This chapter discusses the case of a 43-year-old male having problems with his nocturnal sleep at the age of 23 when he started to present recurrent nocturnal awakenings from sleep associated with involuntary eating. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Actigraphic recordings for 2 weeks disclosed persistent muscular activity during the nocturnal period and two to five episodes per night of further enhanced muscular activity that corresponded to the eating episodes noted by the patient in his diary. The sleep medicine specialist established a diagnosis of sleep-related eating disorder (SRED) based on the clinical history and on the results of the video-polysomnography (PSG) recording. Low-dosage dopaminergic agents such as levodopa/carbidopa at bedtime, sometimes combined with codeine and/or clonazepam, bromocriptine and pramipexole, have been shown to reduce the eating episodes.

This chapter presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on a man who presented with frequent episodes of sudden and unexplained arousals from nocturnal sleep. The sleep medicine specialist ordered a full-night video-polysomnography (PSG) recording including standard bipolar EEG, right and left electro-oculograms (EOGs), surface EMG of the mylohyoideus muscle, ECG, oro-nasal, thoracic and abdominal respirograms, and circulating oxyhemoglobin saturation. The specialist decided to withdraw clonazepam and advised the patient not to drive due to drowsiness until the results of the investigations became available and appropriate therapy was prescribed. The sleep medicine specialist established a diagnosis of nocturnal frontal lobe epilepsy (NFLE) based on historical features and video-PSG findings. Nocturnal frontal lobe epilepsy is a peculiar partial epilepsy whose clinical features comprise a spectrum of paroxysmal motor manifestations of variable duration and complexity, occurring mainly during sleep.

Sleep is a complex behavior. It may be altered by many different factors including age, genetics, volitional control, timing, previous time awake, and environment. The state of wakefulness regularly alternates with the states of sleep. Polysomnography recordings are scored for movement time. Active wakefulness is characterized by a continuous electroencephalographic (EEG) theta activity associated with eye movements and muscular artifacts. Infants, children, and adolescents show different stages of maturation of sleep, in terms of polysomnographic patterns, architecture, and duration of sleep. The duration of nocturnal sleep depends on several factors. Voluntary control of the sleep time is among the most significant in human beings. Young adults report sleeping approximately 7.5 hours a night on weekday nights and 8.5 hours on weekend nights. The timing of sleep has obvious repercussions both on the duration and on the architecture of sleep.