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13 results

  • 7 - Somatic Symptom, Sleep, and Psychological Factors Affecting Health

  • Kenneth Carter, Emory University, Atlanta
  • Book:
    Psychopathology
    Published online:
    22 December 2022
    Print publication:
    22 December 2022, pp 212-251

  • Summary

    Distinguishes between malingering, factitious, and somatic symptom disorders. Discusses the various models and treatments for somatic symptom disorders. Describes the architecture of sleep. Discusses the various ways psychologists measure and track sleep. Describes the types of sleep--wake disorders. Discusses the various models and treatments for sleep disorders. Describes some of the techniques psychologists use as primary and adjunctive treatments for medical conditions. Lists some common medical conditions that are treated by psychological means.

  • Sleep disorders in attention-deficit hyperactivity disorder and autism spectrum disorder: a pragmatic approach to assessment and management

  • Part of
  • Paul J. Shanahan, Miriam Isaac, Jane E Blackwell
  • Journal:
    BJPsych Advances / Volume 27 / Issue 5 / September 2021
    Published online by Cambridge University Press:
    10 September 2020, pp. 320-332
    Print publication:
    September 2021
    • Article
      • You have access
      • Open access
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  • Sleep is essential for survival and humans spend approximately one-third of their life asleep. Adequate sleep is needed to maintain both physical and psychological health. Routinely getting less than the recommended amount of sleep for your age can have profound negative effects on health, such as increasing the likeliness of psychiatric illness, diabetes, cardiovascular disease and stroke. In children and adults with neurodevelopmental disorders, the prevalence of sleep disorders is significantly higher than in the general population. Given the relationship between sleep and psychiatric disorders, it is essential that psychiatrists have knowledge of the principles of sleep medicine. In this article, we focus on the common sleep disorders found in those with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and give an overview of screening, diagnosis and management.

  • Chapter 13 - Epigenetic basis of circadian rhythms and sleep disorders

  • from Section 2 - Geneticsof sleep and circadian rhythms
  • Edited by Paul Shaw, Mehdi Tafti, Michael J. Thorpy
  • Book:
    The Genetic Basis of Sleep and Sleep Disorders
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 127-138

  • Summary

    There has been a significant increase during the last decades in knowledge of genetics of sleep and sleep disorders, and the genetic epidemiologic studies have considerably contributed to this progress in understanding their basis. The primary goal of genetic epidemiology is the resolution of the genetic architecture of a trait, such as sleep length or a disorder. Electroencephalogram (EEG), a parameter included in polysomnography (PSG), has been found to be one of the most heritable characteristics, with heritability estimates greater than 95%, in a sample of 10 MZ and 10 DZ twin pairs. Most studies indicate that certain sleep problems in childhood are largely influenced by genes. Most parasomnias are relatively common to very common in childhood, occurring clearly less frequently in adults. Clinical experience and many studies indicate that parasomnias are often found to co-occur and run in families.

  • Chapter 50 - Sleep, neuroimaging, and polysomnography of Wilson’s disease

  • from Section 5 - Neuroimaging of sleep disorders
  • Edited by Eric Nofzinger, University of Pittsburgh, Pierre Maquet, Université de Liège, Belgium, Michael J. Thorpy
  • Book:
    Neuroimaging of Sleep and Sleep Disorders
    Published online:
    05 March 2013
    Print publication:
    07 March 2013, pp 391-395

  • Summary

    This chapter reviews the current neuroimaging literature regarding disorders of arousal and parasomnias, particularly non-rapid eye movement (NREM) parasomnias. During REM sleep the patient exhibited REM behavior disorder (RBD) with mumbling, complex hand movements, and arm/leg jerks. A repeat magnetic resonance imaging (MRI) showed persistent increased T2 weighted image (WI) hyper intense/T1 WI hypo intense lesions in the right mesencephalic/ pontine tegmentum and the right medulla. MRI of the head revealed a T2 WI hyper intense lesion at the pontomesencephalic lesion presumed to be neurosarcoidosis. Imaging modalities when used in combination with clinical electrophysiology (e.g. EEG and PSG) provide better understanding into both structure and function of electrophysiologically verified parasomnias. Future studies combining both electrophysiology and multiple neuroimaging modalities may help in both the assessment of sleep-related dissociative disorders and the development of new treatment modalities.

