Parasomnias

 

 Buy Article Permissions and Reprints

Parasomnias are defined as unpleasant or undesirable behavioral or experiential phenomena that occur predominately or exclusively during the sleep period. Initially thought to represent a unitary phenomenon, often attributed to psychiatric disease, it is now clear that parasomnias are not a unitary phenomenon but rather are the manifestation of a wide variety of completely different conditions, most of which are diagnosable and treatable. The parasomnias may be conveniently categorized as “primary sleep parasomnias” (disorders of the sleep states per se) and “secondary sleep parasomnias” (disorders of other organ systems, which manifest themselves during sleep). The primary sleep parasomnias can be classified according to the sleep state of origin: rapid eye movement (REM) sleep, non-REM (NREM) sleep, or miscellaneous (i.e., those not respecting sleep state). The secondary sleep parasomnias can be further classified by the organ system involved. The underlying pathophysiology of many parasomnias is state dissociation-the brain is partially awake and partially asleep. The result of this mixed state of being is that the brain is awake enough to perform very complex and often protracted motor and/or verbal behaviors but asleep enough not to have conscious awareness of, or responsibility for, these behaviors.

REFERENCES

• 1 Mahowald M W, Ettinger M G. Things that go bump in the night: the parasomnias revisited.  J Clin Neurophysiol. 1990;  7 119-143
  PubMedGoogle Scholar
• 2 Niedermeyer E, Singer H S, Folstein S E et al.. Hypersomnia with simultaneous waking and sleep patterns in the electroencephalogram.  J Neurol. 1979;  221 1-13
  PubMedGoogle Scholar
• 3 Roth B, Nevsimalova S, Rechtschaffen A. Hypersomnia with “sleep drunkenness”.  Arch Gen Psychiatry. 1972;  26 456-462
  PubMedGoogle Scholar
• 4 Zorick F J, Salis P J, Roth T, Kramer M. Narcolepsy and automatic behavior: a case report.  J Clin Psychiatry. 1979;  40 194-197
  PubMedGoogle Scholar
• 5 Roth B, Nevsimalova S, Sagova V, Paroubkova D, Horakova A. Neurological, psychological and polygraphic findings in sleep drunkenness.  Schweiz Arch Neurol Neurochir Psychiatr. 1981;  129 209-222
  PubMedGoogle Scholar
• 6 Mahowald M W, Schenck C H. REM sleep behavior disorder. In: Kryger MH, Dement W, Roth T Principles and Practice of Sleep Medicine. 2nd ed Philadelphia; WB Saunders 1994: 574-588
  Google Scholar
• 7 Mahowald M W, Schenck C H. Evolving concepts of human state dissociation.  Arch Ital Biol. 2001;  139 269-300
  PubMedGoogle Scholar
• 8 Mahowald M W, Schenck C H. Parasomnias: sleepwalking and the law.  Sleep Med Rev. 2000;  4 321-339
  CrossrefPubMedGoogle Scholar
• 9 Fisher C, Kahn E, Edwards A, Davis D M. A psychophysiological study of nightmares and night terrors. I. Physiological aspects of the stage 4 night terror.  J Nerv Ment Dis. 1973;  157 75-98
  PubMedGoogle Scholar
• 10 Fisher C, Kahn E, Edwards A, Davis D M, Fine J. A psychophysiological study of nightmares and night terrors. III. Mental content and recall of stage 4 night terrors.  J Nerv Ment Dis. 1974;  158 174-188
  PubMedGoogle Scholar
• 11 Naylor M W, Aldrich M S. The distribution of confusional arousals across sleep stages and time of night in children and adolescents with sleep terrors.  Sleep Research. 1991;  20 308
  PubMedGoogle Scholar
• 12 Mahowald M W, Schenck C H. NREM parasomnias.  Neurol Clin. 1996;  14 675-696
  CrossrefPubMedGoogle Scholar
