Parasomnias are undesirable behaviors that occur while falling asleep, during sleep or waking up. The diagnosis is made clinically. Treatment may include medication and psychotherapy.
In many of these disorders history and physical examination can confirm the diagnosis.
Parasomnias are undesirable behaviors that occur while falling asleep, during sleep or waking up. The diagnosis is made clinically. Treatment may include medication and psychotherapy. In many of these disorders history and physical examination can confirm the diagnosis. Somnambulism sitting down, walking or other complex behaviors occur in your sleep on, usually with open eyes, but without evidence of conscious awareness. Somnambulism is most common in late childhood and adolescence and occurs after and during non-REM eye movements (NREM) sleep stage in N3. increase Preceding lack of sleep and poor sleep hygiene is the probability of these episodes and the risk higher among first-degree relatives of patients with this disorder. The episodes can be triggered by factors causing the sleep arousals or enhance (eg. As caffeine, other stimulants and substances that sleep-disrupting behaviors) or increase the N3 sleep (z. B. antecedent sleep deprivation, excessive physical activity ). Patients can repeatedly muttering to himself, and some hurt on obstacles or on stairs. Patients do not remember after waking up or the following morning, to have been dreaming and usually have no memory of the episode. The treatment is aimed at eliminating the triggers for such episodes. It also includes the protection of patients from injury a-z. B. Use of electronic alarm systems to wake patients when they get out of bed, low beds and removing sharp objects and obstacles out of the bedroom. Occasionally, the patients are advised to sleep on mattresses on the floor. Benzodiazepines, clonazepam in particular 0.5-2 mg p.o. at bedtime, usually help if the behavioral measures are not completely effective. Night terrors At night, the patient suddenly scream, they row with the poor and seem to be shocked and strongly activated. The episodes can lead to sleepwalking. Patients are hard to wake. night terrors is more common in children and comes after awakening from the sleep stage N3 before; It is still not nightmares. In adults, night terrors may be associated with mental health problems or alcoholism. In children the reassurance by parents is often the mainstay of treatment. When everyday activities are affected (z. B. when the academic performance deteriorate), (z. B. clonazepam 2-5 mg 1-2 mg, and diazepam) are medium- or long-acting oral benzodiazepines before bedtime may be helpful. Adults can benefit from psychotherapy or drug treatment. Nightmares children have more nightmares than adults. Nightmares occur during REM sleep, usually with fever, excessive fatigue or mental stress or after prior alcohol consumption. The treatment is based on any underlying mental disorder. REM sleep behavior disorder during REM sleep occur (sometimes profane) utterances and often violent movements (eg. As waving of arms, punching, kicking) on. These behaviors can mean the acting out of dreams in patients who do not have the normal atonia during REM sleep for unknown reasons. Patients are vivid dreams aware when they are on their behaviors awake. This disorder is more common in older people, especially with degenerative CNS diseases (eg. As Parkinson’s disease or Alzheimer’s disease, vascular dementia, olivopontozerebelläre degeneration, multiple system atrophy, progressive supranuclear palsy). Similar behavior can also occur in patients who suffer from narcolepsy and norepinephrine reuptake inhibitors (eg. As atomoxetine, reboxetine, venlafaxine) are taking. The cause is unknown usually. In some patients, a Parkinson’s disease develops years after a diagnosis of REM sleep behavior disorder. The diagnosis can be based on the symptoms that tell the patient or their bed partner, accepted. Polysomnography is mostly sufficient to confirm the diagnosis. You may find excessive motor activity during REM sleep; an audiovisual monitoring can document abnormal body movements and vocalizations. A neurological examination is performed to rule out diseases of neurodegenerative diseases. When an anomaly is detected, a CT scan or MRI may follow. The treatment with clonazepam 0.5-2 mg p.o. before going to bed. Most patients have to take the drug indefinitely to prevent relapse; the tolerance or abuse potential is low. Bed partner should be warned that they could possibly be hurt, and pull it possibly intend to sleep in another bed until the symptoms are resolved. Sharp objects should be removed from the bedside table. Sleep-related leg cramps calf or foot muscles cramp often in otherwise healthy patients in middle and old age. The diagnosis is based on history and the absence of physical symptoms or disorders. Stretching the affected muscles before going to sleep for a few minutes has a preventive effect. Stretching immediately upon occurrence of the spasm relieving the symptoms immediately and is preferable to a drug treatment. Numerous drugs (. Eg quinine, calcium and magnesium supplements, diphenhydramine, benzodiazepines, mexiletine) have been used; none appears to be effective and the side effects can be significant (v. a. in the quinine and mexiletine). It can help to avoid caffeine and other sympathetic stimulants.