Sleep and Neuropsychiatric Disorders

Preface
Acknowledgements
Contents
About the Editors
Part I: Basic Sciences
1: Physiology of Normal Sleep
1.1 Introduction
1.2 Changes of Central and Peripheral Functions Across the Sleep/Wake Behavioral State
1.3 Brain Regions and Neurotransmitter Systems Involved in the Regulation of the Behavioral State
1.4 Wakefulness-Promoting Neurotransmitters
1.4.1 Serotonin
1.4.2 Norepinephrine
1.4.3 Dopamine
1.4.4 Histamine
1.4.5 Acetylcholine
1.4.6 Orexin
1.5 Sleep-Promoting Neurotransmitters
1.5.1 Upsi-Aminobutyric Acid
1.5.2 Melanin-Concentrating Hormone
1.5.3 Melatonin and Circulating Factors
1.5.4 Human Circadian Timing System
1.5.5 The Two-Process Model of Sleep Regulation
1.5.6 Polysomnography
1.6 Conclusions
Glossary
References
2: Why Sleep Is Altered Across a Wide Range of Neuropsychiatric Disorders (NPD)?
2.1 Introduction
2.2 Shared Genetics
2.3 Neurobiological Underpinnings Are Common to Both Sleep and Psychiatric Disorders
2.3.1 Role of Neurotransmitters-Dopamine
2.3.2 Role of Neurochemicals-BDNF
2.3.3 Role of Amygdala
2.3.4 Interhemispheric Functional Connectivity
2.3.5 Role of the DMN
2.4 Role of Circadian Rhythm in Sleep and Psychiatric Disorders
2.4.1 Role of Circadian Profile
2.4.2 Common Neurotransmitters and Pathways Underlying Circadian Processes and Psychiatric Disorders
2.4.3 Circadian Gene Variations Associated with Psychiatric Disorders
2.5 Role of Stress as Modulator of Zeitgebers
2.6 Behavioral Correlates of Psychiatric Disorders Impacting Sleep
2.7 Role of Psychotropic Medications
2.7.1 Sedative Hypnotics
2.7.2 Antidepressants
2.7.3 Antipsychotics
2.7.4 Other Psychotropics
2.8 Sleep Disorders Masquerading as Psychiatric Illnesses
2.9 Summary and Conclusion
References
3: Biological Rhythm and Neuropsychiatric Disorders
3.1 Concept of Biological Rhythm
3.2 Human Circadian Rhythm-Concept of Central and Peripheral Clocks
3.3 Anatomy and Physiology of Mammalian Circadian Rhythm and Effect of Its Interaction on Other Body Functions
3.3.1 Role of Melatonin
3.3.2 Role of Corticosteroids
3.3.3 Molecular Mechanism of SCN
3.4 Chronobiological Basis of Neuropsychiatric Disorders
3.4.1 Role of Social Rhythm and Its Association with Neuropsychiatric Disorders
3.4.2 Circadian Rhythm Disruption in Neuropsychiatric Disorders
3.4.3 Probable Mechanism of Circadian Disruption and Neuropsychiatric Disorders
References
4: Neurophysiology of Dreams
4.1 Functional Neuroimaging
4.2 Neurotransmitters of Dream Generation
4.2.1 Acetylcholine
4.2.2 Dopamine
4.2.3 Serotonin
4.3 A Descriptive Neural Model of Dream Phenomenology and Function
4.4 Areas 1 and 2: Ascending Arousal Systems
4.5 Area 3: Limbic Areas
4.5.1 Emotional Regulation and Dreaming
4.5.2 Differential Processing of Episodic and Declarative Memory
4.6 Area 4: Dorsolateral Prefrontal Executive Control Cortex
4.7 Area 5: Basal Ganglia
4.8 Areas 6 and 11: Thalamocortical Relay Centers and Thalamic Subcortical Circuitry
4.9 Area 9: Inferior Parietal Lobe
4.10 Area 11: Visual Association Cortex
4.11 Summary
4.12 Future Aspects
References
5: Dream Consciousness and the Brain: Relevance to Psychopathology
5.1 Introduction
5.2 Sleep and Dreaming in Psychotic Disorders
5.3 Consciousness in Dreams and Psychosis
5.3.1 The Phenomenological Overlap Across Mental States
5.3.2 Frontal Brain Activity and Insight during Dreams and Psychosis
5.4 Dreaming in Patients with Complex Mental Disorders
5.4.1 Measuring Dream Recall Frequency
5.4.2 Content Analysis of Dreams
5.4.3 Formal Analysis of Dreams
5.4.4 Methodological Considerations
5.5 Conclusive Remarks
References
6: Sleepiness, Fatigue, and Sleep Disorders
6.1 Introduction
6.2 Sleepiness
6.2.1 What Is Sleepiness?
6.3 Epidemiology
6.4 Etiology
6.5 Measuring Sleepiness
6.6 Subjective Sleepiness Measures
6.6.1 Sleep Diaries
6.6.2 Epworth Sleepiness Scale (ESS)
6.6.3 Stanford Sleepiness Scale (SSS)
6.6.4 Pittsburgh Sleep Quality Index (PSQI)
6.6.5 Functional Outcomes of Sleep Questionnaire 10 (FOSQ-10)
6.6.6 Time of Day Sleepiness Scale (ToDSS)
6.6.7 Horne and Östberg Morningness-Eveningness Questionnaire (MEQ)
6.6.8 Sleepiness-Wakefulness Inability and Fatigue Test (SWIFT)
6.6.9 Visual Analogue Scale (VAS)
6.6.10 Karolinska Sleepiness Scale (KSS)
6.7 Clinical History
6.8 Objective Sleepiness Measures
6.8.1 Multiple Sleep Latency Test (MSLT)
6.8.2 Maintenance of Wakefulness Test (MWT)
6.8.3 Polysomnography (PSG)
6.8.4 Vigilance Testing
6.8.5 Oxford Sleepiness Resistance (OSleR) Test
6.8.6 Pupillometry
6.8.7 Actigraphy
6.9 Causes of Sleepiness
6.9.1 Obstructive Sleep Apnea (OSA)/Sleep-Disordered Breathing (SDB)
6.9.2 Hypersomnia
6.9.2.1 Narcolepsy Type I (with Cataplexy) and Type II (without Cataplexy)
6.9.2.2 Idiopathic Hypersomnia (IH)
6.9.2.3 Circadian Rhythm Disorders (CRD)
6.9.2.4 Insufficient Sleep Syndrome
6.9.3 Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD)
