Recurrent Isolated Sleep Paralysis.

Recurrent isolated sleep paralysis has a 7.6% lifetime prevalence of at least one episode in the general population. Episodes resolve spontaneously and are benign. Sleep paralysis represents a dissociate state, with persistence of the rapid eye movement (REM)-sleep muscle atonia in the waking state. The intrusion of alpha electroencephalogram into REM sleep is followed by an arousal response and then by persistence of REM atonia into wakefulness. Predisposing factors include irregular sleep-wake schedules, sleep deprivation, and jetlag. No drug treatment is required. Patients should be informed about sleep hygiene. Cognitive behavioral therapy may be useful in cases accompanied by anxiety and frightening hallucinations.

Narcolepsy Severity Scale-2 and Idiopathic Hypersomnia Severity Scale to better quantify symptoms severity and consequences in Narcolepsy type 2.

STUDY OBJECTIVES: Narcolepsy type 2 (NT2) is an understudied central disorder of hypersomnolence sharing some similarities with narcolepsy type 1 and idiopathic hypersomnia (IH). We aimed: (1) to assess systematically the symptoms in patients with NT2, with self-reported questionnaires: Epworth Sleepiness Scale (ESS), Narcolepsy Severity Scale (NSS), IH Severity Scale (IHSS), and (2) to evaluate the responsiveness of these scales to treatment. METHODS: One hundred and nine patients with NT2 (31.4 ±â€…12.2 years old, 47 untreated) diagnosed according to ICSD-3 were selected in a Reference Center for Narcolepsy. They all completed the ESS, subgroups completed the modified NSS (NSS-2, without cataplexy items) (n = 95) and IHSS (n = 76). Some patients completed the scales twice (before/during treatment): 42 ESS, 26 NSS-2, and 30 IHSS. RESULTS: Based on NSS-2, all untreated patients had sleepiness, 58% disrupted nocturnal sleep, 40% hallucinations, and 28% sleep paralysis. On IHSS, 76% reported a prolonged nocturnal sleep, and 83% sleep inertia. In the independent sample, ESS and NSS-2 scores were lower in treated patients, with same trend for IHSS scores. After treatment, ESS, NSS-2, and IHSS total scores were lower, with a mean difference of 3.7 ±â€…4.1, 5.3 ±â€…6.7, and 4.1 ±â€…6.2, respectively. The minimum clinically important difference between untreated and treated patients were 2.1 for ESS, 3.3 for NSS-2, and 3.1 for IHSS. After treatment, 61.9% of patients decreased their ESS > 2 points, 61.5% their NSS-2 > 3 points, and 53.3% their IHSS > 3 points. CONCLUSIONS: NSS-2 and IHSS correctly quantified symptoms' severity and consequences in NT2, with good performances to objectify response to medications. These tools are useful for monitoring and optimizing NT2 management, and for use in clinical trials.

Clinical safety and narcolepsy-like symptoms of dual orexin receptor antagonists in patients with insomnia: a systematic review and meta-analysis.

STUDY OBJECTIVES: Dual orexin receptor antagonists (DORAs) are emerging treatments for insomnia. This meta-analysis study aimed to assess the safety of FDA-approved DORAs (suvorexant, lemborexant, and daridorexant), focusing on narcolepsy-like symptoms associated with these drugs. METHODS: Five prominent databases were searched to identify randomized controlled trials (RCTs) on this topic. Primary safety outcomes included treatment-emergent adverse events (TEAEs), treatment-related TEAEs, TEAEs leading to discontinuation, and serious TEAEs. Excessive daytime sleepiness (EDS), sleep paralysis, and hallucinations were categorized as adverse events (AEs)-related narcolepsy-like symptoms. RESULTS: Eleven RCTs with 7703 patients were included. DORAs were associated with a higher risk of TEAEs (risk ratio [RR], 1.09; 95% confidence interval [CI], 1.03 to 1.15) and treatment-related TEAEs (RR, 1.69; 95% CI: 1.49 to 1.92) when compared to placebo. The DORA group exhibited a significantly higher risk of EDS (RR, 2.15; 95% CI: 1.02 to 4.52) and sleep paralysis (RR, 3.40; 95% CI: 1.18 to 9.80) compared to the placebo group. CONCLUSION: This meta-analysis achieved a comparative evaluation of the clinical safety and tolerability of FDA-approved DORAs for primary insomnia, specifically focusing on AEs-related narcolepsy-like symptoms. This study contributes to understanding the safety profile of FDA-approved DORAs for treating insomnia.

