Disease relevance of Parasomnias

• Formal sleep evaluation including PSG is indicated for parasomnias that are violent and potentially injurious; disruptive to the bed partner or other household members; accompanied by excessive daytime sleepiness; or associated with medical,psychiatric, or neurologic symptoms or findings [2] [1].
• The parasomnias comprise different entities such as nightmares, REM-sleep behavior disorder, sleep enuresis, and bruxism [2].

Psychiatry related information on Parasomnias

• Nocturnal paroxysmal arousals with motor behaviors during sleep: frontal lobe epilepsy or parasomnia [3]?
• In the group of Parasomnias usually associated with REM Sleep, IR was "substantial" (kappa 0.69) for sleep paralysis, "moderate" (kappa 0.46) for RBD, "fair" (kappa 0.25) for nightmares [4].
• REM sleep behaviour disorder is a recently described parasomnia characterized by a history of excessive motor activities during sleep and is associated with pathological absence of muscle atonia during REM sleep [5].
• Only one group of sleep problems, parasomnias (in particular sleepwalking and sleep terrors), had a higher occurrence (p < or = 0.05) in the NF1 group than in the general population [6].
• Other REM parasomnias, including nightmares, REM sleep-related sinus arrest, and sleep-related painful erections, are discussed briefly [7].

High impact information on Parasomnias

• Large and full video-polysomnographical studies are of the utmost importance in order to clarify the real prevalence of both nocturnal frontal lobe epilepsy and parasomnias, and to provide a correct therapy [8].
• Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults [9].
• 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) [10].
• A case of parasomnia at REM sleep onset [11].
• Their seizures started in childhood (mean age, 8 years) and were often misinterpreted as benign nocturnal parasomnias, nocturnal paroxysmal dystonia, or a psychiatric disorder [12].

Chemical compound and disease context of Parasomnias

• CONCLUSIONS: These descriptive data support the need for further investigation into the relationship between caffeine intake and parasomnias, as well as into the observed gender differences [13].
• The median percentage decrease in the parasomnias score was 60 (range 0.0-70.8) in the valproate + melatonin group compared with 36.4 (range 0.0-63.2) in the valproate + placebo group, the difference being statistically significant (P < .05) [14].
• The 2 symptomatic children who were treated with Pramipexole had a complete absence of confusional arousals on the follow-up recording and reported no parasomnia since treatment [15].
• Although no factor emerged that corresponded exactly to the parasomnias, as described by the Association of Sleep Disorders Centers (1979), all of the variables that loaded on Factor 1 were behaviors characteristic of the parasomnias, with the exception of recalled nightmares [16].

Biological context of Parasomnias

• These REM sleep neurobehavioral disorders constitute another category of parasomnia, replicate findings from 21 years ago in cats receiving pontine tegmental lesions, and offer additional perspectives on human behavior, neurophysiology, pharmacology, and dream phenomenology [17].
• Arousal disorders and the parasomnias associated with REM sleep are the primary parasomnias most likely to be seen in a neurology practice [18].

Gene context of Parasomnias

• Rhythmic tongue movements during sleep: A peculiar parasomnia in Costello syndrome [19].
• The considerable similarity of the clinical and paraclinical signs and of the effects of anti-epileptic treatments do not seem to justify the individualization of different subgroups as a function of the EEG patterns: the NPD are always the result of focal epilepsy, and never of a pathology of movement or of parasomnia [20].
• ABC of sleep disorders. Parasomnias [21].
• Sleep disorders. Part III: insomnias and parasomnias [22].

References