6.9.4 Other Untreated Medical Disorders
6.9.5 Sedating Medications
6.9.6 Important Note About Insomnia
6.10 Consequences of Sleepiness
6.10.1 Fatigue
6.10.2 Cognitive Dysfunction
6.10.3 Mood Disturbances
6.10.4 Performance Impairments (Home, Work, School, Etc.)
6.10.5 Safety Behaviors and Social Impact
6.10.6 Driving Safety/Operating Heavy Machinery Safety
6.11 Interventions and Management of Sleepiness
6.11.1 Pharmacological Management
6.11.2 Non-pharmacological/Behavioral Management
6.11.2.1 Bright Light Exposure
6.11.2.2 Scheduled Naps
6.11.2.3 Caffeine
6.11.2.4 Schedule Regularization
6.11.2.5 Extended Nocturnal Sleep Periods
6.12 Fatigue
6.12.1 What Is Fatigue?
6.13 Epidemiology
6.14 Etiology
6.15 Measuring Fatigue
6.15.1 Subjective Fatigue Measures (Table 6.4)
6.15.1.1 Sleep Diaries
6.15.1.2 Epworth Sleepiness Scale (ESS)
6.15.1.3 The Fatigue Questionnaire (FQ)
6.15.1.4 Fatigue Severity Scale (FSS)
6.15.1.5 Multidimensional Assessment of Fatigue (MAF) Scale
6.15.1.6 The Vitality Subscale (Energy/Fatigue) of the Short-Form Health Survey (SF-36)
6.15.1.7 Visual Analogue Scale to Evaluate Fatigue Severity (VAS-F)
6.16 Clinical History
6.16.1 Objective Fatigue Measures (Table 6.5)
6.16.1.1 Laboratory Evaluations/Blood Work
6.16.1.2 Polysomnography (PSG)
6.16.1.3 Actigraphy
6.16.1.4 Vigilance Testing
6.16.1.5 Electroencephalogram (EEG)
6.16.1.6 Neuroimaging
6.16.1.7 Other Studies and Evaluations
6.17 Causes of Fatigue (Table 6.6)
6.17.1 Insomnia Disorder
6.17.2 Obstructive Sleep Apnea (OSA)/Sleep-Disordered Breathing (SDB)
6.17.3 Hypersomnia
6.17.4 Circadian Rhythm Disorders (CRD)
6.17.5 Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD)
6.17.6 Psychiatric Disorders
6.17.7 Other Medical Conditions
6.17.8 Fatigue Syndromes
6.17.9 Other Potential Causes
6.18 Consequences of Fatigue
6.18.1 Reduced Quality of Life
6.18.2 Poor Sleep Quality
6.18.3 Cognitive Deficits
6.18.4 Performance Impairments
6.18.5 Safety Behaviors
6.18.6 Mood Disturbances
6.19 Interventions and Management of Fatigue
6.19.1 Pharmacological Management
6.19.2 Non-pharmacological/Behavioral Management
6.19.2.1 Healthy Sleep Practices (a.k.a. Sleep Hygiene)
6.19.2.2 Schedule Regularization
6.19.3 Bright Light Exposure
6.19.4 Increasing Physical, Social, and Pleasant Activity
6.20 Summary
References
7: Health Economics of Sleep Disorders
7.1 Introduction to Health Economics
7.1.1 Defining Key Outcomes: Health Economic Perspectives in Sleep Medicine
7.2 Measurement Matters: Costs Framework for Sleep Disorders
7.2.1 Direct and Indirect Costs
7.3 Health-Related Quality of Life (HRQoL) as a Measure of Morbidity
7.4 Quality-Adjusted Life Years (QALYs)
7.5 Monetizing QALYs: Cost-Effectiveness
7.6 Economic Aspects of Sleep Disorders and Their Treatments
7.7 The Direct Pathway
7.7.1 Obstructive Sleep Apnea (OSA)
7.7.1.1 Costs of Untreated OSA
7.7.1.2 Costs Associated with OSA Testing and Treatment
7.7.2 Insomnia
7.7.2.1 Cost of Untreated Insomnia
7.7.2.2 Insomnia Treatment Options and Their Costs
Pharmacotherapy
Behavioral Treatments
7.7.3 Restless Leg Syndrome
7.7.4 Narcolepsy
7.7.5 Shiftwork
7.7.6 Jetlag
7.8 The Indirect Pathway
7.8.1 The Economics as Sleep as a Comorbidity
7.8.1.1 OSA
7.8.1.2 Insomnia
7.8.1.3 Narcolepsy
7.8.2 The Economics of Sleep in the Workplace Productivity
7.8.2.1 OSA
7.8.2.2 Insomnia
7.8.2.3 Narcolepsy
7.8.3 The Economic Impact of Sleep on Accidents and Injuries
7.8.3.1 OSA
7.8.3.2 Insomnia
7.8.3.3 Insufficient Sleep and Fatigue
7.9 The Impact of Sleep on Health-Related Quality of Life
7.9.1 OSA
7.9.2 Insomnia
7.9.3 Other Sleep Disorders
7.10 Sleep and Social Disparities
7.11 Conclusions and Future Directions
References
8: Approach to Sleep Complaints
8.1 Physical Examination
8.2 Laboratory Tests [4]
8.3 Imaging Tests [4]
8.4 Sleep Diary [5]
8.5 Questionnaires [5]
8.6 Home Sleep Apnea Test (HSAT)
8.7 In-Laboratory, Attended Polysomnography (PSG) [6]
8.8 Multiple Sleep Latency Test (MSLT) [7-9]
8.9 Maintenance of Wakefulness Test (MWT) [7]
8.10 Actigraphy [10-12]
8.11 Dim Light Melatonin Onset (DLMO) Secretion Test [13-15]
8.12 Conclusion
References
9: Questionnaires for Screening of Sleep Disorders
Appendix
The Epworth Sleepiness Scale (ESS)
The Fatigue Severity Scale (FSS)
ZOGIM-A Questionnaire
Morningness-Eveningness Questionnaire (Owl-Lark Self-Test)
Non-restorative Sleep Scale
Athens Insomnia Scale
STOP-Bang
The Restless legs Questionnaire
Cataplexy Questionnaire
Center for Epidemiological Studies Depression Scale (CES-D) Questionnaire
Zung Self-Rating Anxiety Scale (SAS)
Illness Intrusiveness Scale
References
10: Methods of Evaluation of Sleep Disorders
10.1 Common Diagnoses
10.1.1 Obstructive Sleep Apnea (OSA)
10.1.2 Narcolepsy
10.1.3 Circadian Rhythm Disorder
10.1.4 Mood Disorder
10.1.5 Insomnia
10.1.6 Parasomnia/Non-rapid Eye Movement (NREM) Sleep Arousal Disorder
10.1.7 Sleep History
10.2 Physical Examination
10.3 Mental Status Examination and Neurological Examination
10.4 Investigations
10.4.1 Polysomnography (PSG)
10.4.2 Home Study
10.4.3 DLMO (Dim Light Melatonin Onset) Test
10.4.4 MSLT (Multiple Sleep Latency Test)
10.4.5 MWT (Maintenance of Wakefulness Test)
10.4.6 Actigraphy
10.5 Sleep Diary
10.6 Other Assessment Modalities
10.7 Summary
References
Part II: Behavioral Presentations of Sleep Disorders
11: Behavioral Presentations of Insomnia
11.1 Daytime Sequelae of Insomnia
11.2 Cognitive Effects of Insomnia
11.3 Differential Diagnosis
11.3.1 Chronic Insomnia Disorder
11.3.2 Short-term Insomnia Disorder and Other Insomnia Disorder
11.4 Assessment
11.5 3P Model of Insomnia
11.6 Treatment
11.6.1 Stimulus Control
11.6.2 Sleep Restriction Therapy
11.6.3 Cognitive Therapy
11.6.4 Sleep Hygiene
11.6.5 Relaxation
11.6.6 CBT-I and Improvement in Daytime Symptoms
11.7 Conclusion
References
12: Behavioral Presentations of Sleep-Related Breathing Disorders
12.1 Introduction
12.2 Assessment of OSA
12.3 Management of OSA
12.4 OSA and Emotional Regulation
12.5 OSA and Depression
12.6 Effect of OSA Management on Mood Symptoms
12.7 OSA and Panic Disorder
12.8 OSA and Post-traumatic Stress Disorder
12.9 OSA and Nightmares
12.10 OSA and Parasomnias
12.11 OSA and Cognition
12.12 Neuroimaging and Behavioral Changes in OSA
12.13 OSA and Attention Deficit Hyperactivity Disorder
12.14 OSA and Personality Type
12.15 OSA and Behavioral Presentations in Children
12.16 Conclusion
References
13: Behavioral Presentations of Central Disorders of Hypersomnolence
13.1 Narcolepsy
13.2 Idiopathic Hypersomnia
13.3 Kleine-Levin Syndrome
13.4 Hypersomnia Due to a Medical Disorder
13.5 Hypersomnia Due to a Medication or Substance
13.6 Hypersomnia Associated with a Psychiatric Disorder
13.7 Insufficient Sleep Syndrome
13.8 Evaluation of Excessive Daytime Sleepiness
13.9 Cognitive Dysfunction in Central Disorders of Hypersomnolence
13.10 Conclusion
References
14: Behavioral Presentations of Circadian Rhythm Sleep Disorders
14.1 Introduction
14.2 Assessment and Measurements of CRSD
14.2.1 Sleep Logs/Diaries
14.2.2 Actigraphy-Watch Monitoring
14.2.3 Questionnaire
14.2.4 Patient´s Medical History by Physicians
14.3 Risk Factors of CRSD
14.3.1 Head Trauma
14.3.2 Age
14.3.3 Gender
14.3.4 Drugs Side-Effect
14.3.5 Exposure to Artificial Light at Night (ALAN)
14.4 Advanced Sleep Wake Phase Disorder (ASWPD)
14.5 Delayed Sleep Wake Phase Disorder (DSWPD)
14.6 Irregular Sleep-Wake Rhythm (ISWR)
14.7 Non-24h Sleep Wake Rhythm Disorder (NSWRD)
14.8 Shift Work Disorder (SWD)
14.9 Jet Lag Disorder (JLD)
14.10 Types of Treatment for CRSD
14.10.1 Light Therapy
14.10.2 Melatonin Treatment
14.11 Psychological, Behavioral, and Cognitive Consequences of CRSD
14.11.1 Psychological and Emotional Aspects
14.11.2 Attentional, Memory, and Cognitive Performance
14.11.3 Behavioral and Physical Activity and CRSD
14.12 Conclusion
References
15: Behavioral Presentations of Parasomnias
15.1 Introduction
15.2 History and Examination
15.3 Differentiating Nocturnal Seizures from Parasomnias:
15.4 What Is Sleep-Related Hypermotor Epilepsy (SHE)?
15.5 NREM Parasomnias (Disorders of Arousals)
15.5.1 Confusional Arousal
15.5.2 Sleep Walking
15.5.3 Sleep Terrors
15.6 Epidemiology and Pathogenesis of Disorders of Arousal
15.7 Onset, Course, and Complications
15.7.1 Sleep-Related Eating Disorder
15.8 Parasomnia Overlap Disorder
15.9 REM-Related Parasomnias
15.9.1 REM Sleep Behavior Disorder (RBD)
15.9.2 Recurrent Isolated Sleep Paralysis
15.10 Nightmare Disorder
15.10.1 Exploding Head Syndrome (Sensory Sleep Starts, Sensory Sleep Shocks)
15.10.2 Sleep Enuresis
15.11 Conclusion
References
16: Behavioral Presentation of Sleep-Related Motor Disorders
16.1 Introduction
16.2 Behavioral Presentations of RLS
16.2.1 RLS and Depression
16.2.2 RLS and Anxiety Disorder
16.2.3 RLS and Schizophrenia