[Sleep paralysis during naptime as initial symptom of narcolepsy]. / Parálisis de sueño durante la siesta como síntoma inicial de narcolepsia.

INTRODUCTION: Narcolepsy is a disease of unknown etiology, with a very low prevalence (0.02-0.16% in adults, although it must be higher, given the underdiagnosis), characterized by the presence of excessive daytime sleepiness, hypnagogic and/or hypnopompic hallucinations, sleep paralysis and/or cataplexy (if present, we speak of type 1 narcolepsy and, if not, type 2 narcolepsy), whose average diagnostic delay is between 10 and 15 years. CASE REPORT: A 16-year-old male who consulted after visiting different specialists for presenting sleep paralysis during naps, which cause him fear and occasional objects falling from his hands (diagnosed as possible myoclonus). In the anamnesis we were surprised by the presence of sleep paralysis immediately after the start of the naps and, in the directed anamnesis, these sudden movements caused by emotions were compatible with cataplexies, so we performed a nocturnal polysomnographic study and a multiple sleep latency test. With evolution came hypnopompic hallucinations and fragmented nocturnal sleep, as well as occasional daytime sleepiness (thus completing the typical symptomatic tetrad of type 1 narcolepsy with cataplexy). CONCLUSION: Knowledge of this disease is important, considering it as a differential diagnosis in patients with episodes of intractable sleepiness, send these patients to expert doctors in sleep disorders and doing a good anamnesis, performing the necessary complementary tests for the diagnosis of this underdiagnosed disease for its correct management, which is decisive for improving the quality of life of these patients.

TITLE: Parálisis de sueño durante la siesta como síntoma inicial de narcolepsia.Introducción. La narcolepsia es una enfermedad de etiología desconocida, de prevalencia muy baja (el 0,02-0,16% en adultos, aunque debe ser mayor, dado el infradiagnóstico), caracterizada por la presencia de somnolencia diurna excesiva, alucinaciones hipnagógicas y/o hipnopómpicas, parálisis de sueño y/o cataplejía (si está presente, se habla de narcolepsia de tipo 1 y, si no, de narcolepsia de tipo 2), cuya media de retraso diagnóstico se sitúa entre los 10 y los 15 años. Caso clínico. Varón de 16 años que consulta tras visitar a distintos especialistas por presentar parálisis de sueño durante las siestas, que le producen miedo y ocasional caída de objetos de las manos (diagnosticadas como posibles mioclonías). En la anamnesis nos sorprendió la presencia de parálisis de sueño inmediatamente tras el inicio de las siestas y, en la anamnesis dirigida, esos movimientos bruscos provocados por emociones eran compatibles con cataplejías, por lo que realizamos un estudio polisomnográfico nocturno y un test de latencias múltiples del sueño. Con la evolución aparecieron alucinaciones hipnopómpicas y sueño fragmentado nocturno, así como ocasional somnolencia diurna (se completó así la tétrada sintomatológica típica de la narcolepsia con cataplejía de tipo 1). Conclusión. Es importante el conocimiento de esta enfermedad, plantearla como diagnóstico diferencial en pacientes con episodios de somnolencia incoercible, realizar la derivación a consultas especializadas en trastornos de sueño y una buena anamnesis dirigida, e indicar las pruebas complementarias necesarias para el diagnóstico de esta enfermedad infradiagnosticada para su correcto manejo, tan determinante para la mejora de la calidad de vida de estos pacientes.

Early- and late-onset narcolepsy: possibly two distinct clinical phenotypes.