• 13 Schenck C H, Milner D M, Hurwitz T D, Bundlie S R, Mahowald M W. Sleep-related injury in 100 adult patients: a polysomnographic and clinical report.  Am J Psychiatry. 1989;  146 1166-1173
  Google Scholar
• 14 Guilleminault C, Moscovitch A, Leger D. Forensic sleep medicine: nocturnal wandering and violence.  Sleep. 1995;  18 740-748
  PubMedGoogle Scholar
• 15 Llorente M D, Currier M B, Norman S, Mellman T A. Night terrors in adults: phenomenology and relationship to psychopathology.  J Clin Psychiatry. 1992;  53 392-394
  PubMedGoogle Scholar
• 16 Schenck C H, Mahowald M W. Review of nocturnal sleep-related eating disorders.  Int J Eat Disord. 1994;  15 343-356
  PubMedGoogle Scholar
• 17 Rosenfeld D S, Elhajjar A J. Sleepsex: a variant of sleepwalking.  Arch Sex Behav. 1998;  27 269-278
  CrossrefPubMedGoogle Scholar
• 18 Rosen G, Mahowald M W, Ferber R. Sleepwalking, confusional arousals, and sleep terrors in the child. In: Ferber R, Kryger M Principles and Practice of Sleep Medicine in the Child Philadelphia; WB Saunders 1995: 99-106
  Google Scholar
• 19 Nino-Murcia G, Dement W C. Psychophysiological and pharmacological aspects of somnambulism and night terrors in children. In: Meltzer HY Psychopharmacology: The Third Generation of Progress New York; Raven Press 1987: 873-879
  Google Scholar
• 20 Ohayon M, Guilleminault C, Priest R G. Night terrors, sleepwalking, and confusional arousal in the general population: their frequency and relationship to other sleep and mental disorders.  J Clin Psychiatry. 1999;  60 268-276
  CrossrefPubMedGoogle Scholar
• 21 Klackenberg G. Somnambulism in childhood-prevalence, course and behavior correlates: a prospective longitudinal study (6-16 years).  Acta Paediatr Scand. 1982;  71 495-499
  CrossrefPubMedGoogle Scholar
• 22 Kahn E, Fisher C, Edwards A. Night terrors and anxiety dreams. In: Ellman SD, Antrobus JS The Mind in Sleep: Psychology and Psychophysiology. 2nd ed New York; John Wiley & Sons 1991: 437-447
  Google Scholar
• 23 Crisp A H. The sleepwalking/night terrors syndrome in adults.  Postgrad Med J. 1996;  72 599-604
  PubMedGoogle Scholar
• 24 Mahowald M W, Bundlie S R, Hurwitz T D, Schenck C H. Sleep violence-forensic science implications: polygraphic and video documentation.  J Forensic Sci. 1990;  35 413-432
  PubMedGoogle Scholar
• 25 Mahowald M W, Schenck C H, Goldner M, Bachelder V, Cramer-Bornemann M. Parasomnia pseudo-suicide.  J Forensic Sci. 2003;  48 1158-1162
  PubMedGoogle Scholar
• 26 Lillywhite A R, Wilson S J, Nutt D J. Successful treatment of night terrors and somnambulism with paroxetine.  Br J Psychiatry. 1994;  164 551-554
  PubMedGoogle Scholar
• 27 Balon R. Sleep terror disorder and insomnia treated with trazadone: a case report.  Ann Clin Psychiatry. 1994;  6 161-163
  PubMedGoogle Scholar
• 28 Kales J D, Cadieux R J, Soldatos C R, Kales A. Psychotherapy with night-terror patients.  Am J Psychother. 1982;  36 399-407
  PubMedGoogle Scholar
• 29 Kellerman J. Behavioral treatment of night terrors in a child with acute leukemia.  J Nerv Ment Dis. 1979;  167 182-185
  PubMedGoogle Scholar
• 30 Gutnik B D, Reid W H. Adult somnambulism: two treatment approaches.  Nebr Med J. 1982;  67 309-312
  PubMedGoogle Scholar
• 31 Reid W H, Ahmed I, Levie C A. Treatment of sleepwalking: a controlled study.  Am J Psychother. 1981;  35 27-37
  PubMedGoogle Scholar
• 32 Hurwitz T D, Mahowald M W, Schenck C H, Schluter J L, Bundlie S R. A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror.  J Nerv Ment Dis. 1991;  179 228-233
