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2.
Br Dent J ; 228(8): 565, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32332931

Assuntos
Sonambulismo , Humanos
4.
Postgrad Med ; 132(1): 72-79, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31760836

RESUMO

Parasomnias are abnormal behaviors that occur during sleep and can be associated, in particular during adulthood, with impaired sleep quality, daytime dysfunction, and occasionally with violent and harmful nocturnal behaviors. In these cases, therapies are often considered. Longterm pharmacological treatments are not always well tolerated and often have limited efficacy. Therefore, behavioral approaches remain an important treatment option for several types of parasomnias. However, the evidence-based approaches are limited. In the current review, we highlight results from various nonpharmacological techniques on different types of parasomnias and provide a glimpse into the future of nonpharmacological treatments in this field.


Assuntos
Parassonias/terapia , Terapia Comportamental , Humanos , Terrores Noturnos/terapia , Transtorno do Comportamento do Sono REM/terapia , Transtornos do Despertar do Sono/terapia , Sonambulismo/terapia
5.
JAMA Netw Open ; 2(12): e1918281, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31880797

RESUMO

Importance: The long-term association between sleep duration and mental health in children is currently unknown. Objective: To investigate the prospective associations between sleep duration and symptoms of emotional and behavioral disorders at ages 6, 8, 10, and 12 years. Design, Setting, and Participants: This population-based cohort study obtained data from the Trondheim Early Secure Study in Trondheim, Norway. A representative, stratified random sample of children born between January 1, 2003, and December 31, 2004, were invited to participate. Participants were followed up biennially from age 4 years (2007-2008) to 12 years (2013-2014). Data analysis was conducted from January 2, 2019, to May 28, 2019. Main Outcomes and Measures: Sleep duration was assessed with 1 week of continuous use of a triaxial accelerometer. Symptoms of emotional (anxiety and depression) and behavioral (oppositional defiant, conduct, and attention-deficit/hyperactivity) disorders were measured by semistructured clinical interviews (using the Preschool Age Psychiatric Assessment and the Child and Adolescent Psychiatric Assessment) with parents (at all ages) and children (from age 8 years). Results: The analytical sample comprised 799 children (mean [SD] age at time point 2, 6.0 [0.2] years; 405 [50.7%] boys; and 771 [96.5%] Norwegian). Shorter sleep duration at age 6 years (ß [unstandardized regression coefficient] = -0.44; 95% CI, -0.80 to -0.08; P = .02) and 8 years (ß = -0.47; 95% CI, -0.83 to -0.11; P = .01) forecasted symptoms of emotional disorders 2 years later. Comparatively short sleep duration at age 8 years (ß = -0.65; 95% CI, -1.22 to -0.08; P = .03) and 10 years (ß = -0.58; 95% CI, -1.07 to -0.08; P = .02) was associated with symptoms of behavioral disorders 2 years later among boys but not among girls at age 8 years (ß = -0.14; 95% CI,- 0.52 to 0.24; P = .48) or 10 years (ß = -0.05; 95% CI, = -0.49 to 0.40; P = .84). These associations were statistically significant among boys compared with girls at age 8 years (Δχ21 = 13.26; P < .001) and 10 years (Δχ21 = 10.25; P = .001). Symptoms of psychiatric disorders did not forecast sleep duration at any age. Conclusions and Relevance: This study found an association between short sleep duration and increased risk of future occurrence of emotional disorder symptoms in both boys and girls and between reduced sleep and behavioral disorder symptoms in boys. These results suggest that improving sleep in children may help protect against the development of symptoms of common psychiatric disorders and may be advantageous in the treatment of such disorders.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adolescente , Transtornos de Ansiedade/epidemiologia , Criança , Bem-Estar da Criança/estatística & dados numéricos , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Noruega , Estudos Prospectivos , Sonambulismo/epidemiologia
7.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(5): 505-507, 2019 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-31140411