PURPOSE: To investigate the clinical characteristics and the risk factors associated with excessive daytime sleepiness (EDS) in patients with early- and late-onset narcolepsy. METHODS: Patients with narcolepsy were consecutively recruited. All patients were separated into early- and late-onset groups according to the onset age of disease ≤ 15 and > 15 years, respectively. Demographic, clinical, and sleep parameters were compared between the two groups. Linear regressions were performed to examine the risk factors of subjective and objective EDS in patients with early- and late-onset narcolepsy. RESULTS: A total of 101 patients with narcolepsy (median age at recruitment = 18.0 years) were classified into an early-onset group (67 patients with median age at onset = 12.0 years) and a late-onset group (34 patients with median age at onset = 28.5 years). Compared with early-onset group, late-onset group scored significantly higher on Epworth Sleepiness Scale (ESS), Ullanlinna Narcolepsy Scale (UNS), sleep paralysis, rapid eye movement (REM) sleep behavior disorder (RBD) questionnaire-Hong Kong (all P < 0.050). UNS-cataplexy and sleep paralysis had significantly positive associations with subjective EDS, and N1%, arousal index, and periodic limb movements index were positively associated with objective EDS in the early-onset group (all P < 0.050). However, these associations were not observed in late-onset narcolepsy. CONCLUSION: Late onset narcolepsy had more severe self-reported narcolepsy symptoms. REM sleep related symptoms and disrupted nighttime sleep were associated with EDS in early-onset narcolepsy. These findings suggest that early- and late-onset narcolepsy may represent two distinct phenotypes.

Associations between sleep variables and ostensibly paranormal experiences and paranormal beliefs: A scoping review.

Night-time is a period of great significance for many people who report paranormal experiences. However, there is limited understanding of the associations between sleep variables and seemingly paranormal experiences and/or beliefs. The aim of this review is to improve our understanding of these associations while unifying a currently fragmented literature-base into a structured, practical review. In this pre-registered scoping review, we searched for relevant studies in MEDLINE (PubMed), PsycINFO (EBSCO), Web of Science and EMBASE using terms related to sleep and ostensibly paranormal experiences and beliefs. Forty-four studies met all inclusion criteria. All were cross-sectional and most investigated sleep paralysis and/or lucid dreaming in relation to ostensibly paranormal experiences and paranormal beliefs. Overall, there were positive associations between many sleep variables (including sleep paralysis, lucid dreams, nightmares, and hypnagogic hallucinations) and ostensibly paranormal experiences and paranormal beliefs (including those of ghosts, spirits, and near-death experiences). The findings of this review have potential clinical implications such as reducing misdiagnosis and treatment development and provide foundations for further research. Our findings also highlight the importance of understanding why so many people report 'things that go bump in the night'.

Isolated sleep paralysis: Clinical features, perception of aetiology, prevention and disruption strategies in a large international sample.

STUDY OBJECTIVES: Isolated sleep paralysis is a benign but frightening condition characterised by a temporary inability to move at sleep onset or upon awakening. Despite the prevalence of this condition, little is known concerning its clinical features, associated demographic characteristics, and prevention as well as disruption strategies. METHODS: An online cross-sectional study was conducted. The sample comprised 3523 participants who had reported at least one lifetime episode of ISP and 3288 participants without a lifetime episode. Participants answered a survey including questions about sleep quality, sleep paralysis, and sleep paralysis prevention/disruption techniques. RESULTS: A total of 6811 participants were investigated (mean age = 46.9, SD = 15.4, age range = 18-89, 66.1% female). Those who reported experiencing ISP at least once during their lives reported longer sleep onset latencies, shorter sleep duration, and greater insomnia symptoms. Females (vs. male) and younger (vs. older) participants were more likely to experience ISP. Significant fear during episodes was reported by 76.0% of the participants. Most people (63.3%) who experienced ISP believed it to be caused by 'something in the brain'. A minority endorsed supernatural causes (7.1%). Five prevention strategies (e.g., changing sleep position, adjusting sleep patterns) with at least 60.0% effectiveness, and five disruption strategies (e.g., physical/bodily action, making noise) with varying degrees of effectiveness (ranging from 29.5 to 61.8) were identified through open-ended responses. CONCLUSIONS: ISP is associated with shorter sleep duration, longer sleep onset latency, and greater insomnia symptoms. The multiple prevention and disruption techniques identified in this study support existing treatment approaches and may inform subsequent treatment development. Implications for current diagnostic criteria are discussed.

