Sleep Disorders and Neurologic Diseases potx

SLEEP DISORDERS

Advisory Board

Antonio Culebras, M.D.

Professor of Neurology

Upstate Medical University

Consultant, The Sleep Center

Community General Hospital

Syracuse, New York, U.S.A.

Anna Ivanenko, M.D., Ph.D.

Loyola University Medical Center

Department of Psychiatry and Behavioral Neuroscience

Maywood, Illinois, U.S.A.

Clete A. Kushida, M.D., Ph.D., RPSGT

Director, Stanford Center for Human Sleep Research

Associate Professor, Stanford University Medical Center

Stanford University Center of Excellence for Sleep Disorders

Stanford, California, U.S.A.

Nathaniel F. Watson, M.D.

University of Washington Sleep Disorders Center

Harborview Medical Center

Seattle, Washington, U.S.A.

1. Clinician’s Guide to Pediatric Sleep Disorders, edited by

Mark A. Richardson and Norman R. Friedman

2. Sleep Disorders and Neurologic Diseases, Second Edition,

edited by Antonio Culebras

Edited by

Antonio Culebras

Community General Hospital and Upstate Medical University

Syracuse, New York, U.S.A.

Sleep

Disorders

and

Neurologic

Diseases

SECOND EDITION

Informa Healthcare USA, Inc.

270 Madison Avenue

New York, NY 10016

© 2007 by Informa Healthcare USA, Inc.

Informa Healthcare is an Informa business

No claim to original U.S. Government works

Printed in the United States of America on acid-free paper

10 9 8 7 6 5 4 3 2 1

International Standard Book Number-10: 0-8493-4324-0 (Hardcover)

International Standard Book Number-13: 978-0-8493-4324-7 (Hardcover)

This book contains information obtained from authentic and highly regarded sources. Reprinted material

is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable

efforts have been made to publish reliable data and information, but the author and the publisher cannot

assume responsibility for the validity of all materials or for the consequences of their use.

No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic,

mechanical, or other means, now known or hereafter invented, including photocopying, microfilming,

and recording, or in any information storage or retrieval system, without written permission from the

publishers.

For permission to photocopy or use material electronically from this work, please access www.copyright.

com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC) 222 Rosewood

Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and

registration for a variety of users. For organizations that have been granted a photocopy license by the

CCC, a separate system of payment has been arranged.

Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are

used only for identification and explanation without intent to infringe.

Visit the Informa Web site at

www.informa.com

and the Informa Healthcare Web site at

www.informahealthcare.com

To my wife, Susan, and my daughters, Katerina and Andrea, who felt the

absences and enjoyed the successes with the same intensity that I did.

B Foreword

Sleep is the least understood third of our lives. From its prenatal inception to its

ultimate demise, basic questions persist at all stages. We know that sleep represents

an important phase in brain function, but we know much less about possible

circadian variability in the activity of pathophysiological processes affecting the

brain. For example, we have some idea about how sleep apnea may impact brain

function, but we have no clue, yet, whether so-called silent brain infarcts occur

predominantly in sleep and, if so, why and how.

Fortunately, interest, research, and overall activity in somnology is surging.

As this comprehensive book illustrates, a number of specialties are converging to

deal with the increasingly recognized problems associated with sleep disorders.

Neurosomnology emerges as a distinct subspecialty of neurology, with its

attendant professional organizations, certifications, and, eventually, formal

training programs.

A number of distinguished investigators and practitioners of sleep medicine

contributed to this volume. Although the basics of normal sleep development, func￾tion, and dysfunction receive their due, the emphasis remains decidedly clinical.

Not only neurologists, but pediatricians, internists, pulmonologists, endocrinolo￾gists, psychiatrists, and all those dealing with sleep disorders will find parts intrin￾sically interesting and applicable in practice. This book deserves a wide readership.

The readers and their patients will benefit.

Vladimir Hachinski, MD, FRCPC, DSc

Distinguished University Professor

Department of Clinical Neurological Sciences

Schulich School of Medicine and Dentistry

University of Western Ontario

London, Ontario, Canada

v

B Preface

Sleep is a function of the brain. However, the ultimate physiological function

of sleep remains enigmatic and unknown despite recent extensive research of this

ubiquitous and important brain activity. Sleep intervenes in functions of somatic

growth, regeneration, and memory. Sleep is important in medicine because it

modulates quality of life, while its disorders provoke family pathology, disturb

work routines, alter social activities, and, in general, affect the health of the

individual (1).

Sleep medicine is a unique specialty with input from diverse areas of the

medical sciences. Neurology, pulmonary, cardiology, pediatrics, psychiatry, otorhi￾nolaryngology, and even dental medicine have important contributions to make.

