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Sleep board review question: nocturnal hypoxemia in COPD  [cached]
Poongkunran C,Budhiraja R
Southwest Journal of Pulmonary and Critical Care , 2013,
Abstract: No abstract available. Article truncated at end of question. Question: Which of the following is the strongest predictor of nocturnal hypoxemia in patients with chronic obstructive pulmonary disease (COPD)?1.Forced expiratory volume in 1 second (FEV1)2.Age3.Daytime Oxygen Saturation4.Radiological severity of COPD…
Prevalence of Parasomnia in Autistic Children with Sleep Disorders
Xue Ming, Ye-Ming Sun, Roberto V. Nachajon, Michael Brimacombe and Arthur S. Walters
Clinical Medicine Insights: Pediatrics , 2012,
Abstract: The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD). Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG) and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights’ PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.
Prevalence of Parasomnia in Autistic Children with Sleep Disorders
Xue Ming,Ye-Ming Sun,Roberto V. Nachajon,Michael Brimacombe
Clinical Medicine : Pediatrics , 2009,
Abstract: The prevalence of sleep related complaints is reported by questionnaire studies to be as high as 83.3% in children with autism spectrum disorders (ASD). Questionnaire studies report the presence of various parasomnia in ASD. However, no polysomnographic study reports non-REM parasomnias and only a single study reports REM related parasomnias in ASD. We investigated the prevalence and characteristics of sleep disorders by polysomnographic study and questionnaires in a cohort of 23 children with ASD and 23 age-matched children of a non-autistic comparison group. The results showed significantly more non-REM parasomnias in 14 children with ASD on polysomnograms (PSG) and 16 ASD children by questionnaire, a finding that was not associated with medication use, other comorbid medical or psychiatric disorders, or sleep disordered breathing. Of the 14 children with ASD who had PSG evidence of parasomnia, 11 of them had a history suggestive of parasomnia by questionnaire. There was a high sensitivity but a low specificity of parasomnia in ASD by questionnaire in predicting the presence of parasomnia in the PSG. Of the parasomnias recorded in the laboratory, 13 ASD children had Disorders of Partial Arousal, consistent with sleep terrors or confusional arousals. Furthermore, multiple episodes of partial arousal occurred in 11 of the 13 ASD children who had PSG evidence of Disorders of Partial Arousal. Of the 11 ASD children with multiple episodes of partial arousal, 6 ASD children had multiple partial arousals during both nights’ PSG study. Sleep architecture was abnormal in children with ASD, characterized by increased spontaneous arousals, prolonged REM latency and reduced REM percentage. These results suggest a high prevalence of parasomnia in this cohort of children with ASD and a careful history intake of symptoms compatible with parasomnia could be prudent to diagnose parasomnia in ASD children when performing a PSG is not possible.
The Relationship between Sleep and Epilepsy
Nilda TURGUT
Trakya Universitesi Tip Fakultesi Dergisi , 2004,
Abstract: Sleep is an important factor influencing the activation of seizures and interictal discharges. Sleep may contribute to the activation of many seizures, increase the frequency of epileptiform discharges, altering their morphology and distribution. On the other hand, seizures may influence sleep, leading to sleep abnormalities in epileptic patients. This review summarizes the interactions between sleep and epilepsy, the influence of sleep on seizure disorders, and seizure-induced changes in sleep patterns.
Somnambulism Due to Temporal Lobe Epilepsy - A Case Report
Rajesh S,Durairaj R,Mugundan K,Rajasekar M
Annals of Indian Academy of Neurology , 2004,
Abstract: Somnambulism (sleep walking) is a disorder of arousal that falls under the parasomnia group. It is more common in children than in adults. (1). The onset of sleep walking in adult life is most unusual and suggests the presence of secondary causes rather than a primary sleep disorder (1). We report a 30-year-old male who presented with repeated episodes of sleep waling possibly due to nocturnal temporal lobe epilepsy.
Epilepsy, Antiseizure Therapy, and Sleep Cycle Parameters  [PDF]
Vladimir Shvarts,Steve Chung
Epilepsy Research and Treatment , 2013, DOI: 10.1155/2013/670682
Abstract: A reciprocal relationship exists between sleep and epilepsy. The quality of sleep is affected by the presence and frequency of seizures, type of antiepileptic therapy utilized, and coexisting primary sleep disorders. Daytime somnolence is one of the most common adverse effects of antiepileptic therapy, with specific pharmacologic agents exhibiting a unique influence on components of sleep architecture. The newer generation of antiseizure drugs demonstrates improved sleep efficiency, greater stabilization of sleep architecture, prolongation of REM sleep duration, and increased quality of life measures. The emerging field of chronoepileptology explores the relationship between seizures and circadian rhythms, aiming for targeted use of antiseizure therapies to maximize therapeutic effects and minimize the adverse events experienced by the patients. 1. Introduction Although the complex relationship between sleep and epilepsy has not been fully elucidated, it is well known that sleep disturbance provokes seizures and that seizure activity may influence the quality of sleep. In addition, antiepileptic drugs (AEDs) that are commonly used for seizure treatment affect sleep quality and architecture. Some AEDs tend to cause sleepiness or drowsiness while others can lead to insomnia. Sleep is an essential physiologic state that influences restorative and memory consolidating functions [1]. As previously recognized, the relationship between epilepsy and sleep disturbance is likely multifactorial: the direct effect of seizures, adverse events due to AED therapy, presence of psychiatric comorbidity, and coexisting sleep disorders all have the potential to contribute to alteration of sleep architecture and the subjective quality of sleep. Accordingly, one would expect that lack of sound sleep would significantly impact neurocognitive and psychological function, especially in patients treated with AEDs for their seizures. It is important for clinicians to understand the proclivity of a specific AED to affect the quality of sleep in order to guide epilepsy therapy and prevent disturbance of a patients’ nocturnal recovery. This review systematically evaluates the currently available literature, elucidating the effect of antiepileptic drug therapy upon the sleep cycle. A search of relevant primary research and review articles was performed utilizing the PubMed database. 2. Epilepsy and Sleep Sleep is classically divided into REM and non-REM phases as defined by the parameters of electroencephalography, respiration, eye movement, and electromyography. The non-REM phase
Sleep board review questions: sleep disordered breathing that improves in REM
Budhiraja R
Southwest Journal of Pulmonary and Critical Care , 2012,
Abstract: No abstract available. Article truncated at end of question. Which of the following breathing disorders is usually less severe in rapid eye movement (REM) sleep compared to non-rapid eye movement (NREM) sleep?1.Sleep-related hypoxemia in COPD2.Obstructive Sleep Apnea3.Cheyne Stokes Breathing4.Hypoxemia in Pulmonary Hypertension
Neuroimaging of sleep and sleep disorders. A book Review.  [PDF]
Anne-Marie Landtblom
Frontiers in Neurology , 2014, DOI: 10.3389/fneur.2014.00151
Abstract: Neuroimaging of sleep and sleep disorders Edited by Eric Nofzinger, Pierre Maquet and Michael J Thorpy Cambridge medicine, Cambridge University Press 2013 Sleep physiology is a field of increasing importance because the recent awareness of how sleep affects us all, whether it is good or bad. Sleep disorders have a big impact on daily life and functioning, but importantly, also other disorders that are not primarily associated with sleep disturbances. Subsequently several disorders should be investigated and treated for sleep symptoms because these can be frequent. Examples here are Parkinson′s disease with frequent day time sleepiness and insomnia. Also, epilepsy is frequently connected to disturbed night sleep in a complex way: antiepileptic drugs can be sedative, but seizures can also occur at night and disturb the night sleep. A focus on increased sleep health for persons with epilepsy can improve seizure control, and should be included in future follow up of such patients. Of course, the impact of sleep deprivation on driving is a well-known problem that often concerns doctors, for example in common diseases like obstructive sleep apnoea syndrome,OSAS, as well as other chronic conditions, also regarding medications, with an impact on alertness. Naturally sleep effects in healthy persons are of great importance in the society, concerning both safety and quality of life.. Besides medicine, also new fields have emerged that do not primarily link to pathological conditions. The effects of sleep deprivation on economic decision making is such an example of research that reveals how sleep can affect human behaviour. Neuroimaging of Sleep and Sleep Disorders is an outstanding book with high relevance to physicians and researchers interested in this area. It has a background part with introductory sections about Neuroimaging of wakefulness and sleep, Neuroimaging, sleep loss and circadian misalignment and Sleep and memory containing the important imaging modalities such as magnetic resonance imaging ( MRI), positron emission tomography (PET), single-photon emission computed tomography (SPECT), sonography, magnetization transfer imaging (MTI) and combined EEG and functional magnetic resonance imaging (fMRI). The core chapter thoroughly invents imaging experiences in a large variety of disorders and conditions connected to sleep disturbance: insomnia, depression, schizophrenia, narcolepsy (also including cataplexy as an isolated phenomenon), OSAS, parasomnia, central hypoventilation syndrome, fatal familial insomnia, posttraumatic stress disorder,
Sleep board review questions: CPAP adherence in OSA  [cached]
Luraschi-Monjagatta C,Budhiraja R
Southwest Journal of Pulmonary and Critical Care , 2012,
Abstract: No abstract available. Article truncated after first question. Which of the following has been shown to be associated with a better adherence to positive airway pressure (PAP) therapy in adults with obstructive sleep apnea (OSA)?1.Use of auto-titrating positive airway pressure (autoPAP) instead of CPAP.2.Cognitive behavioral therapy prior to initiation of PAP therapy.3.Severe sleep apnea on diagnostic polysomnography.4.Epworth Sleepiness Scale (ESS) score at initiation of PAP therapy…
Epilepsia y sue o Epilepsy and sleep  [cached]
C. Viteri
Anales del Sistema Sanitario de Navarra , 2007,
Abstract: La relación entre epilepsia y sue o se conoce desde hace más de un siglo. Al final del siglo XIX se observó una relación entre la aparición de las crisis epilépticas y el ciclo vigilia-sue o. Con la aparición de la electroencefalografía se comprobó cual era el efecto del sue o y de la privación del mismo sobre las descargas epileptiformes interictales y las crisis epilépticas. Existen una serie de síndromes epilépticos parciales y generalizados que se asocian con el sue o y que es importante reconocer para poder hacer un buen diagnóstico diferencial de los pacientes con trastornos motores y de comportamiento durante el sue o. En este artículo se revisan todos estos aspectos de la relación entre epilepsia y sue o. The relationship between sleep and epilepsy is known from more than a century ago. At the end of the XIXth century a temporal relationship between the onset of epileptic seizures and the wake-sleep cycle was observed. The introduction of the electroencephalogram allowed establishing the effect of sleep and sleeping deprivation on epileptiform interictal discharges and on epileptic seizures. The recognition of the variety of generalized and partial epileptic syndromes associated to sleep is important to make a correct differential diagnosis of patients presenting with motor and behavioural disturbances of sleep. This article reviews the different aspects of the relationship between epilepsy and sleep.
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