1,721,342 research outputs found
Neurocognitive deficits in pediatric obstructive sleep apnea: A multifaceted pathogenetic model
No full text[No abstract available
Neurobiology of Sleep-Related Movements
No full textSleep-related movements comprise a broad spectrum of simple and usually stereotyped movements that are sometimes associated with sleep disturbance (insomnia, sleep fragmentation, and non-restorative sleep). They may represent a physiological variant or a sleep disorder, depending on their intensity, frequency, and associated sleep disruption degree. Sleep-related movements involve usually the lower limbs; they can be idiopathic or associated with other sleep disorders, neurological disease, and medical condition or occur as a consequence of drug use. Several pathophysiological hypotheses have been proposed, but for the majority of these disorders, the neurobiological mechanism is far from being completely understood. Further studies are needed to elucidate the pathophysiology of sleep-related movements in order to better appreciate their clinical significance. This chapter describes the neurobiology of sleep-related movements, namely, periodic limb movements, alternating leg muscle activation, hypnagogic foot tremor, high-frequency myoclonus, excessive fragmentary myoclonus, propriospinal myoclonus at sleep onset, neck myoclonus during sleep, sleep bruxism, sleep-related rhythmic movement disorder, sleep-related leg cramps, and sleep starts. We also present a mechanistic model of the potential role of the spinal central pattern generator for locomotion in generating the leg movements
Sleep After Traumatic Brain Injury
No full textTraumatic brain injury (TBI) is an important cause of death and disability at all ages in the world. Complete functional recovery is not always complete, and, often, persistent symptoms may last for a long time. Sleep disorders and sleep-wake alterations are among the most common complications both in the acute and chronic phases after the trauma, and they may have a negative impact on daily activities and on quality of life of these patients. Sleep and sleep-wake cycle are not always carefully assessed in patients after TBI, they are overlooked, and often patients have a persistent excessive daytime sleepiness, even for years after the TBI, without receiving a proper diagnosis and treatment. Moreover, scientific evidence has been provided for the role of sleep in neuroprotection and recovery after brain injury; hence, promoting an optimal sleep function and early diagnosing and treating sleep disorders may be helpful for rehabilitation and functional recovery of patients after TBI
Sleep classification according to AASM and Rechtschaffen and Kales: effects on sleep scoring parameters of children and adolescents
No full textRecently, the new American Academy of Sleep Medicine (AASM) rules and the old Rechtschaffen and Kales (R&K) criteria for sleep scoring have been shown to produce significantly different results in adults. The aim of this study was to describe in detail such differences in a group of normal children. Polysomnographic recordings from 45 healthy children (18 females and 27 males) aged between 3 and 16 years were scored following both systems and the results compared. Several significant differences between the two scoring systems were found: N1 (AASM) was significantly higher than S1 (R&K) while Stages N2 and R (AASM) were significantly smaller than S2 and rapid eye movement (R&K). The Kendall Tau correlation coefficient revealed a relatively low concordance between the two systems for the scoring of number of stage shifts per hour, minutes and percentage of Stage N1/S1, and of a percentage of Stage S2/N2. The significant differences between R&K and AASM scoring systems suggest taking some caution in adopting the new scoring criteria in children; these might be shown to be potentially useful if careful selection of the appropriate indicators derived from this new method is carried out, such as the percentage of N1 and the number of stage shifts, which are measures very sensitive to the occurrence of arousals in the new AASM system
Psychophysiology and cognitive neuroscience of sleep and sleep disorders
No full text[No abstract available
From state dissociation to status dissociatus
No full textClinical reviewAbstract not availableElena Antelmi, Raffaele Ferri, Alex Iranzo, Isabelle Arnulf, Yves Dauvilliers, Kailash P. Bhatia, Rocco Liguori, Carlos H. Schenck, Giuseppe Plazz
Periodic leg movements during sleep in narcoleptic patients with or without restless legs syndrome
No full textSleep instability and cognitive status in drug-resistant epilepsies
