scholarly journals Abnormal night melatonin level in a patient with well-controlled epilepsy without sleep disturbances – could it be associated with levetiracetam therapy: A case report

2021 ◽  
Vol 10 (3) ◽  
pp. 085-087
Author(s):  
Orlina Georgieva Chaneva ◽  
Zdravka Nikolaeva Vasileva
Keyword(s):  
Case Report ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Epileptiform Activity ◽  
Serum Levels ◽  
Melatonin Level ◽  
Melatonin Concentration ◽  
Sleep Parameters ◽  
Normal Sleep ◽  
Multiple Sleep Latency

We present a case report of a 23-year old male with newly diagnosed epilepsy manifested with generalized tonic seizures. Levetiracetam (LEV) was started and the patient was seizure free. The patient demonstrated intermediate chronotype determined by the Morningness-Eveningness Questionnaire (MEQ). There was no epileptiform activity on electroencephalography (EEG) and polysomnography (PSG), sleep architecture disturbances (PSG) or daytime sleepiness (Epworth sleepiness score, Multiple sleep latency test) at the onset and after 3 months of LEV therapy. The melatonin serum levels after 3 months of LEV treatment were 22.00 pg/ml at 3 a.m. and 23.60 pg/ml at 8 a.m. - there was no normal night peak concentration. This abnormality may be associated with a later night peak melatonin concentration, the treatment with levetiracetam being a possible explanation. We consider the presented clinical case of special interest because of the combination of absence of normal night peak melatonin concentration, normal sleep parameters and non-extremely presented chronotype. We suggest that such patients could benefit from add-on therapy with melatonin.

scholarly journals Late-Onset Narcolepsy: A Case Report with Brief Review of the Literature

2021 ◽  
Author(s):  
Jeny Jacob ◽  
Rajesh Venkataram ◽  
Nandakishore Baikunje ◽  
Rashmi Soori
Keyword(s):  
Older Adults ◽  
Case Report ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Late Onset ◽  
Sleep Latency ◽  
Early Adulthood ◽  
Review Of The Literature ◽  
Multiple Sleep Latency ◽  
Overnight Polysomnography

AbstractNarcolepsy, a sleep disorder, has its onset in childhood and early adulthood but rarely in older adults. This case report focuses on a man in his late fifties who was noticed to have excessive daytime sleepiness during his stay in our hospital for an unrelated medical ailment. He was further evaluated with overnight polysomnography and next day multiple sleep latency test which confirmed the diagnosis of narcolepsy.

601 Comparison of Sleep Parameters in Children with Achondroplasia and Trisomy 21

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A236-A237
Author(s):  
Jodi Gustave ◽  
Kaelyn Gaza ◽  
Jennifer Marriner ◽  
Seema Rani ◽  
Abigail Strang ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Rem Sleep ◽  
Trisomy 21 ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Sleep Efficiency ◽  
Sleep Architecture ◽  
Poor Sleep ◽  
Arousal Index ◽  
Sleep Parameters

Abstract Introduction Children with achondroplasia and Trisomy 21 (T21) have increased incidence of sleep disturbances including sleep disordered breathing. Abnormal sleep architecture has been documented in children with T21. It is important to continue to analyze sleep parameters in both groups since poor sleep quality is associated with neurocognitive impairment. Methods Following IRB approval, we performed a retrospective chart review of patients at Nemours/A.I. duPont Hospital for Children in Wilmington, DE with achondroplasia and T21 who underwent an initial polysomnogram (PSG) between 2015 and 2020. We compared sleep architecture parameters between the groups including sleep efficiency, total sleep time (TST), sleep latency, arousal index and concentration of N3 and REM sleep. Results In patients with achondroplasia (n=49, mean age 5.8 months and 63.3% male), 12% reported restless sleep. PSG data revealed TST of 392 minutes, mean sleep efficiency of 82%, mean sleep latency of 9.4 min, mean arousal index of 40, 22% REM sleep and 32% N3 sleep. In the patients with T21 (n=32, mean age 17.8 months and 50% male), 59% reported restless sleep. PSG data revealed TST of 393 minutes, mean sleep efficiency of 82%, mean sleep latency of 14 minutes, arousal index of 35, 15% REM sleep and 40% N3 sleep. The differences in REM and N3 sleep between the two groups were statistically significant (p-values of 0.001 and 0.04, respectively), but the differences in arousal index, TST and sleep efficiency were not. Conclusion Our study showed that children with T21 subjectively noted more restless sleep compared to patients with achondroplasia although TST and sleep efficiency were similar. Patients with achondroplasia had a higher arousal index that was not statistically significant. Children with achondroplasia had a shorter sleep latency and more robust REM concentration, likely due to their younger age. There was a higher concentration of N3 sleep in patients with T21. This is likely due to the decrease in REM concentration. In conclusion, it is important to establish expected sleep parameters in patients with achondroplasia and T21 to maximize sleep quality and mitigate negative neurocognitive effects of poor sleep. Support (if any):

Explosive sound without external stimuli following electroencephalography kappa rhythm fluctuation: A case report

