Neuropsychology following brain injury: A pragmatic approach to outcomes, treatment, and applications
Mark J. Ashley, David A. Hovda in Traumatic Brain Injury, 2017
Adequate sleep is essential in promoting physical, cognitive, and psychological well–being. Sleep is frequently disrupted following brain injury secondary to various acute and chronic factors. For instance, many individuals report hypersomnolence during the acute recovery phase due to the brain’s healing process. However, when sleep disturbance becomes chronic, it can have a negative impact on various aspects of daily functioning. It is important to note that brain injury can exacerbate existing sleep issues or possibly trigger a new onset of sleep disruption. In fact, incidence rates of reported sleep disturbance following a brain injury can be quite high, ranging anywhere from 30% to 70% based on prior research.52 Sleep disruption can range from mild to severe and usually involves difficulty with sleep initiation and/or maintenance. There are various types of sleep disorders, such as narcolepsy, obstructive sleep apnea, sleep behavior disorders (e.g., sleep walking, night terrors), and insomnia. Although many people report general fatigue following brain injury, sometimes sleep disturbance can reach the level of insomnia.
The management of common mental health concerns in primary care
Julie M Schirmer MSW, Alain J Montegut MD, Stephen J Spann MD, Gabriel Ivbijaro MD, Alfred Loh MD in Behavioral Medicine in Primary Care, 2017
The causes of sleep disorders, including insomnia, include medical and psychiatric etiologies (seeTable 7.1). The clinical history is the best tool for gathering information about patterns of sleep and differentiating between possible diagnoses.22 Special attention must be given to inquiring about other medications, repetitive behavioral patterns that may condition sleep responses, and medical conditions that may be underlying causes of insomnia, especially respiratory, cardiovascular, and neurological disorders. The use of stimulants such as nicotine, caffeine, cocaine and amphetamines contributes to sleep disorder, as does the use of alcohol, and the sleep disturbances may well persist after the offending substance has been stopped. Patients with sleep disorders frequently present to their primary care physicians with comorbid medical and psychiatric conditions that complicate the diagnostic process. A biopsychosocial approach to the assessment of both dimensions is recommended.
Restless Legs Syndrome and Periodic Limb Movement Disorder in Children and Adolescents
Mark A. Richardson, Norman R. Friedman in Clinician’s Guide to Pediatric Sleep Disorders, 2016
All children and adolescents—especially those with sleep disorders—benefit significantly from establishing a routine of good sleep habits. Children and adolescents often test the limits of sleep, and for those with RLS the result can be sleep deprivation that significantly increases RLS symptoms and adversely affects daytime function. Parents should be made aware of the amount of sleep considered normal for each age, and advised to help the child get sufficient sleep on a regular basis. Typical sleep needs are as follows: age 2, 12 hours (including one nap); age 5, 11 hours; age 10, 10 hours; teen years, nine hours; and adulthood, seven to eight hours. A child or teenager should go to bed and awaken at about the same time every day, including weekends, avoid caffeine intake, especially late in the day or evening, get regular exercise, and maintain a comfortable, quiet bedroom environment, free of stimulating activities. Teens should avoid the use of tobacco and alcohol, which are known to disrupt sleep, confine any napping to the afternoon hours and nap no longer than 45 minutes, and avoid driving when tired (Appendix A).
