Sleepwalking Associated with Hyperthyroidism

Ajlouni, Kamel; Ahmad, Azmi T.; Al-Zahiri, Mohammad M.; Ammari, Fawwaz L.; Jarrah, Nadim; Abujbara, Mousa; Ajlouni, Heitham K.; Daradkeh, Tewfik K.

doi:10.4158/ep.11.1.5

Cited by 36 publications

(10 citation statements)

References 18 publications

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“…Implicated agents have included antidepressants amitriptyline [28], bupropion [29,30], paroxetine [31], and mirtazapine [32], the mood stabilizer, lithium [33,34], the antipsychotics quetiapine [35] and olanzapine [36][37][38], the antihypertensive agent metoprolol [39], the anti-seizure agent topiramate [40], and the antibiotic fluoroquinolone [41]. Medical conditions associated with NREM parasomnias include migraine [42,43], febrile illness [44], vitiligo [45], hyperthyroidism [46], as well as encephalitis and stroke [1]. These diverse conditions and medications likely induce NREM parasomnias through a final common pathway.…”

Section: Clinical Presentationmentioning

confidence: 99%

Parasomnias: An Updated Review

2012

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Parasomnias are abnormal behaviors emanating from or associated with sleep. Sleepwalking and related disorders result from an incomplete dissociation of wakefulness from nonrapid eye movement (NREM) sleep. Conditions that provoke repeated cortical arousals, or promote sleep inertia lead to NREM parasomnias by impairing normal arousal mechanisms. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking disorders. Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after an arousal from sleep. SRED is often associated with the use of sedative-hypnotic medications; in particular, the widely prescribed benzodiazepine receptor agonists. Recently, compelling evidence suggests that nocturnal eating may in some cases be a nonmotor manifestation of Restless Legs Syndrome (RLS). rapid eye movement (REM) Sleep Behavior Disorder (RBD) is characterized by a loss of REM paralysis leading to potentially injurious dream enactment. The loss of atonia in RBD often predates the development of Parkinson's disease and other disorders of synuclein pathology. Parasomnia behaviors are related to an activation (in NREM parasomnias) or a disinhibition (in RBD) of central pattern generators (CPGs). Initial management should focus on decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders. Clonazepam and melatonin appear to be effective therapies in RBD, whereas paroxetine has been reported effective in some cases of sleep terrors. At this point, pharmacotherapy for other parasomnias is less certain, and further investigations are necessary.Keywords Parasomnia . Sleepwalking . Sleep terrors . REM sleep behavior disorder . Restless legs syndrome Classification of ParasomniasParasomnias are typically classified by the sleep state from which they arise: non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM) (see Table 1 NREM parasomnias include: confusional arousals, sleepwalking disorder, and sleep terrors. These behaviors arise when the cortex incompletely arouses from deep NREM sleep, often due to comorbid conditions that provoke repeated arousal or promote sleep inertia. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking and related disorders [3].Sleep-related eating disorder (SRED) is currently classified in the International Classification of Sleep Disorders, 2nd edition (ICSD-2) under "Other Parasomnia" [1]. However the vast majority of SRED cases emanate from NREM [4], and the complex amnestic behaviors with ambulation are striking similar to sleepwalking [5]. Furthermore, both SRED and sleepwalking are frequently triggered by sedating agents in the setting of underlying motor restlessness [6]. Thus, considering these similarities, SRED will be reviewed immediately after NREM parasomnias.REM sleep behavior disorder is the most clinically relevant REM parasomnia. The loss of atoni...

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Section: Clinical Presentationmentioning

confidence: 99%

Parasomnias: An Updated Review

2012

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“…A rare association of somnambulism was reported with hyperthyroidism. [3] Studies of patterns of sleep disturbances per se other than sleep apnea are lacking…”

Section: Discussionmentioning

confidence: 99%

Sleep in thyrotoxicosis

Sridhar

Putcha

Lakshmi

2011

Indian J Endocr Metab

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Objective:Pattern of sleep in hyperthyroid state / thyrotoxicosis has not been systematically studied. It is being characterized as poor without further elaboration. We analyzed the pattern of sleep in a large sample of individuals with thyrotoxicosis who came to our endocrine center in southern India.Materials and Methods:We identified individuals with the diagnosis of ‘thyrotoxicosis’ from our electronic medical record database, and evaluated clinical parameters and pattern of their sleep: difficulty in falling asleep (DFA), difficulty in maintaining sleep (DMS), excess daytime sleepiness). In the first phase, univariate analysis with logistic regression was performed. Multivariate logistic regression was performed in the next phase on variables with a P-value < 0.1: these were considered as potential categories/ variables.Results:In model response variable with DFA, multivariate logistic regression predicted that subjects with abnormal appetite (more 1.7 or less 2.2), change in bowel motion (loose 1.5 or constipation 2.8), in mood (easy loss of temper 3.4), change of voice -- hoarse 7.4 or moderately hoarse 3.1), tended to have higher chances of difficulty in falling asleep (DFA). Patients with tremor (yes = 5.4) had greater likelihood of difficulty in maintaining sleep (DMS).Conclusions:Individuals with hyperthyroidism/thyrotoxicosis principally had difficulty in falling asleep DFA, which was related to hyperkinetic features.

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“…REM sleep behaviour disorder is a dream-enacting disorder with complex and aggressive behaviour emerging during REM sleep with loss of the usual muscle paralysis of REM sleep. Because sleepwalking has also been reported in Parkinson's disease (6), hyperthyroidism (7) and migraine (8), patients suffering from these conditions should be properly evaluated for possible occurrence of sleepwalking. These measures will facilitate early detection and prompt management of sleepwalking.…”

Section: Discussionmentioning

confidence: 99%

“…Sleepwalking also occurs in Parkinson's disease (6), hyperthyroidism (7), migraine (8) and following the use of quetiapine (9) or olanzapine (10). Diagnosing sleepwalking with objective instruments is difficult because episodes rarely occur in the laboratory.…”

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Prevalence of Sleepwalking in an Adult Population

Mume¹

2010

Libyan J Med

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BackgroundSleepwalking consists of a series of behavioral activities that occur during sleep. These activities may be simple, complex or aggressive in nature. They include motor activities, confusion, and amnesia for the events. Sleepwalking is a disorder of arousal from non-rapid eye movement (NREM) sleep. In children, episodes of sleepwalking are rarely violent; in adults, however, sleepwalking might include violence, which could endanger the patient or others and might precipitate legal issues. There is inadequate information on the prevalence and demographic correlates of sleepwalking in Nigeria.ObjectivesOne objective of this study was to determine the lifetime prevalence rate of sleepwalking in an adult population in Ile-Ife, in Southwestern Nigeria. Another objective was to determine the age and sex distribution of sleepwalking among those who have experienced it at least once in their lifetime.Materials and MethodsA random sample of 228 healthy individuals aged 18–60 years was obtained and the members were asked to fill out a survey form about lifetime prevalence rate of sleepwalking.ResultsThe overall lifetime prevalence rate of sleepwalking was 7% (16 of 228 participants). It was 10.4% in males and 3.5% in females, but the difference was not statistically significant (p=0.07).ConclusionThis study has shown that sleepwalking is common in the population. In view of the psychological effects of sleepwalking and the potential physical and legal problems associated with it, adequate efforts should be made for early detection and prompt management of the condition.

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Sleepwalking Associated with Hyperthyroidism

Cited by 36 publications

References 18 publications

Parasomnias: An Updated Review

Parasomnias: An Updated Review

Sleep in thyrotoxicosis

Prevalence of Sleepwalking in an Adult Population

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