Seminars in neurology
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Sleep disturbances are common in neurodegenerative diseases. Disturbed sleep can result in fatigue, irritability, morning headaches, impaired motor and cognitive skills, depression, and daytime somnolence. The major sleep complaints include insomnia, hypersomnia, parasomnia, excessive nocturnal motor activity, circadian sleep-wake rhythm disturbance, and respiratory dysrhythmia. ⋯ Overnight polysomnography (PSG), Multiple Sleep Latency Test, Maintenance of Wakefulness Test, and actigraphy are some important diagnostic laboratory tests in the evaluation of sleep disturbances. Management of sleep disturbances is complex and is based primarily on the nature of the sleep disturbance. The clinical profiles, pathogenetic mechanisms, PSG findings, and management issues are discussed here with reference to some common neurodegenerative diseases.
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Sleep disorders in patients with neuromuscular disease are common, but underrecognized by health care providers, and sometimes by patients themselves. Their symptoms may be confused with those of the underlying disease. Their recognition is an important part of the management of patients with neuromuscular disorders, improving quality of life, and sometimes increasing survival. ⋯ Involvement of the central or peripheral nervous system, or both, may disrupt sleep, with the relative contribution of each depending on the specific disorder. The pertinent anatomy, physiology, and clinical features of sleep disorders in neuromuscular diseases and a basic approach to their assessment is discussed. Specific neuromuscular disorders in which sleep is commonly affected are reviewed and the principles of management of sleep disorders summarized.