Sleep Disorders: Diagnosis, Management and Treatment : a Handbook for Clinicians

By Peretz Lavie; Giora Pillar et al. | Go to book overview

chapter 6

Primary and other forms of hypersomnia

Narcolepsy

Narcolepsy is a relatively rare disorder with a prevalence of 0.02-0.05%, depending on the population studied. It may be more frequent in Japan (prevalence of 0.18%) and is very rare in Israel (0.002%). It is manifested by abnormal sleepiness, disturbed nocturnal sleep and pathological manifestations of REM sleep. In the 1930s, Daniels described the classic tetrad of daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucinations. The onset of clinical manifestations of narcolepsy, although variable, are typically during the second decade of life. The primary symptom is excessive sleepiness, which manifests itself as irresistible episodes of drowsiness or sleep that occur both during monotonous activities and when actively engaged. The sleepiness is classically relieved by brief naps, from which the patient awakens feeling refreshed, only to have sleepiness return within several hours. The other commonly associated symptoms represent manifestations of abnormal REM sleep.

Cataplexy, a 'breakthrough' of REM atonia into wakefulness, is the abrupt, reversible loss of muscle tone, usually triggered by a strong emotion such as laughter or anger. Typically this affects postural muscles, and severity can range from mild sagging of the jaw and weakness of the knees, to collapse from complete paralysis. These episodes may last from seconds to several minutes and consciousness is usually

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Sleep Disorders: Diagnosis, Management and Treatment : a Handbook for Clinicians
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Preface vii
  • Chapter 1 - History of Sleep Medicine 1
  • Chapter 2 - Systemic Function During Normal Sleep 19
  • Chapter 3 - Hypersomnia: an Introduction 41
  • Chapter 4 - Sleep Apnoea Syndrome 47
  • Chapter 5 - Periodic Limb Movement Disorder 89
  • Chapter 6 - Primary and Other Forms of Hypersomnia 97
  • Chapter 7 - Hypersomnia: Summary and Patient Approach 109
  • Chapter 8 - Insomnia 115
  • Chapter 9 - Parasomnias 145
  • Appendix 167
  • Index 177
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