RESUMO

Somnambulism is defined as a state of dissociated consciousness triggered by impaired arousal, which results in partial wakefulness and partial sleep. No effective therapy or medication has been available for treating children with somnambulism. Herein we present a case in a 4.5-year-old girl, who presented with somnambulism associated with separation anxiety disorder every night in a week. The girl received formal assessment and appropriate interventions, and the symptoms disappeared within a week. The treatment was carried out in 5 stages: diagnosis of the disease, establishment of trust, information collection, supervision, and individualized psychotherapy. Although dreams in childhood can be difficult to interpret, close observation of the behaviors in sleepwalking, as a special form of dream, in addition to the more precise description by the guardians, still provides useful clues to understand those dreams. For children with somnambulism, early intervention with psychotherapy can significantly decrease the false revival of the unconscious desires, and thus may serve as a treatment option other than medications.


Assuntos
Terapia Psicanalítica , Sonambulismo , Criança , Pré-Escolar , Feminino , Humanos , Sono , Sonambulismo/terapia
8.
Sleep Med ; 57: 97-99, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30954790

RESUMO

BACKGROUND: It is now recognized that the vast majority of individuals with typical RBD will develop a synucleinopathy; usually 11-16 years after symptom onset. Parasomnia Overlap Disorder (POD) with adolescent-onset dream enactment behavior with phenoconversion to neurodegenerative disease after a long latency has not been previously described. PATIENT: We present a case of a 65-year-old man with presumptive POD who had co-morbid childhood onset sleep walking and adolescent-onset dream enactment behavior beginning at age 17, with subsequent evolution to an increasingly troublesome REM sleep behavior disorder (RBD) at age 64 with Parkinson's Disease (PD) developing a year later. RESULTS: Polysomnography performed at age 64 was consistent with a diagnosis of RBD. Dream enactment behavior preceded PD diagnosis by at least 48 years. Our case represents the youngest reported RBD case who developed PD. CONCLUSIONS: We report the first case of adolescent onset, presumed RBD in the context of presumptive POD developing neurodegenerative disease. Adolescent-onset RBD may have similar prognostic implications as typical RBD, where future phenoconversion to a synucleinopathy is expected.


Assuntos
Levodopa/uso terapêutico , Parassonias/complicações , Doença de Parkinson , Transtorno do Comportamento do Sono REM , Adolescente , Idoso , Humanos , Masculino , Doença de Parkinson/diagnóstico , Doença de Parkinson/tratamento farmacológico , Polissonografia , Transtorno do Comportamento do Sono REM/complicações , Transtorno do Comportamento do Sono REM/diagnóstico , Sonambulismo/etiologia
9.
J Child Neurol ; 34(9): 491-498, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31012364

RESUMO

BACKGROUND: Sleep deprivation commonly increases seizure frequency in patients with genetic generalized epilepsy, though it is unknown whether there is an increased prevalence of sleepwalking or sleep paralysis in genetic generalized epilepsy patients. Establishing this could provide insights into the bio-mechanisms or genetic architecture of both disorders. The aim of this study was to determine the prevalence of sleepwalking and sleep paralysis in a cohort of patients with genetic generalized epilepsy and their relatives in extended families. METHODS: A structured interview based on International League Against Epilepsy (ILAE) and International Classification of Sleep Disorders (ICSD-3) criteria was applied to 67 index cases and their relatives to determine genetic generalized epilepsy subtypes and assess the occurrence of sleepwalking or sleep paralysis. Bivariate analysis was performed using chi-square and Fisher exact tests. RESULTS: The prevalence of sleepwalking and sleep paralysis was 15.3% (95% confidence interval 12.1-18.9) and 11.7% (95% confidence interval 8.7-15.3), respectively. Unusually, no sleepwalkers were found among individuals displaying epilepsy with generalized tonic-clonic seizures. Approximately a quarter of the patients had either parasomnia or genetic generalized epilepsy. Over half the genetic generalized epilepsy families had at least 1 individual with sleepwalking, and more than 40% of the families had one individual with sleep paralysis. CONCLUSION: The prevalence of sleepwalking or sleep paralysis is reported for individuals with genetic generalized epilepsy and their relatives. The co-existence of either parasomnia in the genetic generalized epilepsy patients and the co-aggregation within their families let suggest that shared heritability and pathophysiological mechanisms exist between these disorders. We hypothesize that sleepwalking/sleep paralysis and genetic generalized epilepsy could be variable expression of genes in shared pathways.