  CrossrefPubMedGoogle Scholar
• 33 Tobin Jr J D. Treatment of somnambulism with anticipatory awakening.  J Pediatr. 1993;  122 426-427
  PubMedGoogle Scholar
• 34 Jouvet M, Delorme F. Locus coeruleus et sommeil paradoxal.  C R Seances Soc Biol Fil. 1965;  159 895-899
  PubMedGoogle Scholar
• 35 Ohayon M M, Caulet M, Priest R G. Violent behavior during sleep.  J Clin Psychiatry. 1997;  58 369-376
  PubMedGoogle Scholar
• 36 Schenck C H, Mahowald M W. Polysomnographic, neurologic, psychiatric, and clinical outcome report on 70 consecutive cases with REM sleep behavior disorder (RBD): sustained clonazepam efficacy in 89.5% of 57 treated patients.  Cleve Clin J Med. 1990;  57(suppl) S9-S23
  PubMedGoogle Scholar
• 37 Schenck C H, Bundlie S R, Ettinger M G, Mahowald M W. Chronic behavioral disorders of human REM sleep: a new category of parasomnia.  Sleep. 1986;  9 293-308
  PubMedGoogle Scholar
• 38 Schenck C H, Bundlie S R, Patterson A L, Mahowald M W. Rapid eye movement sleep behavior disorder. A treatable parasomnia affecting older adults.  JAMA. 1987;  257 1786-1789
  CrossrefPubMedGoogle Scholar
• 39 Mahowald M W, Schenck C H. REM sleep behavior disorder. In: Thorpy MJ Handbook of Sleep Disorders New York; Marcel Dekker 1990: 567-593
  Google Scholar
• 40 Tachibana M, Tanaka K, Hishikawa Y, Kaneko Z. A sleep study of acute psychotic states due to alcohol and meprobamate addiction.  Adv in Sleep Research. 1975;  2 177-205
  PubMedGoogle Scholar
• 41 Passouant P, Cadilhac J, Ribstein M. Sleep privation with eye movements using antidepressive agents [in French].  Rev Neurol (Paris). 1972;  127 173-192
  PubMedGoogle Scholar
• 42 Guilleminault C, Raynal D, Takahashi S, Carskadon M, Dement W. Evaluation of short-term and long-term treatment of the narcolepsy syndrome with clomipramine hydrochloride.  Acta Neurol Scand. 1976;  54 71-87
  CrossrefPubMedGoogle Scholar
• 43 Besset A. Effect of antidepressants on human sleep.  Adv Biosci. 1978;  21 141-148
  PubMedGoogle Scholar
• 44 Shimizu T, Ookawa M, Iijuma S et al.. Effect of clomipramine on nocturnal sleep of normal human subjects.  Annu Rev Pharmacopsychiat Res Found. 1985;  16 138
  PubMedGoogle Scholar
• 45 Bental E, Lavie P, Sharf B. Severe hypermotility during sleep in treatment of cataplexy with clomipramine.  Isr J Med Sci. 1979;  15 607-609
  PubMedGoogle Scholar
• 46 Akindele M O, Evans J I, Oswald I. Mono-amine oxidase inhibitors, sleep and mood.  Electroencephalogr Clin Neurophysiol. 1970;  29 47-56
  PubMedGoogle Scholar
• 47 Carlander B, Touchon J, Ondze B, Billiard M. REM sleep behavior disorder induced by cholinergic treatment in Alzheimer's disease.  J Sleep Res. 1996;  5(suppl 1) 28
  PubMedGoogle Scholar
• 48 Ross J S, Shua-Haim J R. Aricept-induced nightmares in Alzheimer's disease: 2 case reports.  J Am Geriatr Soc. 1998;  46 119-120
  PubMedGoogle Scholar
• 49 Schenck C H, Mahowald M W, Kim S W, O'Connor K A, Hurwitz T D. Prominent eye movements during NREM sleep and REM sleep behavior disorder associated with fluoxetine treatment of depression and obsessive-compulsive disorder.  Sleep. 1992;  15 226-235
  PubMedGoogle Scholar
• 50 Schutte S, Doghramji K. REM behavior disorder seen with venlafaxine (Effexor).  Sleep Research. 1996;  25 364
  PubMedGoogle Scholar
• 51 Nash J R, Wilson S J, Potokar J P, Nutt D J. Mirtazapine induces REM sleep behavior disorder (RBD) in parkinsonism.  Neurology. 2003;  61 1161
  PubMedGoogle Scholar
