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PubMed1982

Falls.

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Accidents↗
PubMed1995

[Sleep disorders in childhood].

Sleep disorders in childhood are frequent and usually harmless. They rarely point to a serious disease. Difficulty in falling asleep and nightly awakenings are age-dependent and transitory. While the largely harmless somnambulism and pavor nocturnus occur in the deep sleep of the first third of the night, the anxiety dreams of REM sleep appear preferentially in the second half of the night. Other disorders such as nocturnal enuresis and talking in sleep may occur during the whole night. It is very important to inform the parents because this helps to counter fears and false expectations. Consistent sleep hygiene needs to be developed with avoidance of irregular sleep rhythm and an unrestful sleep environment. Sometimes it is necessary to learn new behaviour patterns with the child. Only exceptionally is drug therapy indicated. However, nocturnal breathing disorders and nocturnal epilepsy do have a pathological significance and need specific therapy. In order to clarify the reasons for sleep disorders, it is necessary to keep a sleep diary, to undertake specific examinations (e.g. psychological, pneumological, neurological, urological, otorhinolaryngological and possibly using diagnostic equipment such as video-polysomnography).

Cataplexy↗
PubMed1979

Resource for managing sleep disorders.

To enhance physicians' knowledge of the prevalent problem of sleep disorders, a 50-minute videotape program designed as a learning and self-assessment experience in evaluating and treating these disorders was coproduced with the Network for Continuing Medical Education. The program has been presented nationally to about 25,000 medical professionals. The mean correct score was 50% for the pretest, 69% for the instructional section, and 79% for the posttest; the composite score on the posttest was 59% higher than that on the pretest. Physicians' responses indicated strengths and weaknesses in their knowledge of sleep disorders, thus delineating future directions for medical education in insomnia, narcolepsy/cataplexy, nightmares, night terrors, sleepwalking, and enuresis. All of these sleep disorders can be best evaluated and treated by the general physician.

Audiovisual Aids↗
PubMed1997

Cognitive deficits in patients with daytime sleepiness.

A chief complaint of subjects with daytime sleepiness is the disturbance of cognitive functions like concentration, learning and memory. Since sleepiness interferes with the regulation of vigilance, one may assume that a disturbance of this basic dynamic variable causes deficiencies in information processing which in turn reduce the capacity for learning and memory. In two studies the time course of vigilance was measured by means of the critical flicker fusion (CFF) test in patients with narcolepsy or with an obstructive sleep apnea syndrome (OSAS). The CFF test was applied at 15 min intervals. The total test duration was ten hours in the study with narcoleptic patients and three hours in the study with OSAS patients. The mean level of performance was similar in healthy subjects and those with narcolepsy, while the latter displayed a three- to four-fold increase in temporal variability. Such an increase in variability of performance was not seen in subjects with OSAS. These data suggest that clinically distinguishable groups of patients with daytime sleepiness differ also in the pattern of performance impairment.

Adult↗
PubMed1997

Value of the multiple sleep latency test (MSLT) for the diagnosis of narcolepsy.

Since its introduction, the multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. We assessed its diagnostic value in a series of 2,083 subjects of whom 170 (8.2%) were diagnosed with narcolepsy. The sensitivity of the combination of two or more sleep onset rapid eye movement (REM) periods (SOREMPs) with a mean sleep latency of < 5 minutes on an initial MSLT was 70% with a specificity of 97%, but 30% of all subjects with this combination of findings did not have narcolepsy. In some narcoleptics who had more than one MSLT, the proportion of naps with SOREMPs varied substantially from the initial MSLT to the follow-up test. The highest specificity (99.2%) and positive predictive value (PPV) (87%) for MSLT findings was obtained with the criteria of three or more SOREMPs combined with a mean sleep latency of < 5 minutes, but the sensitivity of this combination was only 46%. The combination of a SOREMP with a sleep latency < 10 minutes on polysomnography yielded a specificity (98.9%) and PPV (73%) almost equal to those obtained from combinations of MSLT findings, but the sensitivity was much lower. Our results suggest that the MSLT cannot be used in isolation to confirm or exclude narcolepsy, is indicated only in selected patients with excessive daytime sleepiness, and is most valuable when interpreted in conjunction with clinical findings.

Adolescent↗
PubMed1998

[Hypersomnia].

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Cataplexy↗