Assuntos
Epilepsia Generalizada/epidemiologia , Paralisia do Sono/epidemiologia , Sonambulismo/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos de Coortes , Colômbia , Epilepsia Generalizada/genética , Família , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
10.
BMC Pediatr ; 19(1): 70, 2019 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-30841882

RESUMO

BACKGROUND: The effects of prenatal maternal smoking have been studied extensively, however little research has examined the effects of prenatal exposure to maternal smoking on offspring sleep, particularly over several developmental periods. We examined the effects of prenatal maternal smoking and postnatal smoking from birth to 14 years, on offspring sleep at 6 months, 5, 14 and 21 years. METHODS: This was a prospective, community-based birth cohort study involving 7223 women who delivered a singleton child in Brisbane, Australia between 1981 and 1983. Women were recruited at the first antenatal visit. Offspring sleep problems were reported by mothers at 6 months, 5 and 14 years, and by youth at 14 and 21 years. 3738 mothers prospectively reported their smoking status from pregnancy to 14 years postpartum. Youth snoring was reported by mothers at 14 years and by youth at 21 years. Multinomial logistic regression analyses were performed. RESULTS AND DISCUSSION: Prenatal maternal smoking was independently associated with an increased risk of offspring adolescent parasomnias including walking and talking in sleep and nightmares, and an increased likelihood of being in the highest quintile for maternal and youth reported sleep problems at 14 years. Maternal postnatal smoking was associated with increased likelihood of offspring snoring at 14 years. CONCLUSIONS: Exposure to maternal prenatal smoking has different effects on offspring sleep compared to exposure to postnatal smoking. Prenatal smoking exposure may be associated with changes in neurodevelopment whereas postnatal smoking is more likely to affect the respiratory system. These findings highlight the long lasting and potentially serious clinical effects of exposure to pre and postnatal maternal smoking on offspring, the mechanisms by which warrant further investigation.


Assuntos
Comportamento Materno , Efeitos Tardios da Exposição Pré-Natal , Transtornos do Sono-Vigília/epidemiologia , Fumar , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Sonhos , Feminino , Humanos , Lactente , Estudos Longitudinais , Razão de Chances , Gravidez , Transtornos da Transição Sono-Vigília/epidemiologia , Ronco/epidemiologia , Sonambulismo/epidemiologia , Adulto Jovem
11.
J Clin Sleep Med ; 15(2): 355-357, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30736884

RESUMO

ABSTRACT: The most common sleep disorders that can result in injurious or violent behaviors include REM sleep behavioral disorder, sleepwalking, comorbid parasomnias, sleep-related dissociative disorder, and obstructive sleep apnea. Video polysomnography is usually indicated to evaluate recurring sleep-related injury in adults. Only one-third of patients with complex paroxysmal nocturnal events will have one of their habitual events on a single night of in-laboratory video polysomnography, most often those who have prominent, high-frequency motor features. We report evidence of sleep walking induced by sodium oxybate identified by steps recorded on a consumer wearable device coinciding with clinical history and evidence of injury.


Assuntos
Polissonografia , Oxibato de Sódio/efeitos adversos , Sonambulismo/induzido quimicamente , Gravação em Vídeo , Adulto , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Desenho de Equipamento , Feminino , Humanos , Narcolepsia/diagnóstico , Parassonias/induzido quimicamente , Parassonias/diagnóstico , Polissonografia/instrumentação , Oxibato de Sódio/uso terapêutico , Sonambulismo/diagnóstico
13.
Sleep Med Rev ; 43: 92-95, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30537569