16.2.4 RLS and ADHD
16.2.5 RLS and Tourette´s Syndrome
16.2.6 RLS and Impulse Control Disorder (ICD)
16.3 Behavioral Presentation of PLMD
16.4 Behavioral Presentation of Sleep-Related Bruxism
16.4.1 Sleep Bruxism and Depression
16.4.2 Sleep Bruxism and Anxiety Disorder
16.4.3 Sleep Bruxism and Perceived Stress
16.4.4 Sleep Bruxism and Psychopathological Factors in General
16.4.5 Sleep Bruxism and Quality of Life
16.4.6 Sleep Bruxism and Circadian Rhythm
16.5 Behavioral Presentation of Sleep-Related Rhythmic Movement Disorders
16.6 Conclusion
References
Part III: Sleep Disorders and Psychiatric Disorders
17: Sleep in Depression
17.1 Introduction
17.2 Epidemiologic Studies of Insomnia and Depression
17.3 Residual Insomnia Following Antidepressant Therapy
17.4 Hypersomnia and Depression
17.5 EEG and Polysomnographic Studies of Sleep in Depressed Patients
17.6 Sleep and Antidepressant Treatment
17.7 Sleep, Insomnia, and Suicide
17.8 Conclusions
References
18: Sleep and Perinatal Depression
18.1 Introduction on Perinatal Depression
18.2 Sleep and Pregnancy
18.3 Sleep Disorders During Pregnancy
18.3.1 Sleep-Related Breathing Disorders (SRBDs)
18.3.2 Restless Legs Syndrome
18.3.3 Insomnia
18.3.4 Circadian Rhythm Sleep Disorders During Pregnancy
18.4 The Relationship Between Sleep Disturbances and Perinatal Depression
18.5 Sleep Loss and Puerperal Psychosis
18.6 Routine Monitoring and Treatment
References
19: Sleep in Bipolar Disorders
19.1 Introduction
19.2 Sleep Disorders in BPAD
19.2.1 Sleep Disorders in Adults with BPAD
19.2.2 Sleep Disorders in Child and Adolescent with BPAD
19.3 Pathophysiology
19.3.1 Circadian Rhythm Dysfunctions
19.3.2 Role of CLOCK Genes
19.3.3 Chronotype
19.4 Effects of Sleep Disorder in BPAD
19.4.1 Contribution to Relapse
19.4.2 Role in Affective Regulation
19.4.3 Role in Cognitive Functioning
19.4.4 Role in Obesity
19.4.5 Substance Use Disorders
19.5 Effects of BPAD on Sleep Disorders
19.5.1 Obstructive Sleep Apnea
19.5.2 Hypersomnia
19.5.3 Insomnia
19.6 Bidirectionality in Relation Between Sleep Disorders and BPAD
19.7 Approach to Assessing Sleep Disturbance in BPAD
19.7.1 Investigations
19.7.1.1 Sleep Diary
19.7.1.2 Polysomnography
19.7.1.3 Actigraphy
19.8 Management of Sleep Disorder in BPAD
19.8.1 Non-pharmacological Management
19.8.1.1 Education for Sleep and Circadian Rhythm
19.8.1.2 Components of Behavioral Modification
19.8.1.3 Cognitive Components
19.8.1.4 Relapse Prevention
19.8.2 Other Non-pharmacological Methods
19.8.3 Pharmacological Management of Sleep Disorders in BPAD
19.8.4 Other Novel or Miscellaneous Management Techniques
19.9 Conclusion
References
20: Sleep in Schizophrenia
20.1 Introduction
20.2 Characteristics of Sleep Disturbances in Schizophrenia
20.2.1 Subjective Sleep
20.2.2 Sleep Macrostructure
20.2.3 Sleep Microstructure
20.2.3.1 Reduced Sleep Spindles
20.2.3.2 Slow Wave Sleep (SWS) Deficits
20.2.4 Comorbid Sleep Disorders
20.2.4.1 Insomnia
20.2.4.2 Circadian Rhythm Disruption (CRD)
20.2.4.3 Restless Legs Syndrome (RLS)
20.2.4.4 Periodic Limb Movement Syndrome (PLMS)
20.2.4.5 Obstructive Sleep Apnea (OSA)
20.2.4.6 Narcolepsy
20.2.4.7 Parasomnias and Sleep State Misperception
20.3 Pathophysiology
20.3.1 Structural Correlates
20.3.2 Circuitry Correlates
20.3.3 Molecular Correlates
20.3.3.1 Neurotransmitters
20.3.3.2 Genes
20.4 Bidirectional Relationship
20.4.1 Psychotic Symptoms in Sleep Deprived Healthy Population
20.4.2 Psychotic (Schizophrenia) Symptoms in Sleep Disorders
20.4.3 Sleep Disturbances Across Various Stages of Schizophrenia
20.4.3.1 Prior to Illness Onset/Prodromal States/Clinical (or Ultra)-High-Risk (CHR/UHR)
20.4.3.2 Early/First-Episode Versus Chronic Schizophrenia
20.4.3.3 Relapse
20.4.3.4 Moderating Role of Cognitive Dysfunction
20.5 Treatment
20.5.1 Deep Sleep Therapy
20.5.2 Pharmacological Strategies (I): Insomnia
20.5.2.1 Antipsychotics
20.5.2.2 Melatonin
20.5.2.3 Zopiclone/Eszopiclone
20.5.2.4 Sodium Oxybate
20.5.3 Pharmacological Strategies (II): Other Comorbid Sleep Disorders
20.5.4 Non-pharmacological Strategies
20.6 Approach to a Patient
20.7 Conclusion
References
21: Sleep and Substance-Use Disorder
21.1 Introduction
21.2 Extent of Problem
21.3 Individual Substances
