Neurology-Online

Neurological sleep disorders

English: sleep disturbances in neurological disorders

Please also note our topic mentally induced sleep disorder

definition

The Sleep disorder is divided into three areas:

Sleep disorders of falling asleep and staying asleep
Disorders of the sleep-wake cycle
Increased tendency to sleep

Sleep disorder without an organic or psychiatric cause is defined as a primary sleep disorder. In contrast, sleep disorders with a demonstrable organic or psychiatric cause are referred to as secondary sleep disorders. Neurological sleep disorders are primarily caused by a neurological disease such as:

Parkinson's disease
stroke
multiple sclerosis
Muscle disorders
Brain tumor
coma
epilepsy
Headache
Chronic pain

Even so, there are few neurological disorders that can be directly affected by the Sleep disorder define or the immediate consequence of which is a sleep disorder.

Further information on the consequences of lack of sleep can be found here: Consequences of lack of sleep

Narcolepsy - addiction to sleep

Narcolepsy manifests itself in daytime sleepiness, sudden loss of tone Muscles (Cataplexy), Sleep paralysis (Sleep paralysis) and hallucinations that occur shortly before falling asleep (hypnagogic hallucinations).

In around 50 percent, the cause appears to be Narcolepsy to be genetic. But also with tumors, brainstem infarctions and Brain stem- / thalamic lesions, narcolepsy occurs. The cause is generally a disruption of the central Nervous system presumed, i.e. a disruption of those regions that are responsible for the sleep / wake rhythm.

In about 40 percent of those affected, the disease does not occur as a seizure, but it persists due to the enormous daytime sleepiness decreased attention and gaps in memory (amnesia).
If narcolepsy occurs like a seizure, it is caused by a sudden loss of muscle tone (Cataplexy) marked. Emotional movements (e.g. laughter) can trigger such "cataplectic" seizures, in which the affected person has a strong expression of the Narcolepsy Cataplexy Syndrome can even fall to the ground in a flash. The patients are very limited in their sleep periods, i.e. They sleep very poorly, especially at the beginning of the night, and especially then suffer from hallucinations.

In the Diagnosis narcolepsy is that Electroencephalography in addition to other important laboratory tests, the method of choice.

In addition to drug therapy to reduce symptoms, e.g. L-dopa, Anti-epileptic drugs and Imipramine or Clomipramine In order to suppress the cataplectic attacks, special behavioral therapeutic measures are used (sleep hygiene, dealing with the disease).
It is important that the social environment of the person affected receives information about the illness in order to prevent misunderstandings and, if necessary, to provide assistance in the event of an attack of narcolepsy.
Narcoleptics should be on alcohol and calming (sedating) Medication do without and are not allowed to drive a car.

Sleepwalking (somnambulism)

As Sleepwalking the occurrence of unconscious psychomotor activity during sleep is referred to, without the person concerned having sufficient orientation and subsequently on a retroactive one Memory lapse (retrograde amnesia) suffers.

Often this disease occurs in childhood, relatively rarely in adulthood.
Sleepwalking does not only refer to "walking" in sleep, but can also only be characterized by the situation in which the person concerned wakes up and joins reduced orientation e.g. looks at the room or arranges the bedding. Contrary to the widespread opinion that during their nocturnal wandering proceed or "wander" absolutely safely and purposefully, it should be taken into account that sleepwalkers are particularly at risk of injury, especially if they are during the Sleepwalking awakening.

The reason for sleepwalking in children is the insufficiently developed brain region for the sleeping / waking rhythm, which is particularly favored by external causes (e.g. irregular sleep times).
In adults, sleepwalking can be genetic, but here, too, the main cause is external causes (Alcohol, medication, stress) into consideration.

Restless legs syndrome

The R.estless legs syndrome is characterized by a strong urge to move in the legs. In addition, severe abnormal sensations (pain, tingling) occur. This symptomatology occurs especially in the evening hours and at night and therefore leads to Difficulty falling asleep and staying asleep.

This disease is caused by hormonal or metabolic disorders, Polyneuropathies or iron deficiency. It is believed that Restless legs syndrome by a Dopamine disturbances is caused (dopamine is a Neurotransmitters, so a messenger substance for the transmission of information from a Nerve cell).

The speed of the nerves (Electroneurography, ENG), sleep analyzes and a blood / urine test performed. Dopaminergic and / or opioid treatment of this syndrome is often used as a therapeutic measure.

You can find out more about this topic under our topics Restless legs syndrome, twitching when falling asleep

Sleep apnea syndrome

Abbreviated as SAS is the sleep apnea syndrome (also "obstructive Sleep Apnea Syndrome ", OSAS) especially due to respiratory arrest (Apneas) marked during sleep. This syndrome causes sleep disorders, but also occurs as a result of neurological diseases.

The most common symptoms are short sleep episodes (10-20s) with respiratory arrests, significant obesity, respiratory arrests during sleep of 10-40s, reduction in the oxygen content (O2) and at the same time an increase in the carbon dioxide content (CO2) in the blood with compensatory countermeasures (i.e. hyperventilation with increase heart rate) and later an encephalopathy with psycho-organic change.

The therapy of sleep apnea syndrome as an internal disease starts in very mild cases with changing the sleeping position and sleep hygiene (no alcohol consumption before going to bed, regular bed times). Many patients require either breath stimulants or even an external ventilator. A suitable ventilator ensures adequate ventilation of the upper respiratory organs during the night. Before therapeutic measures are initiated, patients should be examined for changes in the respiratory organs (e.g. tonsils) and treated accordingly.

According to the guidelines of the German Society for Neurology (2005), OSAS can also occur as a result of various neurological diseases: