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Clinical neurophysiology of NREM parasomnias.
Handb Clin Neurol 2019; 161:397-410HC

Abstract

The nonrapid eye movement (NREM) parasomnias range from age-related developmental phenomena in children to aggressive and injurious motor behaviors in all age groups. These parasomnias are commonly referred to as disorders of arousal and are an important cause of sleep-related injury. Genetic predisposition plays a role in the disorders of arousal, most evident in sleepwalking. Important concepts guiding our current understanding of the pathophysiology of the NREM parasomnias include sleep state instability (a propensity for arousal during NREM sleep), sleep inertia (incomplete awakening from NREM sleep), state dissociation (an ability to simultaneously straddle both NREM sleep and wakefulness), and activation of central pattern generators (permitting expression of subcortically determined motor behaviors without conscious higher cortical input). Management is multifaceted with an emphasis on education and nonpharmacologic measures. The purpose of this chapter is to review wake and NREM neurobiology and update our current understanding of NREM parasomnia pathophysiology, epidemiology, genetics, clinical features, precipitating factors, neurophysiologic evaluation, diagnosis, and clinical management.

Authors+Show Affiliations

Cleveland Clinic Sleep Disorders Center, Neurological Institute, Cleveland, OH, United States. Electronic address: rodrigc2@ccf.org.Cleveland Clinic Sleep Disorders Center, Neurological Institute, Cleveland, OH, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31307616

Citation

Rodriguez, Carlos L., and Nancy Foldvary-Schaefer. "Clinical Neurophysiology of NREM Parasomnias." Handbook of Clinical Neurology, vol. 161, 2019, pp. 397-410.
Rodriguez CL, Foldvary-Schaefer N. Clinical neurophysiology of NREM parasomnias. Handb Clin Neurol. 2019;161:397-410.
Rodriguez, C. L., & Foldvary-Schaefer, N. (2019). Clinical neurophysiology of NREM parasomnias. Handbook of Clinical Neurology, 161, pp. 397-410. doi:10.1016/B978-0-444-64142-7.00063-1.
Rodriguez CL, Foldvary-Schaefer N. Clinical Neurophysiology of NREM Parasomnias. Handb Clin Neurol. 2019;161:397-410. PubMed PMID: 31307616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical neurophysiology of NREM parasomnias. AU - Rodriguez,Carlos L, AU - Foldvary-Schaefer,Nancy, PY - 2019/7/17/entrez KW - Confusional arousal KW - Disorders of arousal KW - NREM parasomnias KW - Sexsomnia KW - Sleep terror KW - Sleep-related abnormal sexual behavior KW - Sleep-related eating disorder KW - Sleepwalking SP - 397 EP - 410 JF - Handbook of clinical neurology JO - Handb Clin Neurol VL - 161 N2 - The nonrapid eye movement (NREM) parasomnias range from age-related developmental phenomena in children to aggressive and injurious motor behaviors in all age groups. These parasomnias are commonly referred to as disorders of arousal and are an important cause of sleep-related injury. Genetic predisposition plays a role in the disorders of arousal, most evident in sleepwalking. Important concepts guiding our current understanding of the pathophysiology of the NREM parasomnias include sleep state instability (a propensity for arousal during NREM sleep), sleep inertia (incomplete awakening from NREM sleep), state dissociation (an ability to simultaneously straddle both NREM sleep and wakefulness), and activation of central pattern generators (permitting expression of subcortically determined motor behaviors without conscious higher cortical input). Management is multifaceted with an emphasis on education and nonpharmacologic measures. The purpose of this chapter is to review wake and NREM neurobiology and update our current understanding of NREM parasomnia pathophysiology, epidemiology, genetics, clinical features, precipitating factors, neurophysiologic evaluation, diagnosis, and clinical management. SN - 0072-9752 UR - https://www.unboundmedicine.com/medline/citation/31307616/Clinical_neurophysiology_of_NREM_parasomnias L2 - https://linkinghub.elsevier.com/retrieve/pii/B978-0-444-64142-7.00063-1 DB - PRIME DP - Unbound Medicine ER -