21.3.1 Tobacco
21.3.2 Alcohol
21.3.2.1 Alcohol and Its Effects on Sleep in Patients with Alcohol Dependence
21.3.2.2 Sleep Disturbances and Relapse to Alcohol
21.3.3 Opioids
21.3.4 Cannabis
21.3.5 Stimulants Like Cocaine
21.4 Pathophysiological Aspects of the Relationship Between Sleep and Addiction
21.4.1 Neurotransmitters and Neurocircuitry
21.4.2 Genetics
21.4.3 Neuroendocrine, Neurocognitive, and Other Mediators
21.4.4 Relationship: Who Came First-Chicken or Egg?
21.4.5 Adolescent Substance Use and Sleep
21.4.6 Relationship between Sleep and Tobacco
21.4.6.1 Tobacco/Nicotine Affecting Sleep
21.4.6.2 Sleep and Chronotype Predicting Tobacco/Nicotine Use
21.5 Management
21.5.1 Assessment
Box 1 Stepwise Management Plan of Substance Use and Comorbid Sleep Problems
21.5.2 Tobacco
21.5.3 Alcohol
21.5.4 Cannabis
21.5.5 Opioids
21.5.6 Cocaine
21.6 RLS and Substance Use
21.7 Sleep-Related Breathing Disorders and Substance Use
21.8 Policy
21.9 Conclusion and Future Aspects
References
22: Sleep in Posttraumatic Stress Disorder
22.1 Overview of Sleep Disturbances Associated with PTSD
22.2 Other Sleep Disorders and PTSD
22.3 Explanations for the Relationship Between Sleep Disturbances and PTSD
22.4 Clinical Treatment Options
22.5 Conclusions
References
23: Somatic Symptom Disorder and Sleep
23.1 Sleep Disorders and Somatic Symptoms
23.2 Sleep Deprivation
23.3 Obstructive Sleep Apnea (OSA)
23.4 Restless Legs Syndrome (RLS)
23.5 Other Sleep Disorders
23.6 Prevalence of Sleep Disorders and Sleep Architecture in Somatic Symptoms
23.6.1 Fibromyalgia
23.6.1.1 Sleep Architecture in Fibromyalgia
23.6.2 Chronic Fatigue Syndrome
23.6.2.1 Sleep Architecture in Chronic Fatigue Syndrome
23.7 Treatment
23.7.1 Pharmacological
23.7.2 Non-pharmacological
23.7.2.1 Balneotherapy
References
24: Sleep, Sleep Disorders, and Sexual Dysfunctions
24.1 Introduction
24.2 Normal Sleep Pattern and Sexual Function
24.3 Sexual Dysfunction and Sleep Disorders
24.4 Etiopathogenesis, Approach, and Treatment to Sexual Dysfunction in Common Sleep Disorders
24.4.1 Obstructive Sleep Apnea
24.4.1.1 Approach to a Patient with Obstructive Sleep Apnea with Erectile Dysfunction
Evaluation
Treatment
Approach to a Patient of Obstructive Sleep Apnea with Hypogonadism
Evaluation
Treatment
24.4.2 Narcolepsy
24.4.2.1 Treatment of Sexual Dysfunction in Narcolepsy
24.4.3 Insomnia, Chronic Sleep Insufficiency
24.4.3.1 Evaluation
24.4.3.2 Treatment
24.4.4 Circadian Disruption Sleep Disorder
24.4.5 Restless Leg Syndrome
24.4.6 Periodic Limb Movement During Sleep (PLMS)
24.4.7 Sleep Sex or Sexsomnia or Atypical or Abnormal Sexual Behaviors During Sleep (ASBS)
24.4.7.1 Approach/Treatment of Patients with ASBS or Sleep Sex or Sexsomnia (Fig. 24.4)
24.5 Conclusion
24.6 Summary
References
25: Sleep and Attention-Deficit/Hyperactivity Disorder
25.1 Overview
25.2 Primary Sleep Disorders and ADHD
25.2.1 Restless Legs Syndrome
25.2.1.1 Clinical Characteristics
Prevalence
25.2.1.2 Association of RLS and ADHD
25.2.1.3 Pathophysiology of RLS
Dopaminergic Abnormalities
Iron Insufficiency
25.2.1.4 Overlapping Pathophysiology
25.2.1.5 Implications for Treatment
25.2.2 Sleep Disordered Breathing
25.2.2.1 Clinical Characteristics
Prevalence
Prevalence of SDB and ADHD
25.2.2.2 Associations Between SDB/OSA and ADHD Symptoms
25.2.2.3 Pathophysiology of SDB/OSA
25.2.2.4 Overlapping Pathophysiology
25.2.2.5 Implications for Treatment
Weight Loss
Continuous Positive Airway Pressure Therapy (CPAP)
Surgical Intervention
25.2.3 Delayed Sleep-Wake Phase Disorder
25.2.3.1 Clinical Characteristics
Prevalence
25.2.3.2 Association of DSWPD and ADHD
25.2.3.3 Pathophysiology of DSWPD
25.2.3.4 Overlapping Pathophysiology
25.2.3.5 Implications for Treatment
Chronotherapy
Bright Light Therapy
Melatonin
25.3 ADHD and Psychiatric Comorbidity
25.3.1 ADHD and Anxiety Disorders
25.3.2 ADHD and Autism Spectrum Disorder
25.3.3 ADHD and Mood Disorders
25.3.4 Treatment Implications
25.4 The Impacts of ADHD Medication on Sleep
25.4.1 Stimulants
25.4.1.1 Age
25.4.1.2 Medication Schedule
25.4.1.3 Doses
25.4.2 Nonstimulants
25.5 Summary
References
26: Sleep Disorders and Autism: Behavioural Correlates, Diagnostic Tools and Treatment Strategies