Cephalalgia ◽  
2021 ◽  
pp. 033310242110217
Author(s):  
Yukiyoshi Sumi ◽  
Towa Miyamoto ◽  
Satoshi Sudo ◽  
Hiroshi Kadotani ◽  
Yuji Ozeki ◽  
...  
Keyword(s):  
Case Report ◽  
Therapeutic Intervention ◽  
Sleep Latency ◽  
Sleep Onset ◽  
Alpha Band ◽  
Loud Sound ◽  
Band Power ◽  
External Stimuli ◽  
Multiple Sleep Latency ◽  
Band Activity

Background The pathology underlying exploding head syndrome, a parasomnia causing a loud sound/sense of explosion, is not well understood. Kappa rhythm is a type of electroencephalogram alpha band activity with maximum potential between contralateral temporal electrodes We report a case of preceding kappa activity before exploding head syndrome attacks. Case report A 57-year-old woman complained of explosive sounds for 2 months; a loud sound would transpire every day before sleep onset. She was diagnosed with exploding head syndrome. During polysomnography and the multiple sleep latency test, the exploding head syndrome attacks occurred six times. A kappa wave with activity disappearing a few seconds before most exploding head syndrome attacks was observed. The alpha band power in T3-T4 derivation gradually waxed followed by termination around the attacks. Conclusion This case demonstrated that the dynamics of kappa activity precede exploding head syndrome attacks. Finding ways to modulate electroencephalogram oscillation could elucidate their causality and lead to therapeutic intervention.

Multiple Sleep Latency Test by Polysomnography: A Case Report

2003 ◽  
Vol 7 (3) ◽  
pp. 147-149
Author(s):  
Robert Daniel Vorona ◽  
J. Catesby Ware
Keyword(s):  
Case Report ◽  
Sleep Latency ◽  
Multiple Sleep Latency Test ◽  
Multiple Sleep Latency

Acute Restriction of Nocturnal Sleep in Children

1981 ◽  
Vol 53 (1) ◽  
pp. 103-112 ◽  
Author(s):  
Mary A. Carskadon ◽  
Kim Harvey ◽  
William C. Dement
Keyword(s):  
Sleep Latency ◽  
Sleep Restriction ◽  
Nocturnal Sleep ◽  
Attention Task ◽  
Word Memory Test ◽  
Word Memory ◽  
Recovery Sleep ◽  
Sleep Parameters ◽  
Single Night ◽  
Multiple Sleep Latency

Sleep, performance, and sleepiness were evaluated in nine (6 girls, 3 boys) children (ages 11 to 13.2 yr.) with a view toward determining whether children are more sensitive to sleep restriction than adults. In this 3-day study (immediately preceded by 3 adaptive days), sleep was permitted for 10 hr. on the baseline and recovery night, and for 4 hr. on a single restricted night. Effects of sleep restriction and subsequent recovery on nocturnal sleep parameters were very comparable to results seen in adult subjects. No significant effects of the procedure were seen in performance on abbreviated versions of the Wilkinson Addition Test and Williams Word Memory Test or on a listening attention task. Multiple sleep latency tests showed a significant increase with daytime sleepiness following sleep restriction, which persisted into the morning following recovery sleep. Children appear to be able to tolerate a single night of restricted sleep, although they do not recover as rapidly as adult subjects.

Effects of COX-2 Inhibitor in Temporomandibular Joint Acute Inflammation

2007 ◽  
Vol 86 (5) ◽  
pp. 475-479 ◽  
Author(s):  
T.C.B. Schütz ◽  
M.L. Andersen ◽  
S. Tufik
Keyword(s):  
Temporomandibular Joint ◽  
Rem Sleep ◽  
Sleep Disturbances ◽  
Acute Inflammation ◽  
Sham Group ◽  
Sleep Latency ◽  
Sleep Parameters ◽  
Freund’S Adjuvant ◽  
Cox 2 ◽  
Freund's Adjuvant

Since it is recognized that cyclo-oxygenase-2 mediates nociception and the sleep-wake cycle as well, and that acute inflammation of the temporomandibular joint (TMJ) results in sleep disturbances, we hypothesized that cyclo-oxygenase-2 inhibitor would restore the sleep pattern in this inflammatory rat model. First, sleep was monitored after the injection of Freund’s adjuvant (FA group) or saline (SHAM group) into the rats’ temporomandibular joint. Second, etoricoxib was co-administered in these groups. The Freund’s adjuvant group showed a reduction in sleep efficiency, in rapid eye movement (REM), and in non-REM sleep, and an increase in sleep and REM sleep latency when compared with the SHAM group, while etoricoxib substantially increased sleep quality in the Freund’s adjuvant group. These parameters returned progressively to those found in the SHAM group. Etoricoxib improved the sleep parameters, suggesting the involvement of the cyclo-oxygenase-2 enzyme in acute inflammation of the TMJ, specifically in REM sleep.