The associations between paranormal beliefs and sleep variables.

Previous studies have found significant associations between paranormal beliefs and sleep variables. However, these have been conducted on a small scale and are limited in the number of sleep variables investigated. This study aims to fill a gap in the literature by investigating paranormal beliefs in relation to a wide range of sleep variables in a large sample. Participants (N = 8853) completed a survey initiated by the BBC Focus Magazine. They reported on their demographics, sleep disturbances and paranormal beliefs. Poorer subjective sleep quality (lower sleep efficiency, longer sleep latency, shorter sleep duration and increased insomnia symptoms) was associated with greater endorsement of belief in: (1) the soul living on after death; (2) the existence of ghosts; (3) demons; (4) an ability for some people to communicate with the dead; (5) near-death experiences are evidence for life after death; and (6) aliens have visited earth. In addition, episodes of exploding head syndrome and isolated sleep paralysis were associated with the belief that aliens have visited earth. Isolated sleep paralysis was also associated with the belief that near-death experiences are evidence for life after death. Findings obtained here indicate that there are associations between beliefs in the paranormal and various sleep variables. This information could potentially better equip us to support sleep via psychoeducation. Mechanisms underlying these associations are likely complex, and need to be further explored to fully understand why people sometimes report "things that go bump in the night".

Spontaneous and induced out-of-body experiences during sleep paralysis: Emotions, "AURA" recognition, and clinical implications.

Sleep paralysis is characterized by the incapacity to perform voluntary movements during sleep/wake transitions, and could bring great discomfort. During sleep paralysis, out-of-body experiences can occur. Out-of-body experiences refers to the sensation of being outside of the physical body and perceiving the world from this outside perspective; however, they are pleasant in comparison with other sleep paralysis hallucinations. Lucid dreams are dreams in which a subject becomes aware of being dreaming while the dream occurs. Here, we designed an online survey to study the predominant and specific emotions during sleep paralysis and/or out-of-body experience events as well as the somatosensory perceptions that preceded their occurrence. The sample (N = 329) was divided into experimental groups depending on the presence/absence of out-of-body experiences, capacity to induce (or not) out-of-body experiences, and perception/no-perception of the sleep paralysis. We showed that more positive emotions were associated with out-of-body experiences and more negative emotions were associated with sleep paralysis episodes, and for those who claim the ability to induce out-of-body experiences, positive emotions were more frequent in their episodes. We found that subjects perceived auditory, tactile and visual sensations before sleep paralysis episodes, and we proposed that these could be an "aura" of sleep paralysis. Furthermore, subjects that had out-of-body experiences but had never felt the sleep paralysis, perceived tactile and visual sensations to the same extent as subjects with out-of-body experiences that felt the sleep paralysis. Therefore, we proposed that the "aura" recognition could be used under controlled conditions for out-of-body experiences induction in patients with sleep paralysis to diminish the negative symptoms associated with sleep paralysis episodes.

Prevalence, incidence, evolution and associated factors of sleep paralysis in a longitudinal study of the US general population.

BACKGROUND AND OBJECTIVE: Sleep paralysis is a common phenomenon which causes and consequences are seldomly studied. The aim of this study was to investigate the incidence and prevalence of sleep paralysis (SP) in the American adult population and its evolution on a 3-year period. METHODS: This longitudinal study was conducted between 2002 and 2015 and included a representative sample of the US general population. A total of 12,218 subjects were initially interviewed (W1) and 10,931 were re-interviewed three years later (W2). The subjects participated in telephone interviews using the Sleep-EVAL expert system. Each interview lasted for about 1 h. SP episodes were assessed according to their frequency and duration. RESULTS: At W1, 9.7% (95%CI: 9.1%-10.3%) reported having ≥1 episode of SP in the previous year. At W2, 15.1% (95%CI: 14.4%-15.8%) reported SP. A total of 29.9% of subjects with SP at W1 still reported episodes at W2. The 1-year incidence was 2.7% (95%CI: 2.4-3.0%). After adjusting for age and sex, prevalent SP (i.e., present at W2) was predicted by age and race and the following factors present at W1: major depressive disorder, pain, hypersomnolence, cataplexy, hypnagogic and hypnopompic hallucinations, posttraumatic stress disorder, a reduction in sleep duration of ≥60 min, and the use of analgesic/antipyretic medication. Incident SP (i.e. new cases at W2) had similar predictive factors. DISCUSSION: Episodes of SP are frequent in the general population. Its persistence is predicted by several factors associated with narcolepsy like hypersomnolence and cataplexy but also by other factors like posttraumatic stress disorder or pain.

