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Sleep–Wake Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Margaret Kay-Stacey, Eunice Torres-Rivera, Phyllis C. Zee
During transitions from wakefulness to sleep (hypnagogic events) or from sleep to wakefulness (hypnopompic events), vivid dream-like hallucinations that are thought to be related to sleep-onset REM sleep occur repeatedly in 40–80% of patients with narcolepsy with cataplexy. These are distinguished from hallucinations in other psychotic states by their exclusive association with sleep–wake transitions. Similar to sleep paralysis, hypnagogic hallucinations also occur sporadically in the normal population.
Descriptive and Psychodynamic Psychopathology EMIs
Published in Michael Reilly, Bangaru Raju, Extended Matching Items for the MRCPsych Part 1, 2018
Autoscopic hallucination.Elementary hallucination.Extracampine hallucination.Functional hallucination.Hygric hallucination.Hypnagogic hallucination.Hypnopompic hallucination.Kinaesthetic hallucination.Lilliputian hallucination.Negative autoscopic hallucinationReduplicative hallucination.Reflex hallucination.
Nightmares
Published in Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson, Care of the Cancer Patient, 2018
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson
There are two different types of hallucinations: hypnagogic hallucinations, which occur when falling asleep. This term describes the occurrence of visions or dreams during the drowsy state following sleep [Greek hypnos (sleep) and agbgos (leading)]hypnopompic hallucinations, which occur when waking. This denotes the occurrence of visions or dreams during the drowsy state following sleep [Greek hypnos (sleep) and pompe (procession)].
Pitolisant for the treatment of cataplexy in adults with narcolepsy
Published in Expert Opinion on Orphan Drugs, 2021
Gerard J. Meskill, Ulf Kallweit, Donna Zarycranski, Christian Caussé, Olivier Finance, Xavier Ligneau, Craig W. Davis
In the absence of adequate hypocretin activity, patients with NT1 experience not only EDS but also REM sleep dysregulation, which manifests as elements of REM sleep occurring during wakefulness or sleep-wake transitions (i.e. cataplexy, sleep paralysis, hypnagogic hallucinations) [2,9,10]. Muscle atonia is a normal characteristic of REM sleep [18]. During wakefulness, muscle tone is maintained by activity in several neural pathways, including REM sleep-suppressing neurons in the ventrolateral periaqueductal gray and lateral pontine tegmentum (vlPAG/LPT), norepinephrine neurons of the locus coeruleus, serotonin neurons of the dorsal raphe nucleus, and acetylcholine neurons in the lateral dorsal tegmental/pedunculopontine tegmental (LDT/PPT) nuclei [10,12,18–20]. Cataplexy is thought to result from the intermittent activation of REM sleep atonia circuitry, which allows the intrusion of this REM sleep manifestation (i.e. muscle atonia) into wakefulness [9,10,18,21]. Strong emotions activate neural pathways in the prefrontal cortex and amygdala, and hypocretin functions to suppress atonia during normal wakefulness [12,20,21]. Due to the lack of adequate hypocretin activity in patients with NT1, the experience of strong emotions can lead to disinhibition of neurons in the REM sleep atonia circuit and reduced activity in neural pathways that maintain normal muscle tone, which results in the occurrence of muscle atonia during wakefulness (i.e. cataplexy; Figure 1) [9,10,12,18,20,21].
Mental health and wellbeing of medical students in Nigeria: a systematic review
Published in International Review of Psychiatry, 2019
Oluyomi Esan, Arinola Esan, Ayorinde Folasire, Philip Oluwajulugbe
Only one study described sleep practices among undergraduate medical students. The average number of hours of night sleep on a weekday and weekend was six and seven hours respectively. There was a significant correlation between the number of hours of sleep and the use of caffeine. About 11.3% of the respondents experienced unusual sleep practices such as sleepwalking, sleep talking and night terrors(Chinawa, Chukwu, & Obu, 2014). Another study investigated the pattern of isolated sleep paralysis among Nigerian medical students. Isolated sleep paralysis was found in 26.1% of the respondents. Of the respondents with sleep paralysis, 32.6% had hypnapompic/hypnagogic hallucinations during the episode mainly visual (Ohaeri, Odejide, Ikuesan, & Adeyemi, 1989).
Emerging therapeutic targets for narcolepsy
Published in Expert Opinion on Therapeutic Targets, 2021
Marieke Vringer, Birgitte Rahbek Kornum
Even though narcolepsy patients are excessively sleepy during the day, they do not sleep more than healthy individuals over the 24 hour cycle. This is due to the fact that both NT1 and NT2 patients have a very fragmented night-time sleep [24]. This disturbed and fragmented sleep-wake regulation is at the core of narcolepsy symptomatology and can take many forms, including hypnagogic hallucinations, sleep paralysis, and lucid dreaming [3,4]. A giant leap forward in the understanding of NT1 pathophysiology was taken with the discovery of the Hcrt neuropeptides and the observation that Hcrt knock out (KO) mice reproduce the sleep-wake instability of narcolepsy [25,26].