• 52 Stolz S E, Aldrich M S. REM sleep behavior disorder associated with caffeine abuse.  Sleep Research. 1991;  20 341
  PubMedGoogle Scholar
• 53 Vorona R D, Ware J C. Exacerbation of REM sleep behavior disorder by chocolate ingestion: a case report.  Sleep Med. 2002;  3 365-367
  PubMedGoogle Scholar
• 54 Pareja J A, Caminero A B, Masa J F, Dobato J L. A first case of progressive supranuclear palsy and pre-clinical REM sleep behavior disorder presenting as inhibition of speech during wakefulness and somniloquy with phasic muscle twitching during REM sleep.  Neurologia. 1996;  11 304-306
  PubMedGoogle Scholar
• 55 Boeve B F, Silber M H, Ferman J T, Lucas J A, Parisi J E. Association of REM sleep behavior disorder and neurodegenerative disease may reflect an underlying synucleinopathy.  Mov Disord. 2001;  16 622-630
  CrossrefPubMedGoogle Scholar
• 56 Boeve B F, Silber M H, Parisi J E et al.. Synucleinopathy pathology often underlies REM sleep behavior disorder and dementia or parkinsonism.  Neurology. 2003;  61 40-45
  CrossrefPubMedGoogle Scholar
• 57 Schenck C H, Bundlie S R, Mahowald M W. Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder.  Neurology. 1996;  46 388-393
  CrossrefPubMedGoogle Scholar
• 58 Montplaisir J, Petit D, Decary A et al.. Sleep and quantitative EEG in patients with progressive supranuclear palsy.  Neurology. 1997;  49 999-1003
  PubMedGoogle Scholar
• 59 Lai Y Y, Siegel J M. Physiological and anatomical link between Parkinson-like disease and REM sleep behavior disorder.  Mol Neurobiol. 2003;  27 137-152
  PubMedGoogle Scholar
• 60 Comella C L, Nardine T M, Diederich N J, Stebbins G T. Sleep-related violence, injury, and REM sleep behavior disorder in Parkinson's disease.  Neurology. 1998;  51 526-529
  PubMedGoogle Scholar
• 61 Eisehsehr I, Parrino L, Noachtar S, Smerieri A, Terzano M G. Sleep in Lennox-Gastaut syndrome: the role of the cyclic alternating pattern (CAP) in the gate control of clinical seizures and generalized polyspikes.  Epilepsy Res. 2001;  46 241-250
  CrossrefPubMedGoogle Scholar
• 62 Plazzi G, Corsini R, Provini F et al.. REM sleep behavior disorders in multiple system atrophy.  Neurology. 1997;  48 1094-1097
  CrossrefPubMedGoogle Scholar
• 63 Ghorayeb I, Yekhlef F, Chrysosotome V, Balestre E, Biouac B, Tison F. Sleep disorders and their determinants in multiple system atrophy.  J Neurol Neurosurg Psychiatry. 2002;  72 798-800
  CrossrefPubMedGoogle Scholar
• 64 Plazzi G, Cortelli P, Montagna P et al.. REM sleep behavior disorder differentiates pure autonomic failure from multiple system atrophy with autonomic failure.  J Neurol Neurosurg Psychiatry. 1998;  64 683-685
  CrossrefPubMedGoogle Scholar
• 65 Uchiyama M, Isse K, Tanaka K et al.. Incidental Lewy body disease in a patient with REM sleep behavior disorder.  Neurology. 1995;  45 709-712
  CrossrefPubMedGoogle Scholar
• 66 Louden M B, Morehead M A, Schmidt H S. Activation by selegiline (Eldepryl) of REM sleep behavior disorder in parkinsonism.  W V Med J. 1995;  91 101
  PubMedGoogle Scholar
• 67 Schenck C H, Mahowald M W. Motor dyscontrol in narcolepsy: rapid-eye-movement (REM) sleep without atonia and REM sleep behavior disorder.  Ann Neurol. 1992;  32 3-10
  CrossrefPubMedGoogle Scholar
• 68 Eisensehr I, Linke R, Noachtar S, Schwartz J, Gildehaus F J, Tatsch K. Reduced striatal dopamine transporters in idiopathic rapid eye movement sleep behavior disorder. Comparison with Parkinson's disease and controls.  Brain. 2000;  123 1155-1160
  CrossrefPubMedGoogle Scholar