Characteristics of Sleep Paralysis and Its Association with Anxiety Symptoms, Perceived Stress, PTSD, and Other Variables Related to Lifestyle in Selected High Stress Exposed Professions.

Sleep paralysis (SP) is a hypnagogic or hypnopompic state associated with the inability to move while conscious. Recurrent isolated sleep paralysis (RISP) is a type of REM parasomnia. Individuals experiencing anxiety disorders, PTSD, exposure to chronic stress, or shift work are at risk of developing this sleep disorder. This study aimed to assess: (1) the prevalence, frequency, and symptomatology of SP, and (2) the impact of the severity of anxiety symptoms, perceived stress, and lifestyle mode variables on the frequency and severity of SP in four professional groups at high risk of SP (n = 844): nurses and midwives (n = 172), policemen (n = 174), teachers (n = 107), and a group of mixed professions-"other professions" (n = 391). The study used a battery of online questionnaires: the Sociodemographic and Health Status Questionnaire, the SP-EPQ, the PCL -5, the STAI-T, the PSWQ and the PSS-10. The prevalence of SP was the lowest among policemen (15.5%) and the highest in the group of "other professions" (39.4%). The association of SP with symptoms of PTSD and anxiety was confirmed in the group of nurses and "other professions". Among other factors modulating the incidence and severity of SP were: age, BMI, smoking, alcohol consumption, sleep duration, and perceived stress. This study indicates that there exist links between SP and psychological and lifestyle factors, suggesting a complex etiology for this sleep disorder. Due to the high prevalence of SP in the studied groups of occupations, further research is necessary to develop preventive and therapeutic methods for SP.

Risk factors of sleep paralysis in a population of Polish students.

BACKGROUND: Sleep paralysis (SP) is a transitional dissociative state associated with the REM sleep phase that affects approximately 28.3% of the student population during their lifetime. The reasons for the high prevalence of SP in the student population are not entirely clear. Research indicates possible influencing factors such as the intensification of anxiety symptoms, a tendency to worry, the presence of PTSD symptoms, and behavioral factors such as the consumption of psychoactive substances (caffeine, alcohol, nicotine), sleep deprivations and poor sleep hygiene. The study aimed to assess the prevalence of SP and determine the risk factors for the occurrence of SP in the population of Polish students. METHODS: The study used a battery online consisting of a set of questionnaires 1) a personal questionnaire, 2) the SP-EPQ, 3) the PCL -5, 4) the STAI-T, 5) the PSWQ. The questionnaire was sent via Facebook to 4500 randomly selected students from different universities in Poland. The questionnaire was completed by 2598 students. To unify the participant sample, people over 35 were excluded from the study (45 students). Ultimately, data from 2553 students were analyzed. RESULTS: A total of 33.14% of individuals experienced at least one episode of SP in their lives. The highest odds ratio for SP was associated with: the presence of three or more health problems (OR: 2.3; p = 0.002), the presence of any mental disorder (OR: 1.77; p = 0.002), including mood disorders (OR: 2.07; p = 0.002), suffering from at least one somatic disease (OR: 1.34; p = 0.002), a high level of anxiety as a constant personality trait (OR: 1.20; p = 0.035) and smoking (OR: 1.48; p = 0.0002), alcohol consumption (OR: 1.52; p < 0.0001), physical activity (OR: 1.31; p = 0.001). CONCLUSIONS: The results of our research indicate that a large proportion of students experienced isolated sleep paralysis. Mental and somatic health problems and lifestyle factors were found to predispose individuals to this disorder. Due to the numerous risk factors for SP, it is necessary to conduct additional research to confirm the impact of these factors and to investigate the mechanisms of their influence on SP.

Successful treatment of sleep paralysis with the Sleep Position Trainer: a case report.