26.1 Introduction
26.2 The Explanation of Sleep Disorders in Persons with Autism: A Conceptual Model of Interaction
26.2.1 Insomnia and Autism Could Share a Common Underlying Neurological Etiology?
26.2.2 Insomnia Can Be an Intrinsic Feature of the ASD
26.2.3 Insomnia Is More Frequent and Associated with Problematic Behaviours in People with Autism Spectrum Disorder?
26.3 Measuring Sleep in Persons with Autism
26.3.1 Diagnostic Tools
26.3.1.1 Parent-Report Measures
26.3.2 Children´s Sleep Habits Questionnaire (CSHQ)
26.3.3 Family Inventory of Sleep Habits (FISH)
26.3.4 Sleep Disturbance Scale for Children (SDSC)
26.3.5 Sleep Disorders Inventory for Students (SDIS)-Children and Adolescent Form
26.3.5.1 Objective Measures
26.3.6 Recommendations and Strategies of Interventions
26.4 Behavioural Intervention
26.5 Pharmacological Treatment
26.5.1 Melatonin
26.6 Discussion and Conclusion
References
27: Sleep in Dementia
27.1 Introduction
27.2 Normal Sleep and Sleep Architecture
27.3 Sleep and Ageing
27.4 Dementia and Sleep
27.4.1 Sleep Architecture in Alzheimer´s Disease (AD)
27.4.2 Sleep and Lewy Body Dementia (DLB)
27.4.3 Sleep and Fronto-Temporal Dementia (FTD)
27.4.4 Sleep and Vascular Dementia
27.4.5 Sleep and Creutzfeldt-Jakob Disease (CJD)
27.4.6 Sleep and Other Neurodegenerative Disorders
27.5 Bidirectional Relationship
27.5.1 Pathogenesis of Sleep Disorders in AD
27.5.2 Sleep Disruption and Risk of AD
27.6 Common Sleep Disorders in Dementia
27.6.1 Sleep Disordered Breathing (SDB)
27.6.2 Insomnia
27.6.3 Circadian Rhythm Disorders
27.6.4 Sleep-Related Movement Disorders
27.6.4.1 Restless Leg Syndrome
27.6.4.2 Periodic Limb Movement Disorder (PLMD)
27.6.4.3 REM Behavioural Disorder
27.6.5 Secondary Sleep Disorders
27.6.5.1 Medical Disorders
27.6.5.2 Psychiatric Disorders
27.6.5.3 Medications and Substance Misuse
27.6.6 `Sundowning´
27.7 Assessment
27.7.1 Comprehensive Clinical Interview
27.7.2 Neuropsychological Evaluation
27.7.3 Polysomnography (PSG)
27.7.4 Other Methods
27.8 Treatment of Sleep Disorders in Dementia
27.8.1 Non-pharmacological Treatment
27.8.1.1 Physical and Social Activity
27.8.1.2 Bright Light Therapy
27.8.1.3 Sleep Hygiene
27.8.1.4 Alternate Medicine
27.8.2 Pharmacological Treatment
27.8.2.1 Melatonin
27.8.2.2 Melatonin Receptor Agonists
27.8.2.3 Benzodiazepine Receptor Agonists
27.8.2.4 Other Hypnotics
27.8.2.5 Antidepressants with Sedative Property
27.8.2.6 Stimulants
27.8.2.7 Recent Advances and Research
27.9 Conclusion
27.9.1 Future Research
References
28: Sleep in Delirium
28.1 Introduction
28.2 Sleep Disturbance as a Symptom of Delirium
28.3 Sleep Disturbance as a Precipitating or Etiological Factor Associated with Development of Delirium
28.4 Evidence of Sleep-Related Interventions for Management of Delirium
28.5 Management of Delirium
References
29: Sleep Disturbances and Functional Gastrointestinal Diseases
29.1 Introduction
29.2 Sleep Cycle and Its Role in Human Physiology
29.3 Gut-Brain Axis
29.4 Digestive Diseases and Sleep Disorders
29.4.1 Gastroesophageal Reflux Disease and Sleep
29.5 Functional Dyspepsia, Ulcer Disease, and Sleep
29.5.1 Functional Dyspepsia
29.5.2 Peptic Ulcer Disease
29.6 Irritable Bowel Syndrome and Sleep
29.7 Inflammatory Bowel Disease and Sleep
29.8 Chronic Liver Disease and Sleep
29.9 Conclusions
References
30: Quality of Life in Patients with Sleep Disorders
30.1 Introduction
30.2 Epidemiology
30.2.1 Insomnia
30.2.2 Obstructive Sleep Apnoea (OSA)
30.2.3 Restless Leg Syndrome (RLS)
30.3 Quality of Life
30.4 Assessment of Quality of Life in Sleep Disorders
30.4.1 Generic Scales
30.4.2 Disease-Specific Scales
30.5 Scales Commonly Used for Assessment of QOL in Sleep Disorders
30.5.1 Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) [42] and SF-12 [43]
30.5.2 The Nottingham Health Profile (NHP) [45]
30.5.3 Sickness Impact Profile [47]
30.5.4 World Health Organization Quality of Life-Brief Form (WHOQOL-BREF) [49]
30.5.5 The Quality of Life Enjoyment and Satisfaction Questionnaire Short-Form (Q-LES-Q) [51]
30.5.6 QOL Inventory [53]
30.5.7 Functional Outcomes of Sleep Questionnaire (FOSQ) [44]
30.5.8 Calgary Sleep Apnoea Quality of Life Index (SAQLI) [46]
30.5.9 Hotel-Dieu-16 (HD-16) [48]
30.5.10 Quality of Life of Insomniacs Questionnaire [50]
30.5.11 Insomnia Severity Index (ISI) [52]
30.5.12 Restless Leg Syndrome Quality of Life Questionnaire-Abetz [54, 59]
30.6 Sleep Disorders and Quality of Life
30.6.1 Insomnia
30.6.2 Obstructive Sleep Apnoea (OSA)
30.6.3 Restless Leg Syndrome
30.7 Effects of Treatment on Quality of Life in Patients with Sleep Disorders
30.7.1 Insomnia
30.7.2 Obstructive Sleep Apnoea
30.7.3 Restless Leg Syndrome
30.8 Conclusions
References
Part IV: Sleep and Neurological Disorders
31: Sleep in Parkinson´s Disease
31.1 Introduction
31.2 Sleep Fragmentation
31.3 Excessive Daytime Sleepiness
31.4 Obstructive Sleep Apnea
31.5 REM Sleep Behavior Disorder
31.6 Restless Legs Syndrome and Periodic Limb Movements
31.7 Nocturia
31.8 Genetic Association Between PD and Sleep Disorders
31.9 Circadian Disruption in PD
31.10 Conclusion
References
32: Sleep After Traumatic Brain Injury
32.1 Epidemiology of Traumatic Brain Injury
32.2 Sleep and Psychiatric Disorders After TBI
