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Results for “Sleep Wake Disorders”

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At least 19 recordsLinked to original sources
PubMed1996

[Aspects of medical expert assessment of sleep-waking disorders].

Knowledge gained in sleep medicine over the past 10 years has not yet been incorporated into laws for the severely handicapped and pension law. The impact of increased accident incidence of patients with hypersomnia has not yet been recognized in the guidelines for medical diseases in automobile traffic in governmental driving regulations. In preparation for implementation of sleep-wake disorders into medico-legal jurisdiction they must be introduced to the guidelines as a separate medical entity according to the International Classification of Sleep Disorders. Due to different prognoses sleep-wake disorders should be separated into reversible and irreversible disorders. To decide on driving ability, degree of disablement and permanent and total disability therapeutic efficiency should be documented by methods acknowledged in sleep medicine. Professional and nonprofessional drivers and personnel in charge of responsible monitoring should be submitted to regular therapy controls. Degree of disablement or permanent and total disability can only be recommended for patients with symptoms partially or completely refractory to therapy. Accompanying diseases posing a high health risk or those causing sleepiness themselves have to be included in the overall judgement. Sleep specialists have to be nominated as expert witnesses and should furthermore contribute to multiplication of knowledge on sleep medicine for public health officers.

Accidents, Traffic↗
PubMed1983

Age-related sleep-wake disorders at a sleep disorder center.

The specific sleep disorders of 97 patients 61-81 years old were compared with those of 264 middle-aged (41-60 years old) and 202 young (20-40 years old) patients. Sleep disorder diagnoses were made according to the Diagnostic Classification of the Association of Sleep Disorders Centers based on evaluations consisting of mental and physical examinations and all-night sleep recordings. Most young and middle-aged patients complained of excessive daytime sleepiness; the elderly complained of insomnia as often as excessive daytime sleepiness. The evaluations revealed objective findings in 93 per cent of the elderly, but only 77 per cent of younger patients. Nocturnal myoclonus or restless leg syndrome was the diagnosed cause of 23 per cent of elderly patients' sleep-wake problems, but only 11 per cent of middle-aged and 4 per cent of young patients had this problem. Respiratory disorders of sleep were found in 27 per cent of elderly, 35 per cent of middle-aged, and 20 per cent of young patients. Elderly patients (6 per cent) had psychiatric disorders diagnosed as the causes for their problems less frequently than did younger patients (22 per cent).

Adult↗
PubMed1995

Office management of common sleep-wake disorders.

The prevalence of sleep disorders manifest as insomnia and fatigue of excessive daytime sleepiness in the general population; office practice is high. Poor quality sleep may pose a significant health risk for not only the patient but society in general. Sensitivity for potentially serious sleep disorders should be coupled with an organized approach to diagnosis and therapy. Differentiation of the principal complaint into insomnia versus hypersomnia and determination of duration are the key elements. Office-based management of the most common sleep-wake disorders and current diagnostic testing standards are discussed.

Aged↗
PubMed1998

Periodic limb movements and sleep-wake disorder.

The relationship of periodic limb movements (PLM) and sleep-wake disorders in 11 patients was investigated. Two patients complained of insomnia. A patient with cervical spinal canal stenosis had a complaint of difficulty in initiating sleep. Movement index (MI) was 51 and PLM arousal index was 8. A patient with chronic hemodialysis had a complaint of difficulty in initiating and maintaining sleep. MI was 79 and PLM arousal index was 51. One patient with myotonic dystrophy showed 79 in MI and 3 in PLM arousal index. It is suspected that myotonic dystrophy is less sensitive to stimuli during sleep (i.e. PLM). These results suggest that the sleep-wake disorders associated with PLM relate to the threshold of awakening.

Adult↗
PubMed2003

Sleep Apnea and Other Sleep-Wake Disorders in Stroke.

Sleep-disordered breathing (SDB) and sleep-wake disturbances (SWD) are frequent in stroke patients. They deserve attention, because they may significantly influence rehabilitation process and functional outcome. In addition, SDB may increase the risk of stroke recurrence. More than 50% of stroke patients have SDB, mostly obstructive sleep apnea (OSA). In some patients, stroke recovery is accompanied by an improvement of SDB. The treatment of choice for OSA is continuous positive airway pressure. Oxygen, theophylline, and other forms of ventilation may be helpful in patients with other forms of SDB (eg, Cheyne-Stokes breathing). In at least 20% to 40% of stroke patients, SWD are present, mainly in form of increased sleep needs (hypersomnia), excessive daytime sleepiness, or insomnia. Depression, anxiety, SDB, stroke complications (eg, nocturia, dysphagia, and urinary or respiratory infections), and drugs may contribute to SWD and should be addressed first. In patients with SWD of primary neurologic origin, treatment with stimulants or dopaminergic drugs and hypnotics or sedating antidepressants, respectively, can be attempted.

Journal Article↗
PubMed1981

Sleep-wake disorders in the elderly: polysomnographic analysis.

The experience with 83 patients aged 60 or older from the Stanford Sleep-Wake Disorders Clinic is compared with that in 423 younger clinic patients seen during the same two-year period. Each patient received a medical, psychologic and polysomnographic evaluation. The final diagnoses were recorded according to the Diagnostic Classification System of the Association of Sleep Disorders Centers. The most common major diagnoses in the elderly group were sleep apnea syndrome (39 percent) and periodic movements-restless legs syndrome (18 percent). These syndromes showed a significantly greater prevalence in the older than in the younger patients (p less than .001), and were found in 68 percent of the elderly group. The elderly manifested more objective signs of sleep disturbance, including more wake time after sleep onset, and more frequent and longer awakenings; moreover, fewer of them experienced stage-4 sleep. The diagnostic findings seemed to indicate that complaints about sleep-wake functioning in many elderly patients may be a result of specific pathologic sleep disturbances.

Adolescent↗
PubMed2004

Melatonin in wake-sleep disorders in children, adolescents and young adults with mental retardation with or without epilepsy: a double-blind, cross-over, placebo-controlled trial.

The aim of the present study was to verify the clinical efficacy of melatonin (MLT) in children, adolescents and young adults with wake-sleep disorder and mental retardation, most of them on chronic anticonvulsant therapy for epileptic seizures, by means of a randomized, double-blind, placebo-controlled cross-over trial. Twenty-five patients (16 males, nine females), aged from 3.6 to 26 years (mean 10.5 years), all affected with mental retardation mostly with epileptic seizures, were randomized to oral synthetic fast-release MLT or placebo. Melatonin was initiated at the daily dose of 3 mg, at nocturnal bedtime. In case of inefficacy, MLT dose could be titrated up to 9 mg the following 2 weeks at increments of 3 mg/week, unless the patient was unable to tolerate it. The analysis of all the sleep logs disclosed a significant treatment effect of melatonin on sleep latency (P = 0.019). Melatonin was well tolerated in all patients and no side effects were reported. In conclusion, our study supports the efficacy of MLT in young patients with mental disabilities and epileptic seizures in improving the wake-sleep disorders such as time to fall asleep. Overall, MLT appeared to influence the seizure frequency poorly, though there may be occasional seizure worsening or improving. Such a dual effect requires further studies in young epileptic patients.

Administration, Oral↗
PubMed1996

A multicenter study of sleep-wake rhythm disorders: clinical features of sleep-wake rhythm disorders.

A multicenter study of sleep-wake rhythm disorders (i.e. non-24 hour sleep-wake syndrome; non-24), delayed sleep phase syndrome (DSPS), irregular sleep-wake pattern (irregular sleepers), and long sleepers, was conducted with the co-operation of 25 institutions. One hundred and twenty-one primary sleep-wake rhythm disorders were diagnosed and were classified as 13 non-24, 90 DSPS, 12 irregular and six long sleepers. The mean onset age was about 20 years old and psycho-social factors associating the onset of the disorder were identified in 36% of these patients. The major factors of sleep-wake disorders were personal relationships, advancing to a higher level education, gaining employment, and changes in environment. Most patients were 'night active' prior to appearance of their symptoms. Increase in night activities of modern society seem to result in the occurrence of such sleep-wake rhythm disorders.

Adult↗
PubMed2005

Hypocretins (orexins) and sleep-wake disorders.

Since their discovery in 1998, the hypocretins (orexins)-peptides that are produced by a group of neurons situated in the posterolateral hypothalamus--have been shown to excite many CNS areas including many neuronal systems that regulate sleep and wakefulness. Animal studies indicate that hypocretins play a part in the regulation of various functions including arousal, muscle tone, locomotion, regulation of feeding behaviour, and neuroendocrine and autonomic functions. A link between hypocretin deficiency and narcoleptic symptoms was first shown in canine and rodent models of narcolepsy. Hypocretin deficiency, as shown by low or absent concentrations in CSF, was subsequently found in 90% of patients with sporadic narcolepsy-cataplexy, and less commonly in familial narcolepsy. In most other sleep-wake and neurological disorders, hypocretin concentrations are normal. Low concentrations were also found in hypothalamic disorders, acute traumatic brain injury, and a few other disorders. The exact function of the hypocretin system in sleep-wake regulation and its pathophysiological role in hypocretin-deficient and non-deficient narcolepsy as well as in non-narcoleptic, hypocretin-deficiency syndromes remain unclear.

Animals↗
PubMed2003

Medication for sleep-wake disorders.

Medication is indicated for only a limited number of children's sleep disorders. However, correctly chosen and supervised, pharmacological treatment may be justified and helpful. For a given sleep problem it is important to identify the underlying cause (or sleep disorder) which often calls for treatment of a non-medication type. Where medication is appropriate, cautious use and careful review of the child's physical and psychological state is essential in view of the limited information available on effectiveness and possible short and long term effects. It follows that much further research is required to establish the part medication can play in the care of children with sleep disorders, and also to define the possible effects on sleep and wakefulness of other drugs used in clinical practice.

Child↗