Sleep paralysis is a period of paralysis at either sleep onset or upon awakening and is often accompanied by terrifying hallucinations. We report a case of a 32-year-old healthy men with a history of mild positional obstructive sleep apnea and sleep paralysis. The positional sleep apnea was successfully treated with the Sleep Position Trainer. Remarkably, he did no longer experience episodes of sleep paralysis since using the Sleep Position Trainer. This case highlights a possible elegant noninvasive long-term solution for the treatment of sleep paralysis. CITATION: Cui N, van Looij MA, Kasius KM. Successful treatment of sleep paralysis with the Sleep Position Trainer: a case report. J Clin Sleep Med. 2022;18(9):2317-2319.

Predictors of sleep paralysis and relationship of sleep paralysis with sleep quality in university students of Islamabad.

OBJECTIVE: To determine the frequency of sleep paralysis among university students, and to determine the association between sleep paralysis and sleep quality along with different predictive factors leading to sleep paralysis. METHODS: The descriptive cross-sectional study was conducted at the National University of Modern Languages, Islamabad, Pakistan, from June to October, 2019, and comprised adult students of either gender who had experienced at least one episode of sleep paralysis in the past. Demographic variables were obtained using Google Form, while experiences of sleep paralysis were assessed using the Waterloo Unusual Sleep Experience Questionnaire, and sleep quality was assessed with the Sleep Condition Indicator. Data was analysed using SPSS 20. RESULTS: Initially, 440 students were assessed/ Of them, 233(53%) were males, 207(47%) were females, 208(47.3%) were aged 20-23 years, and 129(29.3%) were studying in the third year of their university programme. Of the total, 130(29.5%) subjects had experienced sleep paralysis at least once in their lifetime. The most frequent sensation experienced was feeling of floating 22(16.9%). Mean age at the time of the first experience was 9.7±3.1 years, and 66(50.8%) had experienced the episodes while lying on their back, while 32(24.6%) had positive family history of sleep paralysis. Sleep paralysis had significant relationship with sleep quality (p<0.001). CONCLUSIONS: About one-third of the sample had experienced sleep paralysis once in their lifetime. The relationship between sleep paralysis and insomnia was significant.

Sleep paralysis in college students.

Objective: We examined the prevalence of sleep paralysis (SP), its association with stress and sleep, and associated subjective experiences and beliefs. Participants: 1,115 college students from a large university in the southwestern United States. The sample was predominantly Hispanic (94%) and female (70%). Methods: Validated measures of life-events stress, self-perceived stress, sleep quality and insomnia were administered to participants online. Results: 35% of students had previously experienced SP and reported greater stress and poorer sleep than those who had never experienced it. Effect sizes were larger when comparing those who had/had not experienced SP within the prior year. Conclusions: Based on our predominantly Hispanic and majority female sample, we found that SP is experienced by approximately one-third of undergraduate students and associated with both higher stress and poorer sleep. We therefore recommend that college health practitioners seek ways to integrate relevant assessment and education into campus health practices.

A German online survey of people who have experienced sleep paralysis.

We present some key findings from an online survey on isolated sleep paralysis. The aim of our study was to get a differentiated picture of the correlation between the frequency of sleep paralysis and several phenomena (symptoms, experiences) as well as factors correlated with these phenomena. We also investigated the role of gender in relation to the experience of sleep paralysis. We used a selected sample of subjects who had had at least one sleep paralysis experience, with a total of 380 subjects. On average, the participants experienced 10-20 sleep paralysis episodes. We found high and expected positive correlations between the frequency of sleep paralysis experiences and the amount of phenomena, emotions, and perceived shapes and forms experienced during sleep paralysis. An increased frequency of sleep paralysis also appears to lead to habituation and de-dramatization in some affected individuals. Interestingly, significant correlations are missing where one would have suspected them based on the previous hypotheses. Neither self-perceived general stress nor poor sleep hygiene appeared to influence the frequency of sleep paralysis. We found highly significant gender differences in some items. Women reported more experienced phenomena and emotions overall, had more frequent sleep paralysis experiences of the intruder and incubus type, and were significantly more likely to perceive concrete forms such as human figures or people they know. They were also more likely than men to report experiencing fearful emotions, especially the fear of going crazy. Most of these findings were based on exploratory questions; they require replication for validation.

