Sleep medicine
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Central sleep apnea (CSA) occurs in clinical situations that induce hypocapnia and respiratory instability during sleep. This is true, not only in heart failure patients, but also in patients suffering from neurological diseases and idiopathic CSA. Adaptive Servo Ventilation (ASV) is frequently prescribed in France for the treatment of CSA, but only a few studies have evaluated ASV treatment with regards to long term effectiveness and compliance. ⋯ Our findings suggest that ASV is well tolerated and effective for most patients with hypocapnic central sleep apnea and chronic hyperventilation.
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To clarify the prevalence of restless legs syndrome (RLS) in the chronic kidney disease (CKD) population and determine the relationship between severity of renal dysfunction and risk of RLS as well as the impact of the disorder on mood and sleep disturbance, we conducted a questionnaire survey followed by face-to-face interviews with Japanese CKD patients. ⋯ The risk of RLS in the CKD population was higher than that in the general population and increased with the progression of renal dysfunction. Additionally, the existence of RLS might play a role in an increased risk for developing depression and sleep disturbance in the CKD population.
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Rapid-eye movement (REM) sleep behaviour disorder (RBD) is an REM sleep parasomnia characterized by enactment of dream content during REM sleep associated with loss of muscle atonia. RBD can be either idiopathic or secondary to drugs or other diseases. ⋯ RBD may represent the first feature of neurodegeneration and can be considered an early marker of these disorders. This review describes the main clinical, pathogenetic, and therapeutic features of RBD, pointing to its association with neurodegenerative diseases and emphasizing the clinical and prognostic implications.
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Case Reports
Morvan chorea and agrypnia excitata: when video-polysomnographic recording guides the diagnosis.
Morvan chorea is an antibody-mediated limbic encephalopathy characterized by severe insomnia, mental confusion, hallucinations, enacted dreams, hyperhidrosis, and neuromyotonia. ⋯ Oneiric stupor may represent a useful precocious diagnostic marker in Morvan chorea.