Adolescent ; Humans ; Male ; Parasomnias

Parasomnias are characterized by undesirable physical events or experiences during sleep. They occur alone or combined with other parasomnias. Parasomnias in childhood are more common than those of adulthood. Most of them are mild, benign and self remitted. Careful history takings from the patients and their parents, videotaped recordings of the episodes are invaluable to diagnose parasomnias. Sometimes polysomnographic recordings are helpful to differentiate ambiguous conditions and to diagnose comorbid conditions. Even many parasomnias do not need treatment, some conditions need therapeutic interventions. Medication, cognitive behavioral treatment, biofeedback, and oral appliance are helpful to reduce frequency and complexity of certain kinds of parasomnias.
Biofeedback, Psychology ; Humans ; Parasomnias* ; Parents

Parasomnias are characterized by undesirable physical events or experiences during sleep. They occur alone or combined with other parasomnias. Parasomnias in childhood are more common than those of adulthood. Most of them are mild, benign and self remitted. Careful history takings from the patients and their parents, videotaped recordings of the episodes are invaluable to diagnose parasomnias. Sometimes polysomnographic recordings are helpful to differentiate ambiguous conditions and to diagnose comorbid conditions. Even many parasomnias do not need treatment, some conditions need therapeutic interventions. Medication, cognitive behavioral treatment, biofeedback, and oral appliance are helpful to reduce frequency and complexity of certain kinds of parasomnias.
Biofeedback, Psychology ; Humans ; Parasomnias* ; Parents

Adult ; Female ; Humans ; Parasomnias ; Polysomnography

Parasomnias induced by hypnosedatives are rare but serious side effect. Such parasomnias have not been reported with all hypnosedatives. However, frequent use of hypnosedatives, particularly nonbenzodiazepine receptor agonists is associated with parasomnias. Associated symptoms are sleep eating, sleepwalking with object manipulation, sleep conversations, sleep driving, sleep sex and sleep shopping etc. Mechanisms include high affinity for GABAA receptor, interruption of the consolidation phase of memory formation by drug, pharmacokinetic or pharmacodynamic drug-drug interaction and concomitant administration with alcohol. Managements for parasomnias induced by hypnosedatives involve stopping medication, switch to other medications or nonpharmacological treatment, lowest effective dose of NBRAs (Non-Benzodiazepine Receptor Agonists), taking into consideration drug-drug interactions, identification and treatment of underlying disease states.
Eating ; Hypnotics and Sedatives ; Memory ; Parasomnias ; Somnambulism

Sleep-related behaviors observed in parasomnias can result in serious injuries of patients and/or spouses. Parasomnia is defined as undesirable physical or behavioral phenomenon occurring during sleep. If these disorders are accurately diagnosed, effective treatments are available. Often, these disorders can be even cured. Environmental management for patient and/or spouse safety and good sleep hygiene are the most recommended for individuals behaving abnormally during sleep. The aim of this article is to review the clinical features, diagnosis and treatment of several sleep-related behavior disorders.
Diagnosis ; Humans ; Hygiene ; Mental Disorders ; Parasomnias ; Spouses

Exploding head syndrome (EHS) is characterized by a sudden loud imagined noise or sense of a violent explosion in the head occurring as the patient is falling asleep or waking during the night. EHS is classified as "other parasomnia" on the ICSD-2 (International Classification of Sleep Disorders), and the neurophysiologic mechanisms underlying this hypnagogic phenomenon are unknown. EHS is a rare type of other parasomnia that has not been reported in Korea. We report two cases of EHS that presented with typical clinical symptoms.
Explosions ; Head ; Humans ; Korea ; Noise ; Parasomnias

This review describes the wide spectrum of paroxysmal events during sleep in infancy and childhood. The differential diagnosis between sleep-related non-epileptic paroxysmal events and epileptic seizures is difficult in special occasions. The nocturnal frontal lobe seizure and of the more common non- epileptic paroxysmal events during sleep are described. The main differentiating features characterizing parasomnias are: onset in early childhood, rare episodes of long duration, relatively lower frequency per night, absence of stereotypy, gradual disappearance of older age. Video-polysomnography is the gold standard to diagnosing and differentiating parasomnias from nocturnal frontal lobe seizures.
Diagnosis, Differential ; Epilepsy* ; Frontal Lobe ; Night Terrors ; Parasomnias ; Seizures

INTRODUCTION: In a subset of adults with non-rapid eye movement (NREM) parasomnias, clinical variants might be violent in nature and can potentially result in unintentional but considerable harm. As such, there is substantial interest on the forensic ramifications of these sleep behaviours. METHODS: This review examined the diagnostic criteria for parasomnias established in the context of international classification systems; medicolegal case reports; legal frameworks; and court cases in and outside of Singapore, to provide an overview of the implications of NREM parasomnias. RESULTS: Violent or injurious behaviours that occurred in the context of somnambulism, otherwise known as sleepwalking, have challenged traditional legal theories of criminal culpability. Yet little has changed in the application of sleep science to criminal responsibility. In Singapore, the defence of somnambulism has hitherto not been directly raised. Nonetheless, sleep medicine practitioners may increasingly be requested to render their opinions on legal issues pertaining to violent or injurious behaviours allegedly arising during sleep. Although the understanding of NREM parasomnias has improved, there is still a dearth of evidence to support both medical and legal decisions in this area. CONCLUSION NREM parasomnias come with disquieting legal and forensic implications for adjudicating criminal responsibility. There is a need to critically examine legal perspectives on behaviours occurring during sleep. More reliable empirical studies investigating the pathophysiology of NREM parasomnias can offer clearer diagnostic guidelines and address complex behaviours of NREM that often come with medicolegal implications.
Adult ; Humans ; Parasomnias/diagnosis* ; Singapore ; Sleep/physiology* ; Somnambulism/diagnosis*

It is a significant challenge for the clinician to make distinction between nocturnal epilepsy form non-epileptic sleep disorders. Although in some patients, diagnosis is easy to achieve but sometimes not. At times even with help of polysomnogram and electroencephalogram, diagnostic confusion remains. We present two cases of nocturnal paroaxysmal events, which still need elucidate diagnosis.
Diagnosis ; Electroencephalography ; Epilepsy ; Humans ; Motor Activity* ; Parasomnias ; Polysomnography ; Seizures ; Sleep Wake Disorders