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Parasomnias
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Hypnopompic hallucinations are visual or auditory hallucinations occurring at awakening from sleep. They are phenomenologically identical to hypnagogic hallucinations save for their temporal relationship to the sleep period. Unlike hypnagogic hallucinations, however, they are not suggestive of narcolepsy. Although sometimes frightening to the patient, brief hypnopompic hallucinations have no medical significance and rarely warrant treatment beyond support and reassurance. More elaborate hallucinations sometimes occur in conjunction with somnambulism during the night (IS), in which case they should be treated as part of the sleepwalking disorder. A very rare, benign familial variant has also been described.
Assessment of the psychiatric patient
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Hallucinations These are perceptions in the absence of an external stimulus. They have a similar quality to that of a true perception (i.e. they are perceived in objective space rather than inside the head). Their presence can be suggested by a patient’s behaviour, for example auditory hallucinations by a patient speaking to themself. They can occur in any of the five senses. Brief hallucinations when falling asleep (hypnagogic) or while wakening (hypnopompic) are within the range of normal experience. Since some patients may conceal or are unable to express their hallucinations, enquiries should be tactful and sensitive.
Physiology of Sleep and Sleep Disorders
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Narcolepsy may be associated with other sleep disorders including restless legs syndrome (RLS) and periodic limb movement syndrome (PLMS), parasomnias, snoring, OSA and disorders of appetite and mood.22 Sleepiness is usually severe, with ESS score often above 15. Subjects often develop hypnagogic (sleep onset) or hypnopompic (sleep offset) hallucinations and sleep onset/offset paralysis due to REM intrusion into wakefulness while falling asleep or on waking. These are, however, non-specific features of sleep deprivation and they may occur in other conditions of significant sleep loss including shift work or sleep apnoea.
Onward: The future orientation of constructive memory
Published in American Journal of Clinical Hypnosis, 2021
Ongoing studies showed a growing acceptance for the idea that changes in neural correlates are contributed to by activity, participation, and dreaming. A study by Dotta and Persinger (2009) explored the neurophysiology of dreams by testing a hypothesis that dreams involve the generation and perception of biophotons. The study of 40 discrete cases looked at different intervals in sleep and the convergence of geophysical and cerebral properties in seeking to better understand subjective sensations of time distortion and putative experience of information about future events. The authors summarize that if dreams and altered states of consciousness are actually the experiences of biophotons within the brain, it can help to explain enigmas associated with hypnosis, as well as hypnogogic and hypnopompic intrusions.
Emerging therapeutic targets for narcolepsy
Published in Expert Opinion on Therapeutic Targets, 2021
Marieke Vringer, Birgitte Rahbek Kornum
Narcolepsy has two subtypes: Patients with Narcolepsy type 1 (NT1) have cataplexy and hypocretin (Hcrt, also known as orexin) deficiency, while Narcolepsy type 2 (NT2) patients have neither cataplexy nor Hcrt deficiency [4,9,18]. Cataplexy attacks are brief episodes of muscle atonia during wake typically triggered by strong, mainly positive emotions. Other symptoms are sleep paralysis, hypnagogic, and hypnopompic hallucinations, and disturbed nocturnal sleep. These symptoms can be experienced by both NT1 and NT2 patients, but not every patient experience all the symptoms. Diagnosis requires nighttime and day-time polysomnography to rule out other sleep-wake disorders, objectify a short latency to fall asleep, and document at least two sleep onset REM (SOREM) periods [18]. Diagnosing NT2 can be challenging. This requires the presence of EDS and two SOREM periods but cataplexy and Hcrt deficiency should be absent. Due to the lack of clear biomarkers, diagnosis is mainly based on the exclusion of other sleep disorders [3,18,19].
Hallucinogen persisting perception disorder: A literature review and three case reports
Published in Journal of Addictive Diseases, 2018
Valentin Yurievich Skryabin, Maria Vinnikova, Anna Nenastieva, Vladislav Alekseyuk
The Diagnostic and statistical manual of mental disorders, fifth edition, DSM-V4 lists the diagnostic criteria for 292.89 Hallucinogen Persisting Perception Disorder (Flashbacks), which are the following: Following cessation of use of a hallucinogen, the reeexperiencing of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen (e.g., geometric hallucinations, false perceptions of movement in the peripheral visual fields, flashes of color, intensified colors, trails of images of moving objects, positive afterimages, halos around objects, macropsia and micropsia);The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning;The symptoms are not attributable to another medical condition (e.g., anatomical lesions and infections of the brain, visual epilepsies) and are not better explained by another mental disorder (e.g., delirium, major neurocognitive disorder, schizophrenia) or hypnopompic hallucinations.