  • Chapter 9 - Sexsomnias

  • from Section 1 - Introduction
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 70-80

  • Summary

    If the notions of dream and nightmare are centuries old, going back to ancient Egyptian and Jewish civilizations, the distinction between nightmares and parasomnias is recent. As parasomnias became distinguishable from nightmares, a possible link between such episodic nocturnal phenomena and seizure disorders was proposed. In 1999, Ohayon et al. in their epidemiological studies on sleepwalking and sleep terrors found that obstructive sleep apnea syndrome was the most common sleep disorder associated with parasomnias between the ages of 15 and 24 years. Epileptic disorders were shown to be rarely involved in abnormal behavior during non-rapid eye movement (NREM) sleep, but when sleep-related seizure disorders are present, specific seizure entities are implicated. Nocturnal polysomnography has allowed the dissociation of NREM from REM sleep abnormal behavior. The initial description of what is now known as REM sleep behavior disorder (RBD) came from Japanese researchers.

  • Chapter 18 - Sleep enuresis

  • from Section 4 - Other parasomnias
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 175-183

  • Summary

    The parasomnias most frequently associated with forensic consequences are the disorders of arousal (confusional arousals, sleepwalking/sleep terrors) and their variant sexsomnia, parasomnia due to drug or substance and REM sleep behavior disorder (RBD). There are numerous historical cases documenting sleep-related crimes dating back to the seventeenth century. The insanity defense and automatism remain relevant to criminal liability today, but the Model Penal Code (MPC) definitions still rely on ideas that have not kept up to date with developments in neuroscience. It is important that experts providing evidence for apparent sleep-related forensic cases be acutely aware of and follow guidelines laid down by their respective professional and regulatory bodies in their particular jurisdictions. The assessment of a person accused of a violent act that may have arisen from sleep requires a systematic and thorough evaluation of all possible diagnoses.

  • Chapter 25 - Sleep-related leg cramps

  • from Section 5 - Sleep-related movement disorders and other variants
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 244-251

  • Summary

    Sleep paralysis is classified as a parasomnia associated with rapid-eye-movement periods (REMPs). The paralysis is consistent with atonia observed during normal REMPs produced by hyperpolarization of the spinal motoneurons originating in cholinoceptive neurons in dorsolateral regions of the pontine reticular formation. Estimates of RISP prevalence vary dramatically, yielding estimates between 6% and 40%. Sleep paralysis is often considered as a sleep-onset problem under the assumption that episodes occur at the beginning of the sleep period during Sleep Onset REM Period (SOREMP). Multiphase sleep-wake schedule (MPS) regimes likely produce high level of cognitive arousal precipitating episodes by increasing potential for waking during immediate post-interruption REMPs. Vestibular-motor (V-M) hallucinations likely arise via interactions between subcortical and cortical vestibular centers. RISP associated with a variety of affective disorders including depression, panic disorder, PTSD, and social anxiety. RISP has typically been thought to reflect anomalies of the functioning of monoaminergic and/or cholinergic neural systems.

  • Chapter 22 - Restless legs syndrome (RLS) and periodic leg movements (PLM)

  • from Section 5 - Sleep-related movement disorders and other variants
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 213-228

  • Summary

    During Rhazes' time, research shows that mater puerorum have been used to describe both epileptic attacks and night terrors. In a case report published in 1953, Sullivan described night terrors as an indication of an emotional problem arising out of certain stages in a child's development. Classically, night terrors arise during the first sleep cycle, usually within 1-3 hours of sleep. Parents identified the following as precipitants: overtiredness, fever, separation, loss, moving, divorce, change of school, death in the family, return to school from vacation, or change of school. The prevalence of sleepwalking and night terrors in first-degree relatives was estimated as being ten times greater than in the general population. Treatment of night terrors can be divided into two categories: behavioral and medical strategies. Night terrors are fascinating entities that share many of the same characteristics of the other parasomnias occurring as arousals from non-rapid eye movement (NREM) sleep.

  • Chapter 21 - Sleep-related eating disorder

  • from Section 4 - Other parasomnias
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 202-210

  • Summary

    This chapter focuses on sleepwalking, also known as somnambulism. The symptoms and manifestations that characterize sleepwalking show great variations both within and across predisposed patients. Sleepwalking is more common in childhood than in adulthood, as most children will experience, at least temporarily, one or more of the NREM sleep parasomnias during childhood or early adolescence. Sleep laboratory investigations have yielded considerable information on the polysomnographic characteristics of sleepwalkers. There is a strong genetic component to somnambulism. About 80% of somnambulistic patients have at least one family member affected by this parasomnia, and the prevalence of somnambulism is higher in children of parents with a history of sleepwalking. In addition to the atypical sleep parameters and genetic component reviewed, other factors have been proposed, including psychopathology and deregulation of serotonergic systems. Hypnosis (including self-hypnosis) has been found to be effective in both children and adults presenting with chronic sleepwalking.

