parasomniac

• 睡眠時異常行動の

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parasomnia

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/09 10:26:51」(JST)

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This article is about the disorder. For the 2008 film, see Parasomnia (film).

Parasomnia
Classification and external resources
ICD-10	F51.3-F51.4
ICD-9	307.47, 327.4, 780.59
eMedicine	med/3131
MeSH	D020447

Parasomnias are a category of sleep disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Most parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness and NREM sleep, or wakefulness and REM sleep.

Non-rapid eye movement (NREM) parasomnias

NREM parasomnias are arousal disorders that occur during stage 3 (or 4 by the R&K standardization) of NREM sleep—also known as slow wave sleep (SWS). They are caused by a physiological activation in which the patient’s brain exits from SWS and is caught in between a sleeping and waking state. In particular, these disorders involve activation of the autonomic nervous system, motor system, or cognitive processes during sleep or sleep-wake transitions.

Some NREM parasomnias (sleep-walking, night-terrors, and confusional arousal) are common during childhood but decrease in frequency with increasing age. They can be triggered in certain individuals, by alcohol, sleep deprivation, physical activity, emotional stress, depression, medications, or a fevered illness. These disorders of arousal can range from confusional arousals, somnambulism, to night terrors. Other specific disorders include sleepeating, sleep sex, teeth grinding, rhythmic movement disorder, restless legs syndrome,^{[citation needed]} and somniloquy.

Confusional arousals

With a prevalence of 4%, confusional arousals are not observed very often in adults; however, they are common in children. Infants and toddlers usually experience confusional arousals beginning with large amounts of movement and moaning, which can later progress to occasional thrashings or inconsolable crying. Confusional arousal is a condition when an individual awakens from sleep and remains in a confused state. It is characterized by the individual's partial awakening and sitting up to look around. They usually remain in bed and then return back to sleep. These episodes last anywhere from seconds to minutes and may not be reactive to stimuli. Confusional arousals are not considered dangerous. Another sleeping disorder may be present triggering these incomplete arousals.

Sleepwalking (somnambulism)

Main article: Sleepwalking

Sleepwalking has a prevalence of 1-17% in childhood, with the most frequent occurrences around the age of eleven to twelve. About 4% of adults experience somnambulism. Normal sleep cycles include states varying from drowsiness all the way to deep sleep. Every time an individual sleeps, he or she goes through various sequences of non-REM and REM sleep. Anxiety and fatigue are usually connected with sleepwalking. For adults, alcohol, sedatives, medications, medical conditions and mental disorders are all associated with sleepwalking. Sleep walking may involve sitting up and looking awake when the individual is actually asleep, and getting up and walking around, moving items or undressing themselves. They will also be confused when waking up or opening their eyes during sleep. Some individuals also talk while in their sleep, saying meaningless words and even having arguments with people who are not there.

Sleep terrors (night terrors)

Main article: Pavor nocturnus

Sleep terror is the most disruptive arousal disorder since it may involve loud screams and panic; in extreme cases, it may result in bodily harm or property damage by running about or hitting walls. Unfortunately, all attempts to console the individual are futile and may prolong or intensify the victim’s confused state. Usually the victim experiences amnesia after the event but it may not be complete amnesia. Up to 3% of adults suffer from sleep terrors, and exhibited behavior of this parasomnia can range from mild to extremely violent. They typically occur in stage 3 sleep.

Teeth grinding (bruxism)

Main article: Bruxism

Bruxism is a common sleep disorder where the individual grinds their teeth during sleep. This can cause sleep disruption for the individual and also the bed partner. Grinding can wear and fracture the teeth, and also cause severe jaw pain. This can lead to migraines, teeth impairment, and other complications. A lot of people are not aware of their teeth grinding. Teeth grinding may be caused by stress and anxiety; it could also be caused by a non typical bite, or missing teeth.

Restless legs syndrome & periodic limb movements

Main article: Restless legs syndrome

Both of these conditions (RLS and PLM) are classified as dyssomnias according to the DSM-IV. They are considered parasomnias.

Sleep sex

Main article: Sleep sex

Sleep sex, or sexsomnia, is a condition in which a person will engage in sexual acts while still asleep. A condition usually occupied by another sleep disorder it can include such acts as masturbation, fondling themselves or others, having sex with another person and in more extreme cases sexual assault and rape.

Sleep related eating disorder (SRED)

Main article: Nocturnal_sleep related eating disorder

Sleep Related Eating Disorder is a condition in which individuals eat during sleep. They usually head for the kitchen and indulge in uncooked food, snacks and sometimes even toxic substances. This can be very dangerous and even deadly, especially if the individual has food allergies, or even is diabetic. This disorder usually starts with individuals who sleep walk and develop into SRED.

REM parasomnias

REM sleep behavior disorder

REM sleep behavior disorder is the most common REM sleep parasomnia in which muscle atonia is absent. This allows the individual to act out their dreams and may result in repeated injury—bruises, lacerations, and fractures—to themselves or others. Patients may take self-protection measures by tethering themselves to bed, using pillow barricades, or sleeping in an empty room on a mattress. Demographically, 90% of RBD patients are males, and most are older than 50 years of age.