• 69 Eisehsehr I, Linke R, Tatsch K et al.. Increased muscle activity during rapid eye movement sleep correlates with decrease of striatal presynaptic dopamine transporters. IPT and IBZM SPECT imaging in subclinical and clinically manifest idiopathic REM sleep behavior disorder, Parkinson's disease, and controls.  Sleep. 2003;  26 507-512
  Google Scholar
• 70 Albin R L, Koeppe R A, Chervin R D et al.. Decreased striatal dopaminergic innervation in REM sleep behavior disorder.  Neurology. 2000;  55 1410-1412
  CrossrefPubMedGoogle Scholar
• 71 Shirakawa S-I, Takeuchi N, Uchimura N et al.. Study of image findings in rapid eye movement sleep behavioral disorder.  Psychiatry Clin Neurosci. 2002;  56 291-292
  CrossrefPubMedGoogle Scholar
• 72 Miyamoto M, Miyamoto T, Kubo J, Yokota N, Hirata K, Sato T. Brainstem function in rapid eye movement sleep behavior disorder: the evaluation of brainstem function by proton MR spectroscopy (¹H-MRS).  Psychiatry Clin Neurosci. 2000;  54 350-351
  CrossrefPubMedGoogle Scholar
• 73 Gilman S, Koeppe R A, Chervin R et al.. REM sleep behavior disorder is related to striatal monoaminergic deficit in MSA.  Neurology. 2003;  61 29-34
  PubMedGoogle Scholar
• 74 Fantini M L, Gagnon J F, Petit D et al.. Slowing of electroencephalogram in rapid eye movement sleep behavior disorder.  Ann Neurol. 2003;  53 774-780
  CrossrefPubMedGoogle Scholar
• 75 Mahowald M W, Schenck C H. Status dissociatus-a perspective on states of being.  Sleep. 1991;  14 69-79
  PubMedGoogle Scholar
• 76 Schenck C H, Boyd J L, Mahowald M W. A parasomnia overlap disorder involving sleepwalking, sleep terrors, and REM sleep behavior disorder in 33 polysomnographically confirmed cases.  Sleep. 1997;  20 972-981
  PubMedGoogle Scholar
• 77 Plazzi G, Montagna P, Meletti S, Lugaresi E. Polysomnographic study of sleeplessness and onericisms in the alcohol withdrawal syndrome.  Sleep Med. 2002;  3 279-282
  PubMedGoogle Scholar
• 78 Boeve B F, Silber M H, Ferman J T. Melatonin for treatment of REM sleep behavior disorder in neurologic disorders: results in 14 patients.  Sleep Med. 2003;  4 281-284
  PubMedGoogle Scholar
• 79 Fantini M L, Gagnon J-F, Filipini D, Montplaisir J. The effects of pramipexole in REM sleep behavior disorder.  Neurology. 2003;  61 1418-1420
  CrossrefPubMedGoogle Scholar
• 80 Tan A, Salgado M, Fahn S. Rapid eye movement sleep behavior disorder preceding Parkinson's disease with therapeutic response to levodopa.  Mov Disord. 1996;  11 214-216
  CrossrefPubMedGoogle Scholar
• 81 Schenck C H, Mahowald M W. REM parasomnias.  Neurol Clin. 1996;  14 697-720
  CrossrefPubMedGoogle Scholar
• 82 Zucconi M, Ferini-Strambi L. NREM parasomnias: arousal disorders and differentiation from nocturnal frontal lobe epilepsy.  Clin Neurophysiol. 2000;  111(suppl 2) S129-S135
  CrossrefPubMedGoogle Scholar
• 83 Blatt I, Peled R, Gadoth N, Lavie P. The value of sleep recording in evaluating somnambulism in young adults.  Electroencephalogr Clin Neurophysiol. 1991;  78 407-412
  CrossrefPubMedGoogle Scholar
• 84 Aldrich M S, Jahnke B. Diagnostic value of video-EEG polysomnography.  Neurology. 1991;  41 1060-1066
  PubMedGoogle Scholar
• 85 Joncas S, Zadra A, Paquet J, Montplaisir J. The value of sleep deprivation as a diagnostic tool in adult sleepwalkers.  Neurology. 2002;  58 936-940
  CrossrefPubMedGoogle Scholar
• 86 Mahowald M W, Schenck C H. Parasomnia purgatory: the epileptic/non-epileptic interface. In: Rowan AJ, Gates JR Non-Epileptic Seizures Boston; Butterworth-Heinemann 1993: 123-139
