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  • Print publication year: 2010
  • Online publication date: November 2010

Case 33 - A child with behavioral problems and violent sleep behavior leading to trauma

from Part VII - Sleep-related movement disorders

Summary

Sleep-related eating disorder (SRED) is a parasomnia that arises primarily from NREM sleep with recurrent episodes of involuntary eating and drinking. This chapter discusses the case of a 32-year-old woman who presented with sleep-related eating episodes, who also had difficulty with sleep initiation insomnia, somnambulism, somniloquy and symptoms of restless legs syndrome (RLS) since she was 6 years old. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Overnight diagnostic polysomnography (PSG) was performed. Based on the PSG results, a diagnosis of SRED was made. Complications include obesity, injuries, toxic ingestions and psychological distress with excessive weight gain. Treatment of the underlying sleep disorder, if present, is usually effective. Underlying mood disorder or alcohol or substance abuse should be addressed. Pharmacotherapy consists of administration of antidepressants (e.g. SSRIs), dopaminergic agonists or topiramate.

Suggested reading

Review
DykenME, Lin-DykenDC, YamadaT.Diagnosing rhythmic movement disorder with video-polysomnography. Pediatr Neurol 1997; 16: 37–41.
General
AASM (American Academy of Sleep Medicine). International Classification of Sleep Disorders, 2nd edn.: Diagnostic and Coding Manual. Westchester, Illinois: American Academy of Sleep Medicine, 2005.
ASDA (American Sleep Disorders Association). International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Rochester, Minnesota: American Sleep Disorders Association, 1997.
EtzioniT, KatzN, HeringE, et al. Controlled sleep restriction for rhythmic movement disorder. J Pediatr 2005; 3: 393–5.
GharagozlouP, SeyffertM, SantosR, et al. Rhythmic movement disorder associated with respiratory arousals and improved by CPAP titration in a patient with restless legs syndrome and sleep apnea. Sleep Med 2009; 4: 501–3.

Review

DykenME, Lin-DykenDC, YamadaT.Diagnosing rhythmic movement disorder with video-polysomnography. Pediatr Neurol 1997; 16: 37–41.

General

AASM (American Academy of Sleep Medicine). International Classification of Sleep Disorders, 2nd edn.: Diagnostic and Coding Manual. Westchester, Illinois: American Academy of Sleep Medicine, 2005.
ASDA (American Sleep Disorders Association). International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. Rochester, Minnesota: American Sleep Disorders Association, 1997.
EtzioniT, KatzN, HeringE, et al. Controlled sleep restriction for rhythmic movement disorder. J Pediatr 2005; 3: 393–5.
GharagozlouP, SeyffertM, SantosR, et al. Rhythmic movement disorder associated with respiratory arousals and improved by CPAP titration in a patient with restless legs syndrome and sleep apnea. Sleep Med 2009; 4: 501–3.