32.3 Presentation and Classification of Sleep Disorders
32.3.1 Insomnias
32.3.2 Sleep-Related Breathing Disorders
32.3.3 Hypersomnia of Central Origin
32.3.4 Circadian Rhythm Sleep Disorders
32.3.5 Parasomnias
32.3.6 Sleep-Related Movement Disorders
32.4 Sleep Disorders and Psychiatric Disorders in TBI
32.4.1 Sleep Disorders and Psychotic Disorders After TBI
32.4.2 Sleep and Adjustment Disorders
32.4.3 Sleep Disorders and Substance Use Disorders after TBI
32.4.4 Sleep in TBI Persons and Somatoform Disorders
32.5 Assessment of Sleep in TBI Patients
32.6 Treatment Considerations
32.7 Conclusions
References
33: Sleep and Epilepsy
33.1 Introduction
33.2 Historical Introduction
33.3 Effects of Sleep on Epilepsy
33.3.1 Effects of Sleep Stages on Epilepsy
33.3.2 Cyclical Alternating Pattern (CAP) and Epileptic Phenomena
33.3.3 Effects of Sleep Fragmentation on Epilepsy
33.4 Circadian Rhythm and Epilepsy
33.5 Epilepsies Associated with Sleep
33.6 Comorbid Sleep Disorders in Epilepsy
33.6.1 Excessive Daytime Sleepiness
33.6.2 Obstructive Sleep Apnea (OSA)
33.6.3 Insomnia
33.6.4 Parasomnias
33.6.5 Effects of Epilepsy on Sleep Quality
33.7 Effects of ASMs on Sleep
33.8 Effect of Vagus Nerve Stimulation on Sleep
33.9 Sudden Unexpected Death in Epilepsy and Sleep
33.10 Conclusions
References
34: Sleep Disorders in Multiple Sclerosis
34.1 Introduction
34.2 Fatigue in MS
34.3 Hypersomnia/Excessive Daytime Sleepiness
34.4 Insomnia in MS
34.5 Sleep-Related Breathing Disorders
Box 34.1: Mythical story of Ondine´s curse
34.6 Nocturnal Urinary Symptoms in MS
34.7 Narcolepsy in MS
34.8 REM Sleep Behaviour Disorder in MS
34.9 Circadian Rhythm in MS
34.10 Sleep-Related Movement Disorders in MS
34.11 Conclusion
References
35: Sleep Disorders in Myopathies
35.1 Introduction
35.2 Functional Anatomy of Sleep and Awake State
35.3 Myopathies
35.4 Pathophysiology of Sleep Disorders in Myopathies
35.5 Patterns of Sleep Disorders in Myopathies
35.6 Various Sleep Disorders in Specific Myopathies Are as Follows
35.7 Clinical Manifestations
35.8 General Approach and Suggested Management
35.9 Consequences of Sleep Disorders
35.10 General Principles in the Treatment of Sleep Dysfunction in Myopathies
35.11 Treatment Options
35.12 Summary
References
36: Sleep in Critically Ill Patient
36.1 Background
36.2 Prevalence of Sleep Deprivation in Critically Ill Patients
Box 36.1: Source of Noise in ICU Setting
36.3 Factors Affecting Sleep in Critically Ill Patients
36.3.1 Environmental Factors
36.3.1.1 Noise
36.3.1.2 Light
36.3.1.3 ICU Structure
Box 36.2: Common Time-Sensitive Routine Patient Care Activities
36.3.1.4 Discomfort
36.3.1.5 Treatment Modalities
Frequent Monitoring and Patient Care Activities
36.3.2 Medication
36.3.2.1 Sedatives
36.3.2.2 Analgesics
36.3.2.3 Antipsychotics
36.3.2.4 Antidepressants
36.3.2.5 Cardiovascular (CVS) Drugs
36.3.2.6 Respiratory System Medication
36.3.2.7 Other Medications
36.3.3 Mechanical Ventilation
36.3.4 Nutritional Support
36.3.5 Patient Factors
36.3.5.1 Patient Demographics
36.3.5.2 Patient´s Conditions
36.3.5.3 Sleep Knowledge Deficit among Healthcare Professionals
36.4 Effects of Sleep Deprivation on Physiological Processes of Critically Ill Patients
36.4.1 Changes in Temperature Regulation
36.4.2 Changes in Respiratory Function
36.4.3 Changes in Cardiovascular Function
36.4.4 Changes in Gastrointestinal Function
36.4.5 Changes in Endocrine Function
36.4.6 Changes in Hematologic/Immunologic Function
36.4.7 Changes in Psychological/Neurocognitive Function
36.5 Management of Sleep Problems of Critically Ill Patients
36.5.1 Non-pharmacologic Strategies
36.5.1.1 Control of Noise
36.5.1.2 Measures to Control Unnecessary Noise in Critical Care Unit
36.5.1.3 Other Strategies
36.5.1.4 Minimizing Lights
Proposed Interventions for Minimizing the Light During Night in the ICU
36.5.1.5 Rescheduling of Patient Care Activities
36.5.1.6 Motivation and Encouragement
36.5.1.7 Proper Communication
36.5.1.8 Raising Staff Awareness of Nursing and Medical Staff
36.5.1.9 Possible Remedies to Improve Sleep with Mechanical Ventilation
36.5.1.10 Illness-Specific Management
36.5.1.11 Complementary Therapies
36.5.1.12 Cognitive Behavioral Therapy (CBT)
36.5.1.13 Other Interventions
36.5.2 Pharmacological Consideration
36.5.2.1 Antidepressant
36.5.2.2 Antihistamines
36.6 Nursing Process in Management of Sleep Problems in Critically Ill Patients
36.7 Desired Outcomes/Goal
36.7.1 Short Term
36.7.2 Long Term
36.8 Nursing Interventions
36.8.1 Environmental Management
36.8.2 Promoting Sleep Hygiene Activities
References
Part V: Sleep and Neuropsychopharmacology
37: Sleep in Patients with Schizophrenia or Unipolar or Bipolar Disorder: The Effect of Second-Generation Antipsychotic Drugs
37.1 The Sleep-Wakefulness Cycle in Man
37.2 Sleep Disturbances in Patients with Unipolar and Bipolar Disorder
37.3 Sleep Disturbances in Schizophrenia Patients
37.4 Pharmacotherapy of Schizophrenia and Unipolar and Bipolar Disorder
37.5 Receptor-Binding Affinity of Second-Generation Antipsychotic Drugs
37.6 Pharmacokinetics of Second-Generation Antipsychotic Drugs
37.7 Effects of Second-Generation Antipsychotic Drugs on Sleep Variables in Patients with Schizophrenia and Unipolar and Bipol...