  Google Scholar
• 87 Vetrugno R, Provini F, Plazzi G, Vignatelli L, Lugaresi E, Montagna P. Catathrenia (nocturnal groaning): a new type of parasomnia.  Neurology. 2001;  56 681-683
  Google Scholar
• 88 DeRoeck J, Van Hoof E, Cluydts R. Sleep-related expiratory groaning: a case report.  Sleep Res. 1983;  12 237
  PubMedGoogle Scholar
• 89 Happe S, Ludemann P, Ringelstein E B. Persistence of rhythmic movement disorder beyond childhood: a videotape demonstration.  Mov Disord. 2000;  15 1296-1297
  CrossrefPubMedGoogle Scholar
• 90 Kohyama J, Masukura F, Kimura K, Tachibana N. Rhythmic movement disorder: polysomnographic study and summary of reported cases.  Brain Dev. 2002;  24 33-38
  CrossrefPubMedGoogle Scholar
• 91 Kempenaers C, Bouillon E, Mendlewicz J. A rhythmic movement disorder in REM sleep: a case report.  Sleep. 1994;  17 274-279
  PubMedGoogle Scholar
• 92 Gagnon P, De Koninck J. Repetitive head movements during REM sleep.  Biol Psychiatry. 1985;  20 176-178
  CrossrefPubMedGoogle Scholar
• 93 Whyte J, Kavey N B, Gidro-Frank S. A self-destructive variant of jactatio capitis nocturna.  J Nerv Ment Dis. 1991;  179 49-50
  PubMedGoogle Scholar
• 94 Plazzi G, Provini F, Ligouri R, Lugaresi E, Montagna P. Propriospinal myoclonus at the transition from wake to sleep.  Sleep Research. 1996;  26 438
  PubMedGoogle Scholar
• 95 Vetrugno R, Provini F, Meletti S et al.. Propriospinal myoclonus at the sleep-wake transition: a new type of parasomnia.  Sleep. 2001;  24 835-843
  PubMedGoogle Scholar
• 96 Montagna P, Provini F, Plazzi G, Liguori R, Lugaresi E. Propriospinal myoclonus upon relaxation and drowsiness: a cause of severe insomnia.  Mov Disord. 1997;  12 66-72
  CrossrefPubMedGoogle Scholar
• 97 Welch K M, Cutrer F M, Goadsby P J. Migraine pathogenesis.  Neurology. 2003;  60(suppl 2) S9-S14
  PubMedGoogle Scholar
• 98 Dexter J D, Weitzman E D. The relationship of nocturnal headaches to sleep stage patterns.  Neurology. 1970;  20 513-518
  PubMedGoogle Scholar
• 99 Dexter J D, Riley T L. Studies in nocturnal migraine.  Headache. 1975;  15 51-62
  CrossrefPubMedGoogle Scholar
• 100 Kayed K, Godtlibsen O B, Sjaastad O. Chronic paroxysmal hemicrania. IV. “REM sleep locked” nocturnal headache attacks.  Sleep. 1978;  1 91-95
  PubMedGoogle Scholar
• 101 Pfaffenrath V, Pollmann W, Ruther E, Lund R, Hajak G. Onset of nocturnal attacks of chronic cluster headache in relation to sleep stages.  Acta Neurol Scand. 1986;  73 403-407
  CrossrefPubMedGoogle Scholar
• 102 Sahota P K, Dexter J D. Sleep and headache syndromes: a clinical review.  Headache. 1990;  30 80-84
  CrossrefPubMedGoogle Scholar
• 103 Coria F, Claveria L E, Jimenez-Jimenez F J, DeSeijas E V. Episodic paroxysmal hemicrania responsive to calcium channel blockers.  J Neurol Neurosurg Psychiatry. 1992;  55 166
  PubMedGoogle Scholar
• 104 Chervin R D, Zallek S N, Lin X, Hall J M, Sharma N, Hedger K M. Timing patterns of cluster headaches and association with symptoms of obstructive sleep apnea.  Sleep Res Online. 2000;  3 107-112
  PubMedGoogle Scholar
• 105 Chervin R, Zallek S N, Lin X, Hall J M, Sharma N, Hedger K M. Sleep disordered breathing in patients with cluster headache.  Neurology. 2000;  54 2302-2306
  PubMedGoogle Scholar
• 106 Aldrich M S, Chauncey J B. Are morning headaches part of the obstructive sleep apnea syndrome?.  Arch Intern Med. 1990;  150 1265-1267
  CrossrefPubMedGoogle Scholar
• 107 Sand T, Hagen K, Schrader H. Sleep apnoea and chronic headache.  Cephalalgia. 2003;  23 90-95
