Skip to main content Accessibility help
×
Home
  • Print publication year: 2008
  • Online publication date: August 2009

9 - Sleep and neurologic disorders

from SECTION 3 - SLEEP IN SPECIALTY AREAS

Summary

Introduction

Sleep is a complex and colorful phenomenon, driven by different activities of the brain. Dysfunctions of the brain can change wakefulness and sleep and cause various sleep disorders. The details of these sleep disorders depend on the localization of the damage in the brain or other parts of the central nervous system. Almost every neurological disease is associated with sleep disorders. This chapter describes only a small selection of neurological diseases, those which are most strongly associated with sleep disorders.

Sleep and Parkinson's disease

The prevalence of sleep disorders in Parkinson's disease (PD) is estimated to be as high as 74–81%. Polygraphic sleep recordings in people with PD found decreased sleep efficiency, increased wake after sleep onset, and sleep fragmentation. Up to 80% of those with PD report having 2–5 awakenings per night. Sleep disorders in PD may be based on the neurodegenerative process, or they may result from nocturnal bradykinesia and rigidity, medication, psychiatric disorders, circadian rhythm disturbance, or REM sleep behavior disorder (RBD).

Parkinson's disease and sleep-disordered breathing

Sleep breathing disorders are common in PD. About half of all individuals with PD show obstructive sleep-disordered breathing. Rigidity, diaphragmatic dyskinesias, failure of autonomic control, and disorder of the mechanisms of breathing control can reduce the function of respiratory muscles and thus cause a restrictive respiratory dysfunction. Furthermore, abnormal movement in glottic or supraglottic structures, for example tremor-like oscillations and stridor during dystonic episodes, can cause intermittent closure of the upper airway.

FURTHER READING
Attarian, HP, Brown, KM, Duntley, SP, Carter, JD, Cross, AH. The relationship of sleep disturbances and fatigue in multiple sclerosis. Arch Neurol 2004; 61:525–8.
Bourke, SC, Gibson, GJ. Sleep and breathing in neuromuscular disease. Eur Resp J 2002; 19: 1194–201.
Clarenbach, P, Wessendorf, T. Sleep and stroke. Rev Neurol 2001; 157:46–52.
Simone, R, Marano, E, Ranieri, A, Bonavita, V. Hypnic headache: an update. Neurol Sci 2006; 27 (Suppl 2):S144–8.
Eisensehr, I, Noachtar, S. Haematological aspects of obstructive sleep apnoea. Sleep Med Rev 2001; 5:207–21.
Eisensehr, I, Schmidt, D. Epilepsy and sleep disorders. MMW Fortschr Med 2005; 147:54–7.
Eisensehr, I, Ehrenberg, BL, Noachtar, S, et al. Platelet activation, epinephrine, and blood pressure in obstructive sleep apnea syndrome. Neurology 1998; 51:188–95.
Eisensehr, I, Linke, R, Noachtar, S, et al. Reduced striatal dopamine transporters in idiopathic rapid eye movement sleep behaviour disorder: comparison with Parkinson's disease and controls. Brain 2000; 123:1155–60.
Eisensehr, I, Noachtar, S, Schlippenbach, C, et al. Hypersomnia associated with bilateral posterior hypothalamic lesion: a polysomnographic case study. Eur Neurol 2003; 49:169–72.
Fleming, WE, Pollak, CP. Sleep disorders in multiple sclerosis. Semin Neurol 2005; 25:64–8.
Garcia-Borreguiro, D, Larrosa, O, Bravo, M. Parkinson's disease and sleep. Sleep Med Rev 2003; 7:115–30.
Kaynak, H, Altintas, A, Kaynak, D, et al. Fatigue and sleep disturbance in multiple sclerosis. Eur J Neurol 2006; 13:1333–9.
Malow, BA, Bowes, RJ, Ross, D. Relationship of temporal lobe seizures to sleep and arousal: a combined scalp-intracranial electrode study. Sleep 2000; 23:231–4.
Marrie, RA, Fisher, E, Miller, DM, Lee, JC, Rudick, RA. Association of fatigue and brain atrophy in multiple sclerosis. J Neurol Sci 2005; 228:161–6.
Moldofsky, H. Sleep and pain. Sleep Med Rev 2001; 5:387–98.
Neau, JP, Paquereau, J, Meurice, JC, Chavagnat, JJ, Gil, R. Stroke and sleep apnoea: cause or consequence?Sleep Med Rev 2002; 6:457–70.
Rains, JC, Poceta, JS. Headache and sleep disorders: review and clinical implications for headache management. Headache 2006; 46:1344–63.
Schenck, CH, Callies, AL, Mahowald, MW. Increased percentage of slow-wave sleep in REM sleep behavior disorder (RBD): a reanalysis of previously published data from a controlled study of RBD reported in SLEEP. Sleep 2003; 26:1066–7.