37.7.1 Patients with Unipolar and Bipolar Disorder
37.7.2 Patients with Schizophrenia
37.8 Conclusions
References
38: Effect of Antiepileptics on Sleep
38.1 Chrono-Epileptology
38.2 Chronobiologic Changes of Sleep in Epilepsy
38.3 Macro and Micro-Architectural Changes
38.4 Impact of Antiepileptic Drugs on Sleep Indices
38.5 Prevalence and Risk Factors
38.6 How to Manage
38.7 Summary and Conclusion
References
39: Sleep During Hypnotic Therapy
39.1 Types of Insomnia
39.2 Management of Insomnia
39.3 Historical Aspect of Hypnotic Drugs Use
39.4 Properties Required in Ideal Hypnotic Agent
39.5 Medications Used in Insomnia
39.6 Currently Approved Hypnotic Agents
39.6.1 Benzodiazepines (BZD)
39.6.2 Adverse Effect Profile
39.6.3 Drug Interactions
39.6.4 Clinical Indication
39.7 Nonbenzodiazepine BZRA
39.7.1 Pharmacokinetics
39.7.2 Adverse Effect Profile
39.7.3 Clinical Indication
39.8 Low-Dose Doxepin
39.8.1 Pharmacokinetics
39.8.2 Clinical Indication
39.9 Melatonin Receptor Agonist
39.9.1 Pharmacokinetics
39.9.2 Adverse Effect
39.9.3 Clinical Indication
39.10 Orexin/Hypocretin Receptor Antagonist
39.10.1 Pharmacokinetics
39.10.2 Adverse Effect
39.10.3 Clinical Indication
39.11 Alternate Medications Prescribed for Sleep
39.12 Newer Agents in Pipeline
39.12.1 Lemborexant
39.12.2 Lumateperone
39.12.3 Piromelatine
39.12.4 Lorediplon
39.13 Hypnotic Medications and EEG Changes
39.14 Conclusion
References
40: Stimulants and Sleep
40.1 Introduction
40.1.1 Nicotine
40.1.1.1 Sleep Findings in Acute Administration and Intoxication of Nicotine
40.1.1.2 Sleep Findings in Nicotine Dependence
40.1.1.3 Sleep Findings in Nicotine Withdrawal
40.1.1.4 Factors Affecting Sleep in Nicotine Use
40.1.1.5 Smoking Cessation and Sleep Disturbances
40.1.2 Caffeine
40.1.2.1 Sleep Findings in Acute Administration of Caffeine
40.1.2.2 Sleep Findings in Chronic Administration of Caffeine
40.1.2.3 Laboratory Studies of Sleep Disturbance with Caffeine Use
40.1.2.4 Individual Sensitivity to Effect of Caffeine on Sleep Architecture
40.1.2.5 Perinatal Effects of Caffeine on Sleep
40.1.3 Cocaine
40.1.3.1 Acute Effects of Cocaine on Sleep
40.1.3.2 Sleep in Cocaine Withdrawal and Abstinence
40.1.3.3 Mediating Factors for Sleep Disturbance in Cocaine Users
40.1.4 Methamphetamine
40.1.4.1 Acute Use
40.1.4.2 Amphetamine Withdrawal and Sleep
40.1.4.3 Mediating Factors for Sleep Disturbance in Methamphetamine Users
40.1.4.4 Amphetamines and Mood Disorders
40.1.5 Ecstasy
40.1.5.1 Effects of Ecstasy Use on Sleep
40.1.6 Khat
40.1.6.1 Sleep Problems in Khat Users
40.1.6.2 Management of Sleep Problems in Psychostimulant Users
40.2 Conclusion
References
41: Effect of Dopamine Agonists on Sleep
41.1 Introduction
41.2 DA Receptor Family and Sleep
41.3 Dopamine Receptor Agonists and Sleep: Evidence from Animal Model Studies
41.4 Dopamine Agonists and Sleep in Humans
41.4.1 Excessive Daytime Sleepiness and Sleep Attacks
41.4.2 Risk Factors for EDS and Sleep Attacks with DA Agonists
41.4.3 Evaluation of Sleep Dysfunction Due to DA Agonists
41.4.4 Management of EDS and Sleep Attacks
41.4.5 Pharmacological Measures
41.4.5.1 Modification in Dopaminergic Therapy
41.4.5.2 Specific Pharmacological Agents
41.4.6 Non-pharmacological Approach
41.4.6.1 Hallucinations
41.5 Conclusion
References