Association of sleep disturbance with diabetic retinopathy

2020 ◽  
pp. 112067212097429
Author(s):  
Somsubhra Dutta ◽  
Sambuddha Ghosh ◽  
Srijit Ghosh
Keyword(s):  
Diabetic Retinopathy ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Severe Difficulty ◽  
Normal Sleep ◽  
Internal Homogeneity

Purpose: Diabetes mellitus (DM) patients are more likely to experience sleep disturbances than normal. Sleep disturbances may contribute to the development of diabetic retinopathy (DR) by higher inflammatory markers in circulation. We investigated the association between sleep quality and DR. Methods: Institutional case control study with type 2 DM patients of <10 years duration and HbA1c ⩽8%; 70 cases with DR and 70 controls without DR (NODR) (power 0.8). Sleep quality was assessed by Pittsburg sleep quality index (PSQI) questionnaire and compared. Results: Cronbach’s alpha was 0.777 with high internal homogeneity. Global PSQI score in DR (7.44 ± 3.99; 95%CI 6.88, 9.42) was more than in NODR (4.30 ± 3.26; 95%CI 3.87, 6.45) ( p < 0.001). All sleep disturbance scores were more in DR except sleep duration. Poor sleep (PSQI score>5) was more prevalent in DR ( p = 0.000) and associated with increasing DR severity ( p = 0.026). Normal sleep latency was recorded in 78.57% and 42.85% patients in NODR and DR respectively ( p < 0.001). Severe difficulty in subjective sleep quality ( p = 0.024), sleep latency ( p = 0.002) and daytime dysfunction ( p < 0.001) was seen more in DR. Elevated daytime dysfunction was observed with increasing DR severity ( p = 0.008). The optimal cut-off for global PSQI score and sleep latency for DR was 5.5 (OR: 5.97; 95%CI 2.86, 12.47) and 25 min(OR: 4.89; 95%CI 2.32, 10.26) respectively. Conclusion: Sleep disturbance is positively associated with DR. Our study identifies cut off value for DR of a modifiable parameter like sleep latency. It emphasizes the need of sleep quality assessment for risk assessment of DR.

scholarly journals Daytime Sleepiness and Parkinson’s Disease: The Contribution of the Multiple Sleep Latency Test

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Marcelo Ataide ◽  
Clélia Maria Ribeiro Franco ◽  
Otavio Gomes Lins
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daytime Sleepiness ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Small Sample Size ◽  
Small Sample ◽  
Multiple Sleep Latency Test ◽  
Major Factors ◽  
Multiple Sleep Latency

Background. Sleep disorders are major nonmotor manifestations of patients with Parkinson’s disease (PD), and excessive daytime sleepiness (EDS) is one of the most common symptoms.Objective. We reviewed a current literature concerning major factors that influence EDS in PD patients, using Multiple Sleep Latency Test (MSLT).Methods. A Medline search found 23 studies.Results. The presence of EDS was observed in 12.7% to 47% in patients without complaints of daytime sleepiness and 47% to 66.7% with complaints of daytime sleepiness. Despite being recognized by several authors, major factors that influence EDS, such as severity of motor symptoms, use of dopaminergic medications, and associated sleep disturbances, presented contradictory data.Conclusions. Available data suggest that the variability of the results may be related to the fact that it was conducted with a small sample size, not counting the neuropathological heterogeneity of the disease. Thus, before carrying out longitudinal studies with significant samples, careful analysis should be done by assigning a specific agent on the responsibility of EDS in PD patients.

Recurrent hypersomnia: Kleine-Levin syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S595-S595
Author(s):  
L. Rodríguez Andrés ◽  
A. Rodríguez Campos ◽  
L. Gallardo Borge ◽  
G. Isidro García ◽  
E. Mayor Toranzo
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Rem Sleep ◽  
Sleep Latency ◽  
Abnormal Behavior ◽  
Cognitive Changes ◽  
Personality Changes ◽  
Competing Interest ◽  
Multiple Sleep Latency

IntroductionKleine-Levin syndrome was first described by Kleine in 1925 and elaborated on by Levi in 1936. It is an infrequent syndrome that predominantly affects to teenagers, and boys are four times more likely to be affected than girls. It is rare for patients over 30 years although some cases have been reported. Kleine-Levin syndrome is a recurrent hypersomnia characterized by episodes of hypersomnia lasting for 2 days to 4 weeks associated with symptoms of hyperphagia, hypersexuality and cognitive impairment. It can be accompanied by other abnormal behavior such as aggression, personality changes and irritability. Deficits are resolved between episodes.Case reportIt is presented the case report of a patient that suffers from recurrent episodes of hypersomnia associated with hyperphagia and abnormal behavior.ElectroencephalographyEEG demonstrates slowing of drowsiness and a decrease in REM sleep. The test of multiple sleep latency is abnormal and the rest of complementary test are normal.DiagnosisF51.1 Recurrent hypersomnia (Kleine-Levin syndrome) [307.44].DiscussionKleine-Levin syndrome is an intriguing, severe and homogenous disease with no obvious cause or treatment. Treatment is generally supportive. It should be considered in any teenager presenting with recurrent episodes of hypersomnia concurrent with cognitive changes or disinhibition.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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