Periodic leg movements should not be overlooked as a possible cause of insomnia, and perhaps rarely, excessive daytime sleepiness

2014 ◽  
pp. 192-197
Author(s):  
Lizabeth Binns
Keyword(s):  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Periodic Leg Movements ◽  
Possible Cause ◽  
Leg Movements

scholarly journals Pupillographic Sleepiness Test and Polysomnography in Nondemented Patients with Ischemic White Matter Lesions

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ralf Landwehr ◽  
Robert Liszka
Keyword(s):  
Sleep Apnea ◽  
White Matter ◽  
Sleep Disorders ◽  
Daytime Sleepiness ◽  
White Matter Lesions ◽  
Primary Insomnia ◽  
Periodic Leg Movements ◽  
Nonrestorative Sleep ◽  
Pupillographic Sleepiness Test ◽  
Leg Movements

Background. Patients with ischemic white matter lesions (WML) frequently report nonrestorative sleep or daytime sleepiness. However, subjective estimations of sleep and sleepiness can differ considerably from objective measures. The pupillographic sleepiness test (PST) could identify patients with sleep disorders requiring polysomnography (PSG) and further treatment. Methods. We performed a PST and a PSG of 35 nondemented patients with WML, who reported nonrestorative sleep or daytime sleepiness, and assessed the diagnostic value of the pupillary unrest index (PUI). Sleep parameters were compared to normative data. Results. The mean PUI of WML patients was normal (5.89 mm/min) and comparable to PUIs of patients with other neurological disorders. All 9 of the 35 WML patients (25.7%) who had a PUI above normal also had clinically relevant sleep disorders (5: sleep apnea, 7: periodic leg movements, and 4: insomnia). Six patients with a normal PUI had mild to moderate primary insomnia. Conclusion. PST and PSG parameters were physiological in most patients with WML. Age-related changes and affective and neuropsychological disorders might account for their sleep-related complaints. An elevated PUI in patients with WML seems to indicate comorbid sleep disorders that require further diagnostic evaluation and treatment (sleep apnea, insomnia with periodic leg movements, but not primary insomnia).

Sleep disorders

2016 ◽  
Author(s):  
Zenobia Zaiwalla ◽  
Roo Killick
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Eye Movement ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Sleep Apnoea ◽  
Rapid Eye Movement ◽  
Periodic Leg Movements ◽  
Sleep Studies ◽  
Obstructive Sleep

As sleep medicine advances, there is increasing demand on services including neurophysiology to investigate sleep disorders. This chapter classifies the sleep disorders according to the main symptom presenting to the clinician, including excessive daytime sleepiness, insomnia, patients sleeping at the wrong times due to a circadian rhythm disorder, and movements or behaviours in sleep. The clinical presentation of common sleep disorders in each category are outlined, including obstructive sleep apnoea, narcolepsy, restless leg syndrome, periodic leg movements disorder, circadian rhythm disorders, and non-rapid eye movement and rapid eye movement parasomnias. The chapter discusses the overlap of symptoms in different sleep disorders, and the importance of selecting appropriate sleep studies, and recognizes the pitfalls, both clinical and in interpretation of sleep studies. The difficulties in diagnosing narcolepsy and differentiating from other causes of excessive daytime sleepiness, and when to investigate parasomnias is explained.

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