  CrossrefPubMedGoogle Scholar
• 108 Goder R, Friege L, Fritzer G, Strenghe H, Aldenhoff J B, Hinze-Selch D. Morning headaches in patients with sleep disorders: a systematic polysomnographic study.  Sleep Med. 2003;  4 385-391
  PubMedGoogle Scholar
• 109 Declerck A C, Arends J B. An exceptional case of parasomnia: the exploding head syndrome.  Sleep-Wake Research in The Netherlands. 1994;  5 41-43
  PubMedGoogle Scholar
• 110 Pearce J MS. Clinical features of the exploding head syndrome.  J Neurol Neurosurg Psychiatry. 1989;  52 907-910
  CrossrefPubMedGoogle Scholar
• 111 Sachs C, Svanborg E. The exploding head syndrome: polysomnographic recordings and therapeutic suggestions.  Sleep. 1991;  14 263-266
  PubMedGoogle Scholar
• 112 Walsleben J A, O'Malley E B, Freeman J, Rapoport D M. Polysomnographic and topographic mapping of EEG in the exploding head syndrome.  Sleep Research. 1993;  22 284
  PubMedGoogle Scholar
• 113 Pearce J MS. Exploding head syndrome.  Headache. 2001;  41 602-603
  CrossrefPubMedGoogle Scholar
• 114 Fornazzari L, Farcnik K, Smith I, Heasman G A, Ichise M. Violent visual hallucinations and aggression in frontal lobe dysfunction: clinical manifestations of deep orbitofrontal foci.  J Neuropsychiatry Clin Neurosci. 1992;  4 42-44
  PubMedGoogle Scholar
• 115 Jacome D E. Exploding head syndrome and idiopathic stabbing headache relieved by nifedipine.  Cephalalgia. 2001;  21 617-618
  CrossrefPubMedGoogle Scholar
• 116 Gould J D, Silberstein S D. Unilateral hypnic headache: a case study.  Neurology. 1997;  49 1749-1751
  PubMedGoogle Scholar
• 117 Ghlotto N, Sances G, Di Lorenzo G et al.. Report of eight new cases of hypnic headache and mini-review of the literature.  Funct Neurol. 2002;  17 211-219
  PubMedGoogle Scholar
• 118 Raskin N H. The hypnic headache syndrome.  Headache. 1988;  28 534-536
  CrossrefPubMedGoogle Scholar
• 119 Newman L C, Lipton R B, Solomon S. The hypnic headache syndrome: a benign headache disorder of the elderly.  Neurology. 1990;  40 1904-1905
  PubMedGoogle Scholar
• 120 Dodick D W, Mosek A C, Campbell J K. The hypnic (“alarm clock”) headache syndrome.  Cephalalgia. 1998;  18 152-156
  CrossrefPubMedGoogle Scholar
• 121 Ivanez V, Soler R, Barreiro P. Hypnic headache syndrome: a case with good response to indomethacin.  Cephalalgia. 1998;  18 225-226
  CrossrefPubMedGoogle Scholar
• 122 Relja G, Zorzon M, Locatelli L, Carraro N, Antonello R M, Cazzato G. Hypnic headache: rapid and long-lasting response to prednisone in two new cases.  Cephalalgia. 2002;  22 157-159
  CrossrefPubMedGoogle Scholar
• 123 Vieira-Dias M, Esperanca P. Hypnic headache: report of two cases.  Headache. 2001;  41 726-727
  CrossrefPubMedGoogle Scholar
• 124 Pinessi I, Rainero I, Cicolin A, Zibetti M, Gentile S, Mutani R. Hypnic headache syndrome: association of the attacks with REM sleep.  Cephalalgia. 2003;  23 150-154
  CrossrefPubMedGoogle Scholar
• 125 Evers S, Goadsby P J. Hypnic headache: clinical features, pathophysiology, and treatment.  Neurology. 2003;  60 905-909
  CrossrefPubMedGoogle Scholar
• 126 Sibon I, Ghorayeb I, Henry P. Successful treatment of hypnic headache syndrome with acetazolamide.  Neurology. 2003;  61 1157-1158
  PubMedGoogle Scholar
• 127 Peatfield R C, Mendoza N D. Posterior fossa meningioma presenting as hypnic headache.  Headache. 2003;  43 1007-1008
  CrossrefPubMedGoogle Scholar

Mark W MahowaldM.D. 

Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center

701 Park Avenue, Minneapolis

MN 55415