  • Chapter 28 - Sleep-related rhythmic movement disorder

  • from Section 5 - Sleep-related movement disorders and other variants
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 270-277

  • Summary

    Sleep-related dissociative disorders, a variant of dissociative disorders, are parasomnias that can emerge at any point during sleep period, either at transition from wakefulness to sleep or within several minutes after awakening from stages 1 or 2 non-rapid eye movement (NREM) sleep or REM sleep. Patient's clinical features may support a specific dissociative disorder subtype diagnosis associated with sleep-related episodes, specifically dissociative identity disorder, dissociative fugue, or dissociative disorder NOS. With any form of sleep-related dissociative disorder, onset can be gradual and sporadic in nature. Females are reported to be affected predominantly, and onset can range from childhood to midlife. Sexualized and frankly sexual behaviors can emerge with sleep-related dissociative disorders. There are several potential considerations for differential diagnosis of sleep-related dissociative disorders, including an NREM arousal disorder parasomnia, parasomnia associated with REM sleep, or nocturnal seizures.

  • 14 - Forensic sleep medicine issues: violent parasomnias

  • from SECTION 3 - SLEEP IN SPECIALTY AREAS
  • Edited by Harold R. Smith, University of California, Irvine, Cynthia L. Comella, Birgit Högl
  • Book:
    Sleep Medicine
    Published online:
    08 August 2009
    Print publication:
    10 April 2008, pp 240-255

  • Summary

    Violent behaviors during sleep may result in events which have forensic science implications. The apparent suicide (for example, leap to death from a second-storey window), assault or murder (for example, molestation, strangulation, stabbing, shooting) may be the unintentional, non-culpable but catastrophic result of disorders of arousal, sleep-related seizures, REM sleep behavior disorder (RBD), or psychogenic dissociative states. Violent sleep-related behaviors have been reviewed in the context of automatic behavior in general, with many well-documented cases resulting from a wide variety of disorders. Conditions associated with sleep-period-related violence fall into two major categories: neurologic and psychiatric. Psychogenic dissociative disorders may arise exclusively or predominantly from the sleep period. Recent interest in the forensic aspects of parasomnias provides sleep medicine professionals with an opportunity to educate and assist the legal profession in cases of sleep-related violence. One infrequently used tactic to improve scientific testimony is to use a court-appointed impartial expert.

  • 2 - Evaluation and testing of the sleepy patient

  • from SECTION 1 - NORMAL SLEEP
  • Edited by Harold R. Smith, University of California, Irvine, Cynthia L. Comella, Birgit Högl
  • Book:
    Sleep Medicine
    Published online:
    08 August 2009
    Print publication:
    10 April 2008, pp 25-46

  • Summary

    Sleep disturbances can affect people throughout their life span, and the frequency of sleep disturbances increases as we age. People with sleep disturbances may complain of difficulty falling asleep or maintaining sleep, abnormal behaviors during the night, daytime sleepiness or fatigue. Asking about typical bedtime rituals, sleep times and habits is a good place to start in the assessment of any sleep disorder. Many people who present with the classic symptom of insomnia may have more than one problem with sleep. Sleep disorders such as obstructive sleep apnea (OSA), parasomnias, narcolepsy, and nocturnal seizures sometimes require formal evaluation in the sleep laboratory. The most commonly used techniques used in recording and evaluating sleep disorders include the polysomnogram (PSG), the multiple sleep latency test (MSLT), and under special circumstances, the maintenance of wakefulness test (MWT).

  • SECTION 2 - SLEEP DISORDERS

  • Edited by Harold R. Smith, University of California, Irvine, Cynthia L. Comella, Birgit Högl
  • Book:
    Sleep Medicine
    Published online:
    08 August 2009
    Print publication:
    10 April 2008, pp -

  • Summary

    Parasomnias involve automatic behavior, i.e., seemingly goal-directed, complex purposeful behaviors enacted without the conscious awareness and volition of the individual, who cannot exercise conscious deliberate control over his or her behaviors and sleep-related experiences. It could be subdivided by taking into account the motoric versus autonomic/ sensory activation. This chapter deals with the most common disorders, covering the appropriate diagnostic and therapeutic strategies. Disorders of arousal include sleepwalking or somnambulism, sleep terrors, and confusional arousals. The pathophysiology of REM sleep behavior disorder (RBD) lies in a dysfunction of the brainstem structures modulating REM sleep. Enuresis consists of recurrent involuntary urination during sleep. It includes primary forms, where bladder control has never been achieved, and secondary variants occurring after a period of bladder control. Catathrenia, also known as nocturnal groaning or expiratory vocalization during sleep, consists of the emission of an unusual expiratory noise occurring in bursts without associated motor phenomena.