ABSTRACT
Restless legs syndrome is a common motor-sensory disease of the nervous system. The main manifestations are an urge to move the legs, usually accompanied by or thought to be caused by uncomfortable and unpleasant sensations in the legs. These symptoms may begin or worsen during periods of rest or inactivity such as lying down or sitting and be partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues. This article will systematically review the pathogenesis, clinical manifestations, diagnostic criteria, differential diagnosis and treatment of restless legs syndrome.
ABSTRACT
Parkinson's disease(PD)and restless legs syndrome(RLS)are relatively common movement disorders.There has been much debate over whether an etiological link exists between these two diseases and whether they share common pathophysiological mechanisms.PD and RLS may co-occur and respond well to dopaminergic agents, suggesting there is underlying dopamine dysfunction in both conditions.Despite the overlapping clinical features, the mechanisms underlying idiopathic RLS and RLS associated with PD may differ.In this article, we review studies related to the epidemiology, pathophysiology and genetics of PD with concurrent RLS, in order to provide evidence for exploring the link between RLS and PD.
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@#Objective To analyze the use of drugs andinfluencing factors of objective sleep disturbance among chronic insomnia patientsand to provide some normalization reference for clinical drug use. Methods 357 patients with definite chronic insomnia were selected. All patients were assessed with the Symptom Checklist (SCL-90),Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),Pittsburgh sleep quality index (PSQI),Epworth sleepiness scale (ESS). Polysomnography was used to evaluate objective sleep quality. Results (1)The use of sedative and hypnotic drugs and other drugs that may affect sleep in the past 1 month before the first visit to the Sleep Center of our hospital was 53.50% for no drugs,46.5% for drugs and 18.21% for BzRAs among them. (2) The ESS scores of pharmacologic-therapy group was significantly lower than those in no-drugs group (Z=-2.463,P=0.014). The total time sleep(Z=-3.521,P<0.001),Sleep efficiency(Z=-3.164,P=0.002),R%(Z=-3.044,P=0.003)were both significantly lower than those in no-drugs group. (3)The multivariate logistic regression results showed male (OR=1.938,95%CI 1.071~3.505,P=0.029),highly educated(OR=2.222,95%CI 1.196~4.130,P=0.012),anxiety state(OR=2.029,95%CI 1.018~4.043,P=0.044) and medication history(OR=1.974,95%CI 1.091~3.573,P=0.025) were the factors influencing SL>30 min. Age is the common factors for WASO>30 min(OR=1.052,95%CI 1.023~1.082,P<0.001),WASO>60 min(OR=1.068,95%CI 1.046~1.091,P<0.001) and SL>30 min and/or WASO>60 min (OR=1.068,95%CI 1.046~1.091,P<0.001). Conclusion Some patients have a high percentage of sleep-related medications before their first visit in our center,Most used was benzodiazepine receptor agonists. Gender,education,anxiety state and medication historywere the factors influencingsleep latency. Age is the common factors for difficulty maintaining sleep.
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Objective To assess the epidemiology and clinical characteristics of sleep disorders in a single center in northwest China.Methods Using the International Classification of Sleep Disorders, 3rd Edition, all consecutive patients which were suspected as sleep disorders in Tangdu Hospital between January 2007 and December 2016, were included retrospectively.Results The average age of 8 037 patients was (46.59±15.83) years with male-female ratio 1∶1.24.Chronic insomnia was found in 3 848 (47.9%) patients, obstructive sleep apnea was found in 2 648 (32.9%) patients, narcolepsy was found in 294 (3.7%) patients, Kleine-Levin syndrome was found in 11 (0.1%) patients, circadian rhythm sleep-wake disorders were found in 14 (0.2%) patients, rapid eye movement behavior disorder was found in 193 (2.4%) patients, restless legs syndrome was found in 139 (1.7%) patients, periodic limb movement disorder was found in 109 (1.4%) patients, and other possible sleep disorders were found in 478 (5.9%) patients, respectively.Chronic insomnia and obstructive sleep apnea combided with somatic diseases.Conclusions Patients diagnosed by polysomnography in our single center suggested consultation rate of sleep disorders was increasing in past ten years, of which chronic insomnia and obstructive sleep apnea were dominant and comorbided with somatic diseases.
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Narcolepsy is a chronic rapid eye movement sleep disorder that is characterized by lethargy and its four common clinical features are excessive daytime sleeps, cataplexy, hypnagogic and hypnopompic hallucinations, and sleep paralysis. Narcolepsy onset usually occurs in childhood. Because of the onset with atypical symptoms, the poor expression in children and currently no special diagnostic criteria for children, the rate of missed diagnosis and misdiagnosis were increased in children. This paper reviews the progress of research in pathogenesis of narcolepsy and the differences of children from adult in clinical symptoms, diagnosis and treatment.