The Relaxation SystemTherapeutic Modalities
Len Wisneski in The Scientific Basis of Integrative Health, 2017
Hypnagogia is an experience of psychological and physical withdrawal or relaxation at the threshold of sleep; the technique incorporates intense visual and sometimes auditory experiences. Hypnagogia, a hypnotic-like state of consciousness that hovers between being awake and being asleep, involves a loosening of ego boundaries and a conscious participation in the experience. The technique incorporates intense visual and sometimes auditory experiences. It is the conscious experience of being in the theta state and can be intentionally prolonged to promote mental clarity and insight. Hypnagogia induces experiences that are physiologically similar to the spiritual experiences of advanced meditators, with subjects showing decreases in heart rate and oxygen consumption as well as a shift from alpha to theta on the EEG. The technique also induces experiences that are psychologically similar to those reported by advanced meditators, having the two key features of intense concentration and the dissolution of a sense of self as distinct from a sense of otherness (Mavromatis, 1987).
Epilepsy and Sleep Disorders
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Some of these represent REM sleep phenomena such as hypotonia/atonia, and dreams occurring at inappropriate times. Cataplexy is a sudden decrease in voluntary muscle tone (especially jaw, neck and limbs) that occurs with sudden emotion like laughter, elation, surprise or anger. This can manifest as jaw dropping, head nods or a feeling of weakness or, in more extreme cases, as falls with ‘paralysis’ lasting sometimes for several minutes. Consciousness is preserved. Cataplexy is a specific symptom of narcolepsy, although narcolepsy can occur without cataplexy. Sleep paralysis and hypnagogic hallucinations are not specific and can occur in other sleep disorders and with sleep deprivation (especially in the young). Both these phenomena occur shortly after going to sleep or on waking. Sleep paralysis is a feeling of being awake, but unable to move. This can last for several minutes and is often very frightening, so can be associated with a feeling of panic. Hypnagogic/hypnapompic hallucinations are visual or auditory hallucinations occurring while dozing/falling asleep or on waking; often the hallucinations are frightening, especially if associated with sleep paralysis.
Common sleep disorders
Ravi Gupta, S. R. Pandi Perumal, Ahmed S. BaHammam in Clinical Atlas of Polysomnography, 2018
Narcolepsy is a relatively rare autoimmune disease. It has pentad of clinical features including:Irresistible attacks of sleep, which is usually present in all patients. The other feature of narcolepsy is not present in all patients.Cataplexy, characterized by sudden bilateral loss of muscle tone brought on by emotions, which can be limited to certain muscles or generalized, resulting in falling down. Full consciousness during cataplexy. Cataplexy is pathognomonic for narcolepsy and is not present in all narcolepsy patients. If cataplexy is present, the patient has narcolepsy type 1. A diagnosis of narcolepsy without cataplexy (Narcolepsy type 2) is appropriate when excessive daytime sleepiness is present with REM phenomenology (hypnogogic hallucinations and sleep paralysis) but without cataplexy.Hypnagogic hallucination: Vivid dreams that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic).Sleep paralysis: It is a temporary inability to move or speak that happens when the patient is waking up or falling asleep.Interrupted fragmented sleep: Narcolepsy patients may complain of fragmented sleep.
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].
Effects of chronotherapy on circadian rhythm and ADHD symptoms in adults with attention-deficit/hyperactivity disorder and delayed sleep phase syndrome: a randomized clinical trial
Published in Chronobiology International, 2021
Emma van Andel, Denise Bijlenga, Suzan W. N. Vogel, Aartjan T. F. Beekman, J. J. Sandra Kooij
The Sleep Diagnosis List (SDL), the Dutch version of the Sleep Disorders Questionnaire (SDQ), assessed the presence of 13 common sleep disorders and sleep-related problems: insomnia (Cronbach’s α = 0.93), anxiety/depression (Cronbach’s α = 0.92), restless legs syndrome (Cronbach’s α = 0.90), sleep apnea (Cronbach’s α = 0.88), hypersomnia (Cronbach’s α = 0.81), daytime dysfunctioning (Cronbach’s α = 0.80), hypnagogic hallucinations/dreaming (Cronbach’s α = 0.76), sexual and social dissatisfaction (Cronbach’s α = 0.73), sleep paralysis (Cronbach’s α = 0.70), cataplexy (Cronbach’s α = 0.64), restless sleep (Cronbach’s α = 0.74), negative conditioning surrounding sleep and the bedroom (Cronbach’s α = 0.49), and automatic behavior (Cronbach’s α = 0.69) (Sweere et al. 1998). Sleep hygiene was evaluated by the Sleep Hygiene Questionnaire (VSH), which was based on the Adolescent Sleep Hygiene Scale (LeBourgeois et al. 2004) and consisted of 22 items scored on a 5-point Likert scale ranging from 1 (never) to 5 ((almost) always). The total score ranged from 22 to 110, with higher scores indicating worse sleep hygiene.
Narcolepsy Treatment: Voices of Adolescents
Published in Behavioral Sleep Medicine, 2022
Lena Xiao, Anna Chen, Arpita Parmar, Lucy Frankel, Alene Toulany, Brian J. Murray, Indra Narang
Narcolepsy is a debilitating lifelong sleep disorder that is increasingly recognized in the pediatric population. The overall estimated incidence of narcolepsy in Europe is 0.93 per 100,000 person-years and approximately 0.83 per 100,000 person-years in the adolescent population (Wijnans et al., 2013). There is frequently a delay between symptom onset and diagnosis with a median interval of 10.5 years (Morrish et al., 2004). The median age of symptom onset is 18 years and age at diagnosis is 35 years (Morrish et al., 2004). The classic clinical syndrome consists of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations and sleep paralysis. The symptomatology is mediated by the hypothalamic loss of the excitatory neuropeptide hypocretin which is responsible for sleep-wake regulation and wake promotion (Houghton et al., 2004; Thannickal et al., 2000).
Related Knowledge Centers
- Consciousness
- Hallucination
- Qualia
- Sleep
- Sleep Paralysis
- Wakefulness
- Sleep Onset
- Hypnopompia
- Lucid Dream
- Meditation