Narcolepsia na infância: a atuação multidisciplinar com a psicologia do sono do diagnóstico ao tratamento em um relato de caso / Child narcolepsy: the multidisciplinary approach with sleep psychology from diagnostics to treatment in a case report / Narcolepsia en la infancia: actuación multidisciplinar con la psicología del sueño desde el diagnóstico hasta el tratamiento en un caso clínico

A narcolepsia, distúrbio neurológico crônico caracterizado pela sonolência diurna excessiva, pode ser associada à cataplexia, fragmentação do sono, alucinações relacionadas ao sono e paralisia do sono. Frequentemente, é confundida com outros transtornos, como Transtorno do Déficit de Atenção com Hiperatividade (TDAH), epilepsia e até esquizofrenia, assim, por vezes, é diagnosticada inadequadamente. Objetiva-se relatar o diagnóstico diferencial bem-sucedido da narcolepsia na infância e suas dificuldades, realizado por uma equipe multidisciplinar, enfocando a atuação da psicologia do sono em avaliação e intervenção. Um menino de 10 anos foi recebido no Ambulatório de Narcolepsia e Apneia do Sono Infantil (AMBNAP), alocado no Hospital Universitário Onofre Lopes da Universidade Federal do Rio Grande do Norte (UFRN) com queixas de sonolência diurna excessiva, sono fragmentado e episódios de perda de tônus muscular. Foi submetido a entrevistas psiquiátrica e psicológica pormenorizadas, a exames, aplicação de escalas específicas para rastreio e diagnóstico de transtornos de sono e diário de sono, solicitação de recursos de mídia e de relatório escolar e avaliação neurológica. A partir da investigação multidisciplinar, o diagnóstico foi de Narcolepsia e Síndrome da Apneia Obstrutiva do Sono (SAOS). O paciente foi submetido a técnicas da Terapia Cognitivo-Comportamental (TCC) e segue em acompanhamento, apresentando resultados satisfatórios. Este estudo evidencia que uma equipe multidisciplinar especializada na área de sono atuando em conjunto com a Psicologia do Sono oportuniza o diagnóstico e intervenções precoces eficazes para o tratamento do distúrbio do sono na infância.(AU)

Narcolepsy is a chronic neurologic disorder characterized by excessive daytime sleepiness which can be associated with cataplexy, sleep fragmentation, sleep-related hallucinations, and sleep paralysis. This sleep disorder is often confused with other disorders such as Attention Deficit Hyperactivity Disorder (ADHD), epilepsy, and even schizophrenia, and is, thus, misdiagnosed. This study aims to report the successful differential diagnosis for childhood narcolepsy carried out by a multidisciplinary team and its challenges, with a focus on the role of sleep psychology in assessment and intervention. A 10-year-old child was received at the Child Narcolepsy and Sleep Apnea Clinic (AMBNAP), located at the Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte (UFRN), with complaints of hypersomnolence, fragmented sleep, and episodes of loss of muscle tone. He underwent detailed psychiatric and psychological interviews, analysis of exams, application of specific scales for screening and diagnosis of sleep disorders and sleep diary, request of media resources and school report, and neurological assessment. From the multidisciplinary investigation, excluding of other neurological diagnoses, the diagnosis was Narcolepsy and Obstructive Sleep Apnea Syndrome (OSAS). The patient was submitted to Cognitive Behavioral Therapy (CBT) techniques, such as psychoeducation, scheduled naps, cognitive therapy for dysfunctional beliefs, and sleep hygiene strategies, and continues to be followed up, with satisfactory results since the first two months of intervention. The findings presented in this study show that a multidisciplinary team specialized in the sleep area, acting alongside Sleep Psychology provides early diagnosis and interventions for the sleep disorder treatment in childhood.(AU)

