Subjective and polysomnographic characteristics of patients diagnosed with narcolepsy.
ABSTRACT In order to better characterize the subjective and polysomnographic findings in patients with narcolepsy, a follow-up questionnaire was mailed to all patients diagnosed with the disorder at the Henry Ford Hospital Sleep Disorders and Research Center. The questionnaire inquired regarding the present, previous, and change in status for the constellation of narcolepsy symptoms. Memory problems, problems of daytime function, and nocturnal sleep disturbance were included among the questions related to the symptomatic constellation. By definition, all patients were symptomatic of daytime sleepiness and were diagnosed with narcolepsy only if there were two or more rapid eye movement (REM) onsets documented on the polysomnographic evaluation. A high percentage of patients reported nocturnal sleep disturbance, which was one of the symptoms with the latest reported onset. Retrospective comparison of questionnaire responses to the clinical polysomnography revealed significantly more sleep maintenance difficulties in the group of patients reporting this symptom on the questionnaire. Patients with disturbed nocturnal sleep reported taking more naps during the day, although the Multiple Sleep Latency Test (MSLT) failed to show differences in sleep latency. Interestingly, this group of patients was found to have a significantly higher number of sleep onset REM episodes on the MSLT. Finally, the findings are discussed as they compare to studies that required the presence of cataplexy as part of their inclusion criteria.
SourceAvailable from: Pandi-Perumal Seithikurippu Ratnas[Show abstract] [Hide abstract]
ABSTRACT: Recent scientific evidences have brought a paradigm shift in our approach towards the concepts of insomnia and its management. The differentiation between primary and secondary insomnia was proved more hypothetical than actual and based upon the current evidences insomnia subtypes described in earlier system have been lumped into one-Insomnia Disorder. Research in this field suggests that insomnia occurring during psychiatric or medical disorders has a bidirectional and interactive relationship with and coexisting medical and psychiatric illnesses. The new approach looks to coexisting psychiatric or medical disorders as comorbid conditions and hence specifying two coexisting conditions. Therefore, the management and treatment plans should address both conditions. A number of sleep disorders may present with insomnia like symptoms and these disorders should be treated efficiently in order to alleviate insomnia symptoms. In such cases, a thorough history from the patient and his/her bed-partner is warranted. Moreover, some patients may need polysomnography or other diagnostic tests like actigraphy to confirm the diagnosis of the underlying sleep disorder. DSM-5 classification system of sleep-wake disorders has several advantages, e.g., it has seen insomnia across different dimensions to make it clinically more useful; it focuses on the assessment of severity and guides the mental health professional when to refer a patient of insomnia to a sleep specialist; lastly, it may encourage the psychiatrists to opt for the Sleep Medicine as a career.Asian Journal of Psychiatry 09/2014; DOI:10.1016/j.ajp.2014.09.003
Dataset: When insomnia is not just insomnia
Article: Hypersomnias of Central Origin[Show abstract] [Hide abstract]
ABSTRACT: This article presents a succinct understanding of how to diagnose and manage hypersomnias of central origin, including narcolepsy, idiopathic hypersomnia, and recurrent hypersomnias.Neurologic Clinics 11/2012; 30(4):1027–1044. DOI:10.1016/j.ncl.2012.08.002 · 1.61 Impact Factor