Typical clinical features of REM sleep behavior disorder are:

• Male gender predilection
• Mean age of onset 50–65 years (range 20–80 years)
• Vocalisation, screaming, swearing that may be associated with dreams
• Motor activity, simple or complex, that may result in injury to patient or bed-partner
• Occurrence usually in latter half of sleep period (REM sleep)
• May be associated with neurodegenerative disease

Acute RBD, occurs mostly as a result of a side-effect in prescribed medication—usually antidepressants. But if not then 55% of the time the cause is unknown the other 45% the cause is associated with alcohol.

Chronic RBD is idiopathic, meaning of unknown origin, or associated with neurological disorders. There is a growing association of chronic RBD with neurodegenerative disorders—Parkinson's disease, multiple system atrophy (MSA), or dementia—as an early indicator of these conditions by as much as 10 years.

Patients with narcolepsy also are more likely to develop RBD.

Recurrent isolated sleep paralysis

Recurrent Isolated Sleep Paralysis is an inability to perform voluntary movements at sleep onset, or upon waking from sleep.

Catathrenia

Catathrenia, a rapid-eye-movement sleep parasomnia consisting of breath holding and expiratory groaning during sleep, is distinct from both somniloquy and obstructive sleep apnea. The sound is produced during exhalation as opposed to snoring which occurs during inhalation. It is usually not noticed by the person producing the sound but can be extremely disturbing to sleep partners, although once aware of it, sufferers tend to be woken up by their own groaning as well. Bed partners generally report hearing the person take a deep breath, hold it, then slowly exhale; often with a high-pitched squeak or groaning sound.

See also

• Dyssomnia
• Insomnia
• Jactatio capitis nocturna
• Sleep medicine
• Sleep paralysis

References

• Mahowald & Schenck. Insights from studying human sleep disorders. Nature (2005); 437(7063):1279-85.
• Bassetti et al., Lancet (2000); 356: 484–485
• Boeve et al. Journal of Geriatr Psychiatry Neurol 2004; 17:146-157
• Aurora RN et al. Journal of Clinical Sleep Medicine 2010; 6(1):85-95.
• Aurora RN et al. Journal of Clinical Sleep Medicine 2010; 6(4):398-401.
• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001811/

Notes

Further reading

• Siegel, Ronald (1992). Fire in the Brain: Clinical Tales of Hallucination.
• Warren, Jeff (2007). The Head Trip: Adventures on the Wheel of Consciousness. ISBN 978-0-679-31408-0.

External links

• Stanford: Parasomnias - Arousal Disorders Information
• Primary Sleep Disorders: Parasomnias
• Psychnet UK
• Insomnia/Parasomnia
• [1]

• [2]

English Journal

• Not Only Sleepwalking But NREM Parasomnia Irrespective of the Type Is Associated with HLA DQB1*05:01.

• Heidbreder A1,2, Frauscher B2, Mitterling T2, Boentert M1, Schirmacher A1, Hörtnagl P3, Schennach H3, Massoth C1, Happe S4, Mayer G5, Young P1, Högl B2.
• Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.J Clin Sleep Med.2016 Apr 15;12(4):565-70. doi: 10.5664/jcsm.5692.
• STUDY OBJECTIVES: Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only.METHODS: We retrospectively analyzed clinical, polysomnographic, and HLA findings of 74 adults (37 men) with NREM parasomnia
• PMID 26951409

• While You Were Sleepwalking: Science and Neurobiology of Sleep Disorders & the Enigma of Legal Responsibility of Violence During Parasomnia.

• Popat S1, Winslade W2.
• Neuroethics.Neuroethics.2015;8(2):203-214. Epub 2015 Apr 24.
• In terms of medical science and legal responsibility, the sleep disorder category of parasomnias, chiefly REM sleep behavior disorder and somnambulism, pose an enigmatic dilemma. During an episode of parasomnia, individuals are neither awake nor aware, but their actions appear conscious. As these ac
• PMID 26203309

• A scale for assessing the severity of arousal disorders.

• Arnulf I1, Zhang B2, Uguccioni G1, Flamand M1, Noël de Fontréaux A1, Leu-Semenescu S1, Brion A1.
• Sleep.Sleep.2014 Jan 1;37(1):127-36. doi: 10.5665/sleep.3322.
• BACKGROUND: Arousal disorders may have serious health consequences.OBJECTIVE: To develop a scale assessing the severity of arousal disorders (Paris Arousal Disorders Severity Scale, PADSS).SETTING: University hospital.DESIGN: Controlled study.PARTICIPANTS: Consecutive patients (older than 15 y), wit
• PMID 24470702

Related Links

• Parasomniac | definition of Parasomniac by Medical dictionary

parasomnia Parasomniac paraspadias paraspasm paraspasm faciale paraspecific therapy Paraspidodera paraspinal paraspinal line parastasis parasteatosis parasternal parasternal line parasternal lymph nodes parasternal region ...

• Parasomniac - definition of Parasomniac by The Free Dictionary

par·a·som·ni·a (păr′ə-sŏm′nē-ə) n. Any of various sleep dysfunctions, such as sleepwalking, night terrors, enuresis, or nocturnal seizures. [Probably para-+ (in)somnia.] Translations par·a·som·ni·a n. parasomnia, término que se refiere ...

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★リンクテーブル★

リンク元

「睡眠時異常行動」

「睡眠時異常行動」

　　[★]

英

parasomnia、parasomniac

関

眠気、睡眠随伴症、睡眠時随伴症