No full textObjective: The aims of this study were to evaluate the sleep habits of children with drug resistant epilepsy and to correlate sleep abnormalities with epilepsy and level of intelligence. Subjects and methods: Twenty five subjects with drug resistant epilepsy (14 males, age range 2-16.4 years) were recruited for this study. A control group was formed by 23 normal children. Two instruments to assess sleep habits were administered to the patients with epilepsy: a questionnaire on sleep habits (to preschool children) and a questionnaire on sleep behavior (for children aged more than seven years old); a cognitive test (Wechsler Intelligence Scale for Children-WISC) was also performed. Patients underwent a complete polysomnographic study and sleep parameters, including CAP, were analyzed and correlated according to cognitive-behavioral measures in children with epilepsy. Results: Children with drug-resistant epilepsy and severe mental retardation showed sleep abnormalities such as low sleep efficiency, high percentage of wakefulness after sleep onset, reduced slow wave sleep, and reduced REM sleep. Sleep microstructure evaluated by means of CAP analysis showed a decrease in A1 index during N3 in patients with more severe cognitive impairment. Children with epilepsy and cognitive impairment (n = 10) had higher Sleep Behavior Questionnaire for Children (SBQC) total scores (65.60 +/- 18.56) compared to children with epilepsy and normal IQ (50.00 +/- 10.40), p < 0.05. Conclusions: Children with drug-resistant epilepsy have a greater incidence of sleep problems regarding qualitative aspects, macrostructure, and CAP. The decrease of CAP rate and of A1, mainly during slow wave sleep (associated to REM sleep reduction), might represent a sleep microstructural pattern of intellectual disability. (C) 2012 Elsevier B. V. All rights reserved
Polysomnographic assessment of sleep disturbances in children with developmental disabilities and seizures
No full textThe aim of this study was to assess the presence of sleep breathing disorder and periodic leg movements during sleep (PLMS), and to evaluate NREM sleep instability in a group of children with mental retardation (MR) and epilepsy. Eleven subjects with MR and epilepsy (6 males, age range 9-17 years) were recruited for this study. A control group was formed by 11 age-matched normal children. Three children with MR and epilepsy showed an apnea-hypopnea index > 5, two of them had also a PLMS index > 5. Another subject had only a PLMS index > 5. Children with MR showed many sleep architecture differences compared to controls. They also showed higher cyclic alternating pattern (CAP) rate, increased A1 index, long and less numerous CAP sequences than controls. A detailed investigation and treatment of sleep disorders in children affected by MR and epilepsy may have a positive impact on seizure control
Prader-Willi syndrome: sorting out the relationships between obesity, hypersomnia, and sleep apnea
No full textPurpose of review Although several studies in the last years have evaluated obesity, obstructive sleep apnea (OSAS), and excessive daytime sleepiness (EDS) in patients with Prader-Willi syndrome (PWS), their pathophysiologies and interactions and the role of treatment with growth hormone are not completely understood. The present review analyzes the contributing role of obesity, OSAS, and sleep structure abnormalities in determining the EDS and the role of specific treatment in improving the clinical outcome. Recent findings The studies on sleep structure of PWS patients show abnormalities of rapid eye movement (REM) sleep and a decrease in non-REM sleep instability, corroborating the hypothesis of the presence of a primary disorder of vigilance and the similarities with narcolepsy. These sleep alterations might also be linked to the action of mediators of inflammation (i.e. adiponectin or cytokines) determined by obesity. Obesity and hypothalamic dysfunction could be responsible for the primary abnormalities of ventilation during sleep that, in turn, might contribute to EDS. Although EDS seems to resemble narcolepsy, PWS patients do not present the other typical symptoms of narcolepsy. Summary The most consistent hypothesis for linking the three different symptoms of PWS is a primary central hypothalamic dysfunction. Further research is needed to evaluate the contribution of the upper airway resistance syndrome in the pathogenesis of EDS, the role of the alterations of sleep microstructure, the relationships between PWS and narcoleptic phenotype, the involvement of orexin/hypocretin, and the effects of drugs acting on REM sleep and/or wakefulness
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