RESUMO

The DSM-5 and ICSD-3 have removed alcohol from the list of potential triggers for sleepwalking due to the lack of empirical evidence. Recent imaging and EEG based studies of sleepwalking and confusional arousals have provided a more data-based method of examining if alcohol is compatible with what is known about the neurophysiology and neurochemistry of sleepwalking. These studies have demonstrated a deactivation of the frontal areas of the brain, while the cingulate or motor cortex remains active and characterized activation in the form of beta EEG. This increase in activation is attributed to a decrease in the inhibitory activity the neurotransmitter GABAA. This cerebral excitability of the cingulate cortex of sleepwalkers is also present in the brains of sleepwalkers during wakefulness compared to normal controls. Alcohol is well established to have an inhibitory effect on the brain and specifically on the motor areas via the inhibitory effects of increased GABAA activity. Thus, the empirical data show sleepwalking is characterized by a decrease in the inhibitory activity of GABAA - permitting or facilitating motor activity while alcohol has the opposite effect of increasing GABAA and inhibiting motor activity. This is inconsistent with theories that alcohol is somehow a trigger or facilitator for sleepwalking.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Encéfalo/fisiopatologia , Neuroquímica , Neurofisiologia , Sonambulismo/fisiopatologia , Nível de Alerta/fisiologia , Eletroencefalografia , Giro do Cíngulo , Humanos , Córtex Motor , Polissonografia , Vigília
14.
Curr Opin Psychiatry ; 32(2): 73-78, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30557269

RESUMO

PURPOSE OF REVIEW: To provide an update of the most recent studies on Smith-Magenis syndrome (SMS) with a focus on the unique pattern of behavioral and sleep disturbances associated with the condition. RECENT FINDINGS: The recent literature on SMS has focused on the characteristic severe behavioral and sleep disturbances. A better understanding of the underlying pathophysiological mechanisms and common clinical course has helped further characterize SMS, while much is left to be discovered in regard to effective treatment/management. SUMMARY: SMS is a difficult to manage genetic condition defined by pervasive and progressive behavioral and sleep disturbances with a unique pattern that can often be easily discerned from other neurodevelopmental disorders. Common behavioral features include maladaptive/self-injurious, aggressive, stereotypic, and the newly appreciated food seeking behaviors associated with SMS. In addition, there is a sleep disturbance defined by an altered circadian rhythm with frequent nighttime waking and daytime sleepiness, causing patients and families significant distress. Small studies have suggested some treatment/management approaches to the behavioral and sleep disturbances, however, much remains to be discovered.


Assuntos
Transtornos do Sono do Ritmo Circadiano , Síndrome de Smith-Magenis , Agressão , Progressão da Doença , Feminino , Humanos , Masculino , Psicopatologia , Transtornos do Sono do Ritmo Circadiano/etiologia , Transtornos do Sono do Ritmo Circadiano/psicologia , Síndrome de Smith-Magenis/diagnóstico , Síndrome de Smith-Magenis/genética , Síndrome de Smith-Magenis/fisiopatologia , Síndrome de Smith-Magenis/psicologia , Sonambulismo , Comportamento Estereotipado
15.
Neuropsychiatr ; 33(3): 165-169, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-29992439

RESUMO

It is generally accepted, that sleepwalkers show complex behaviors leading to non-intended consequences. It is not unusual that these persons are thereby injured. However, sporadically a bizarre endangering of themselves or others is reported also, which ranges from homicide of the life partner to accidental (pseudo-)suicide.In this article, we report on a 28year-old man who unexpectedly attempted to hang himself by a whip at night. We discuss the reasons, why this bizarre act should actually be taken as a scenic behavior in the course of a NREM-parasomnia, and the difficulty to proof this claim.


Assuntos
Acidentes/psicologia , Fases do Sono/fisiologia , Sonambulismo/psicologia , Tentativa de Suicídio/psicologia , Adulto , Humanos , Masculino , Polissonografia , Reprodutibilidade dos Testes
16.
Curr Biol ; 28(22): R1288-R1289, 2018 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-30458142

RESUMO

Arnulf describes the fascinating behavior of sleepwalking and its associated parasomnias.


