleep for NM recallers. Findings partially replicate past research by demonstrating higher relative "slow-theta" (3-4Hz) for NM recallers than for controls. Conclusions: Findings are consistent with a neurocognitive model of nightmares that stipulates cross-state anomalies in emotion processing in NM-prone individuals.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170921
[Lr] Last revision date:170921
[St] Status:In-Process
[do] DOI:10.1093/sleep/zsx110


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