This diversity is the backbone of sleep medicine. But sleep medicine is branching

out and it is clear that sleep, being a function of the brain, suffers dysfunctions

that are distinctly neurological. Conditions such as epilepsy with expression only

in sleep, neuromuscular disorders masquerading as sleep apnea, parasomnias

mimicking seizure disorders, intrinsic hypersomnias with definite brain pathophys￾iology, sleep alterations in Parkinson’s disease, the risk of stroke in sleep, the

organic insomnias, the emerging autonomic dysfunctions of sleep, and so many

other unique neurological disturbances can only be evaluated, studied, diagnosed,

and managed with comfort by neurologists with special expertise in sleep dis￾orders. Non-neurological physicians with a title of “sleep specialist” may not

have sufficient training to tackle the above conditions, despite a sleep diploma or

certificate, and will value having immediate access to this important segment of

sleep medicine in the form of a book.

The subspecialty of neurosomnology will eventually emerge with strength

comparable to that of other subspecialties in neurology. The consequence is that

sleep centers may be compelled to add specialized neurosomnology, for which

they will need a neurosomnologist on staff. Eventually, clinical neurosomnology

will become a subspecialty of sleep medicine and neurology to incorporate all

that is new, unique, and only available in the neurology of sleep.

This book serves as a reference for those who practice sleep medicine and

encounter neurological pathology. The non-neurologist will value the special

information contained herein, and the neurologist will find updated clinical

science in their area of expertise. The chapters have a clinical orientation; pro￾cedural aspects and laboratory tests are not addressed, except where important

to enhance the understanding of clinical manifestations. Some topics are

covered in more than one chapter, not by accident but by design. This should

not be viewed as duplication but rather a way of presenting diverse views of

the same topic.

The authors are prestigious clinical neuroscientists with an international

name in the field of sleep medicine. They were invited to update work presented

in the first edition (2) or to collaborate with new information developed since

vii

this book was initially published only a few years ago. All collaborators have dili￾gently compiled their chapters despite multiple other obligations and should be

commended for their excellent work.

Antonio Culebras, MD

REFERENCES

1. Culebras A, ed. Clinical Handbook of Sleep Disorders. Boston: Butterworth-Heinemann

publishers, 1996.

2. Culebras A, ed. Sleep Disorders and Neurological Disease. First edition. New York: Marcel

Dekker, Inc publishers, 2000.

viii Preface

B Contents

Foreword Vladimir Hachinski .... v

Preface . . . . vii

Contributors . . . . xiii

PART I: INTRODUCTION

1. Concept of Sleep Medicine and of Neurosomnology 1

Antonio Culebras

PART II: INFANCY AND DEVELOPMENT

2. Disorders of Development and Maturation of Sleep 7

Stephen H. Sheldon

3. Sleep Disorders Associated with Mental Retardation 27

Michael J. Rack

PART III: INSOMNIA AND CIRCADIAN DYSRHYTHMIAS

4. Insomnia in Neurology 39

Federica Provini, Carolina Lombardi, and Elio Lugaresi

5. Delayed Sleep Phase Disorder and Other Circadian

Rhythm Sleep Disorders 53

Baruch El-Ad

PART IV: NARCOLEPSY AND OTHER HYPERSOMNIAS

6. Narcolepsy 83

Claudio L. Bassetti

7. Secondary Narcolepsy 117

Thomas E. Scammell

8. Hypocretin—Hypothalamic System 135

Christian R. Baumann and Claudio L. Bassetti

9. Idiopathic Hypersomnia and Recurrent Hypersomnia 143

Douglas B. Kirsch and Ronald D. Chervin

ix

PART V: MOTOR DISORDERS OF SLEEP

10. Motor Disorders of Sleep: Periodic, Aperiodic, and

Rhythmic Motor Disorders 157

Roberto Vetrugno and Pasquale Montagna

11. Restless Legs Syndrome 171

Renata Egatz, Belen Cabrero, and Diego Garcia-Borreguero

12. Periodic Leg Movements of Sleep 193

Diego Garcia-Borreguero, Oscar Larrosa, and Renata Egatz

13. Sleep in Parkinson’s Disease 205

Robert L. Rodnitzky

PART VI: EPILEPSY AND PARASOMNIAS

14. Epilepsy and Sleep 229

Bradley V. Vaughn and O’Neill F. D’Cruz

15. Somnambulism, Somniloquy, and Sleep Terrors 255

Rosalia Silvestri

16. Rapid Eye Movement Sleep Behavior Disorder 263

Mark W. Mahowald and Carlos H. Schenck

PART VII: SLEEP APNEAS

17. Obstructive and Nonobstructive Sleep Apnea: The Neurological

Perspective 277

Gulcin Benbir and Christian Guilleminault

18. Sleep Apnea and Stroke 301

Antonio Culebras

PART VIII: NEURODEGENERATIVE DISORDERS

19. Sleep Disturbances in Dementia and Other Neurodegenerative

Disorders 315

Alon Y. Avidan

20. Autonomic Dysfunctions in Sleep Disorders 337

Pietro Cortelli and Carolina Lombardi

PART IX: MISCELLANEOUS NEUROLOGIC DISORDERS

21. Headache Disorders and Sleep 349

Antonio Culebras

x Contents