Assuntos
Sonambulismo/metabolismo , Sonambulismo/fisiopatologia , Sonambulismo/psicologia , Feminino , Humanos , Masculino , Parassonias/fisiopatologia , Polissonografia
17.
Nihon Eiseigaku Zasshi ; 73(3): 365-372, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-30270304

RESUMO

OBJECTIVES: In this study, we examined whether a combined regimen of a short-term nap and a light physical exercise is effective in improving sleep among elderly individuals with mild-to-moderate dementia in communal living group homes. METHODS: Twenty-three female residents (aged 87.4±5.6 years) living in two group homes for the elderly with dementia were included in the present study. After undergoing an assessment for eligibility, they were randomly allocated to either the study group (N=11), who participated in the regimen of a short-term nap (<30 min) and light physical exercise for four weeks, or the control group (N=12), who received the usual nursing care without participating in the nap and exercise regimen. The lengths of sleep time and wake time were measured using a sleep monitor with a radiofrequency motion sensor. The frequencies of nocturnal behavioral and psychological symptoms associated with dementia including excitement, violence, night delirium, wandering, and unhygienic behavior were investigated throughout the study period. RESULTS: The subjects participating in the nap and physical exercise regimen showed a significant increase in sleep efficacy as well as a reduction in the total nocturnal wake time, whereas no clear change was observed in the control subjects. The frequencies of nocturnal episodes of urination in the study group also decreased during the course of the study. However, there was no significant decrease in the frequencies of nocturnal behavioral or psychological symptoms associated with dementia. CONCLUSIONS: The findings of this study suggest that a short-term nap and a light physical exercise may be effective in adjusting the sleep-wake biorhythm in elderly patients with mild-to-moderate dementia and may improve sleep among these individuals.


Assuntos
Demência/fisiopatologia , Demência/psicologia , Exercício Físico/fisiologia , Instituição de Longa Permanência para Idosos , Sono/fisiologia , Idoso de 80 Anos ou mais , Comportamento Agonístico , Sintomas Comportamentais , Feminino , Humanos , Masculino , Periodicidade , Índice de Gravidade de Doença , Sonambulismo , Fatores de Tempo , Micção , Vigília/fisiologia
19.
Sleep ; 41(5)2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29514303

RESUMO

Study Objectives: The present study assessed brain perfusion patterns with single-photon emission computed tomography (SPECT) during sleepwalkers' post-sleep deprivation slow-wave sleep (SWS) and resting-state wakefulness. Methods: Following a 24 hr period of sleep deprivation, 10 sleepwalkers and 10 sex- and age-matched controls were scanned with a high-resolution SPECT scanner. Participants were injected with 99mTc-ethylene cysteinate dimer after 2 min of stable SWS within their first sleep cycle as well as during resting-state wakefulness, both after a subsequent 24 hr period of sleep deprivation. Results: When compared with controls' brain perfusion patterns during both SWS and resting-state wakefulness, sleepwalkers showed reduced regional cerebral perfusion in several bilateral frontal regions, including the superior frontal, middle frontal, and medial frontal gyri. Moreover, reduced regional cerebral perfusion was also found in sleepwalkers' left postcentral gyrus, insula, and superior temporal gyrus during SWS compared with controls. During resting-state wakefulness compared with controls, reduced cerebral perfusion was also found in parietal and temporal regions of sleepwalkers' left hemisphere, whereas the right parahippocampal gyrus showed increased regional cerebral perfusion. Conclusions: Our results reveal patterns of reduced regional cerebral perfusion in sleepwalkers' frontal and parietal areas when compared with controls, regions previously associated with SWS generation and episode occurrence. Additionally, reduced perfusion in the dorsolateral prefrontal cortex and insula during recovery SWS is consistent with the clinical features of somnambulistic episodes, including impaired awareness and reduced pain perception. Altered regional cerebral perfusion patterns during sleepwalkers' resting-state wakefulness may be related to daytime functional anomalies in this population.


Assuntos
Circulação Cerebrovascular/fisiologia , Privação do Sono/fisiopatologia , Sono de Ondas Lentas/fisiologia , Sonambulismo/fisiopatologia , Vigília/fisiologia , Adulto , Encéfalo/fisiopatologia , Córtex Cerebral/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/fisiopatologia , Sono , Lobo Temporal/fisiopatologia , Tomografia Computadorizada de Emissão de Fóton Único
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