Vitamin D and the nervous system
Published in Neurological Research, 2019
Giulia Bivona, Caterina Maria Gambino, Giorgia Iacolino, Marcello Ciaccio
Sleep disorders are defined as any disorder that affects, disrupts, or involves sleep. The term includes several conditions that can be classified as insomnia, sleep-related breathing disorders, central disorders of hypersomnolence, circadian rhythm sleep-wake disorders, parasomnias and sleep-related movement disorders. Over the last decades sleep disorders have become epidemic throughout the developed world [116,117]. Epidemiology studies have investigated the association between hypovitaminosis D and the risk of sleep disorders. Vitamin D plays a prominent role in brainstem sleep regulation. Indeed, brain areas that regulate the sleep–wake cycle, such as hypothalamus, prefrontal cortex and substantia nigra, express VDR. Moreover, hypovitaminosis D has been associated with the development of symptoms of wakefulness and chronic nonspecific pain that are commonly related to sleep disorders [118]. Finally, some epidemiologic evidence has verified the impact of vitamin D supplements on sleep disorders, revealing that the administration of vitamin D supplementation could prevent and ameliorate the course of sleep disorders [119,120]. All these evidence support a role for hypovitaminosis D in sleep disorders. However, literature studies achieved contrasting results [121]. Thus, more studies are mandatory to elucidate if vitamin D has a role in these clinical conditions.
Sleep is something, not nothing: an interprofessional approach to sleep assessment and treatment to support substance use recovery
Published in Journal of Social Work Practice in the Addictions, 2023
Jennifer Gardner, Margaret Swarbrick, Robert H. Kitzinger
Sleep disorders are disorders that involve the quality, quantity and timing of sleep (APA, 2022; American Sleep Association, 2022). Sleep disorders include insomnia disorders, sleep related breathing disorders, hypersomnolence disorders, circadian rhythm sleep or wake disorders, parasomnias, sleep related movement disorders and any other sleep disorder (APA, 2022). Insomnia disorder is the most common sleep disorder that is characterized by dissatisfaction with sleep quantity or quality associated with difficulty initiating and maintaining sleep, as well as early morning waking (APA, 2022). While some individuals with substance use disorders may be diagnosed with one or more of the outlined sleep disorders, the authors have observed that sleep disturbance is more common of an experience for those who are seeking services. Sleep disturbance, in the context of this manuscript, can be viewed in more symptom-related context, which may include physiological, emotional and behavioral impairments. Frequently reported sleep disturbance symptoms, in the authors’ experience, include but are not limited to, difficulty falling and staying asleep, worry about sleep onset and ability to remain asleep, irritability, racing thoughts, staying up late into the night, discomfort and pain associated with withdrawal symptoms, engaging in too much screen time before bed, difficulty creating new or revised sleep schedules and nightmares/bad dreams.
Systematic review of proposed definitions of nocturnal polyuria and population-based evidence of their diagnostic accuracy
Published in Acta Clinica Belgica, 2018
Tine Kold Olesen, Marie-Astrid Denys, Johan Vande Walle, Karel Everaert
Nocturia is a symptom with many different causes mainly related to a mismatch between nocturnal diuresis and functional bladder capacity overnight. In the past decades, major attention was given to bladder dysfunction. A key factor is the bladder storage capacity. A reduced functional bladder index, bladder hypersensitivity/over activity, or bladder outlet obstruction (prostate hypertrophy) will increase the likelihood of nocturia. Increase in production of urine during sleep (nocturnal polyuria) has been ambiguous in the absence of good definitions and standardization of the diagnostic approach. The pathophysiology of nocturnal polyuria is multi-factorial [1]. Conditions associated with water/solute diuresis may relate to disturbances in the circadian rhythm of producing the antidiuretic hormone (ADH), congestive heart failure, renal insufficiency, or estrogen deficiency. Also, the conditions associated with sleep disorders may relate to sleep apnea or restless leg syndrome. Further, symptomatic nocturia may be due to a nocturnal urine overproduction, but disrupted sleep, secondary to overactive bladder contractions might increase nocturnal diuresis-rate. Based on the diverse pathophysiology, nocturnal polyuria occurs at all adult ages, in both sexes, and any ethnicity. The first definition accepted and endorsed by an international scientific organization, the International Continence Society, ICS [1] described the condition as abnormally high ratio of urine production at night versus the total 24-h urinary volume.
Related Knowledge Centers
- Actigraphy
- Circadian Rhythm Sleep Disorder
- Hypersomnia
- Insomnia
- Parasomnia
- Polysomnography
- Sleep
- Sleep Apnea
- Dyssomnia
- Narcolepsy