Dyssomnia & Parasomnia

DYSSOMNIA & PARASOMNIA


DYSSOMNIA & PARASOMNIA

I) Dysomnia

Introduction:

  • Characterized by abnormality in duration or quality of sleep.

Subtypes:

  • Insomnia.
  • Hypersomnia.

1. Insomnia:

Features:

  • Decreased sleep.
  • Difficulty in initiation of sleep.
  • Difficulty in maintenance of sleep.
  • Frequent awakening during night.
  • Early morning awakening.
  • Nonrestorative sleep.
  • Not feeling refreshed in morning due to poor quality of sleep.

Syndromes associated:

Periodic limb movement disorder: 

  • Non-restorative sleep and day time sleepiness.

Restless leg syndrome (Ekbom syndrome):

  • Difficulty in initiation of sleep due to moving legs. Treated with ropinirole (dopamine agonist).

Treatment:

  • Benzodiazepines, zolpidem & hypnotics.

2. Hypersomnia:

Features: 

  • Excessive sleepiness.
  • Prolonged sleep episodes.
  • Excessive day time sleep episodes.

Syndromes associated:

Narcolepsy:

  • Reduced latency of REM sleep (reaching REM sleep earlier).
  • Sleep attacks (irresistible urge for sleep at anytime of day) & sleep paralysis (Occurs in morning. patient awake but unable to move body).

Kleine-Levin syndrome:

  • Characterized by episodes of hypersomnia, hyperphagia & hypersexuality (increased sexual activity).

II). PARASOMNIA:

Introduction:

  • Disorders characterized by dysfunctional events associated with sleep.

Subtypes:

Stage 4, NREM sleep disorders:

  • Occur during stage 4, NREM.

Events:

  • Night terror or sleep terror (pavor nocturnus).
  • Sleepwalking (somnambulism).

Sleep-related enuresis – 

  • Most common cause of bed wetting – Due to psychosocial (sibling rivalry).
  • Treated by bed alarms, imipramine & intranasal desmopressin.
    • Bruxism (teeth grinding).
    • Sleep talking (somniloquy).

Other sleep disorders:

Nightmare:

  • Occurs during REM sleep.
  • Patient able to recall dream (contrast to night terror).

Exam Important

  • Restless leg syndrome (Ekbom syndrome) is associated with sleep disturbances treated with ropinirole.
  • Narcolepsy exhibits reduced latency of REM sleep.
  • Kleine-Levin syndrome is characterized by episodes of hypersomnia, hyperphagia & hypersexuality.
  • Night terror or sleep terror (pavor nocturnus), Sleepwalking (somnambulism), Sleep-related enuresis & Bruxism (teeth grinding) are all features of Stage 4, NREM sleep disorders.
  • Sleep-related enuresis is most common cause of bed wetting.
  • Nightmare occurs during REM sleep.
Don’t Forget to Solve all the previous Year Question asked on DYSSOMNIA & PARASOMNIA

Module Below Start Quiz

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this:
Malcare WordPress Security