La narcolepsia es un trastorno neurológico crónico caracterizado por somnolencia diurna excesiva que puede asociarse con cataplejía, fragmentación del sueño, alucinaciones relacionadas con el sueño y parálisis del sueño. El trastorno del sueño a menudo se confunde con otros trastornos como el TDAH, la epilepsia e incluso la esquizofrenia, y se diagnostica erróneamente. El objetivo es presentar el diagnóstico diferencial exitoso de la narcolepsia en la infancia y sus dificultades, realizado por un equipo multidisciplinario, con foco en el papel de la psicología del sueño en la evaluación e intervención. El estudiante de 10 años fue recibido en la Clínica de Narcolepsia Infantil y Apnea del Sueño (AMBNAP), ubicada en el Hospital Universitario Onofre Lopes de la Universidad Federal de Rio Grande do Norte, con quejas de hipersomnolencia, sueño fragmentado y episodios de pérdida de tono muscular. Se sometió a entrevistas psiquiátricas y psicológicas detalladas, análisis de exámenes, aplicación de escalas específicas para la detección y diagnóstico de trastornos del sueño y el diario del sueño, solicite recursos de medios y informe escolar y evaluación neurológica. La investigación multidisciplinaria, el diagnóstico fue Narcolepsia y SAOS. El paciente fue sometido a técnicas de terapia cognitivo-conductual (TCC), como psicoeducación, siestas programadas, terapia cognitiva por creencias disfuncionales y estrategias de higiene del sueño, y se le dio seguimiento con resultados satisfactorios. Los resultados demostraron que un equipo multidisciplinario especializado en el campo del sueño, actuando en conjunto con la psicología del sueño, proporciona el diagnóstico y las intervenciones tempranas para el trastorno del sueño de la narcolepsia en la infância.(AU)

Perceived awareness of sleep paralysis phenomenon (old hag syndrome) and its most common risk factors among people from Al-Ahsa, Saudi Arabia.

OBJECTIVES: To assess prevalence and perception of sleep paralysis and its relationship with socioeconomic determinants, and risk factors in a cross-sectional sample of Saudi general population from Al-Ahsa city. METHODS: A cross-sectional sampling survey was conducted during 2020 to 2021. The targets were aged above 18 and belonged to Al-Ahsa. Patients were sent self-reported anonymous questionnaires to complete. RESULTS: A total of 524 participants, whose ages ranged from 18 to 60 years, were analyzed. Among 85.7% of participants aged 55 years and over, compared to 65.8% of those who were aged under 35, 379 (72.3%) respondents were females. Moreover, 438 (83.6%) participants were university graduates, 271 (51.7%) were students and 40.8% had psychological disorders including anxiety (25.2%) and depression (5.7%). Family history of sleep paralysis was reported by 369 (70.4%) participants. A total of 97.5% study participants were aware of sleep paralysis. CONCLUSION: Sleep paralysis is a common occurrence in people residing in Al-Ahsa, Saudi Arabia. A considerable number of the society held wrong beliefs regarding sleep paralysis. Therefore, raising public of identity of sleep paralysis is crucial. We recommend applying the study in other cities within Saudi Arabia to identify common risk factors and perceptions among the society.

Detecting lucid dreams only by submentalis electromyography.

Lucid dreams (LDs) occur when people become aware that they are dreaming. This phenomenon has a wide range of possible applications from the perspectives of psychology, training physical movements, and controlling computers while asleep, among others. However, research on LDs might lack efficiency because the standard LD verification protocol uses polysomnography (PSG), which requires an expensive apparatus and skilled staff. The standard protocol also may reduce LD-induction efficiency. The current study examines whether humans can send phasic signals through submentalis electromyography (EMG) during muscle atonia via pre-agreed chin movements (PACM). This ability would manifest both REM sleep and consciousness, which are the main features of LDs. In laboratory conditions volunteers were instructed to open their jaws three times while in an LD right after the standard verification protocol to achieve the research goal. Results: 4 of 5 volunteers proved to be in an LD using the standard protocol, and then all of them made PACM. The outcomes show that dream signals cannot be blocked in the submentalis area during muscle atonia. Also, this finding can be considered to develop a simplified, reliable LD protocol that needs only one EMG sensor. The cost of this protocol could be only a small percentage of the current protocol, making it more convenient for researchers and volunteers. It can also be used remotely by inbuilt in wearable gadgets. Considering PACM could speed up LD research and provide many discoveries and new opportunities. Also, it can be used in sleep paralysis studies.