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Semin Neurol 2004; 24(3): 283-292
DOI: 10.1055/s-2004-835064
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Parasomnias

Mark W. Mahowald1 , Michel Cramer Bornemann2 , Carlos H. Schenck3
  • 1Minnesota Regional Sleep Disorders Center, and Departments of Neurology, Hennepin County Medical Center, and the University of Minnesota Medical School, Minneapolis
  • 2Minnesota Regional Sleep Disorders Center, and Departments of Pulmonary Medicine, Hennepin County Medical Center, and the University of Minnesota Medical School, Minneapolis
  • 3Minnesota Regional Sleep Disorders Center, and Departments of Psychiatry, Hennepin County Medical Center, and the University of Minnesota Medical School, Minneapolis
Further Information

Publication History

Publication Date:
27 September 2004 (online)

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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.

KEYWORDS

Parasomnias - sleepwalking - sleep terrors - REM sleep behavior disorder - sleep-related headaches - sleep-related expiratory groaning - rhythmic movement disorder

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
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 3 Roth B, Nevsimalova S, Rechtschaffen A. Hypersomnia with “sleep drunkenness”.  Arch Gen Psychiatry. 1972;  26 456-462
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    Search in Google Scholar
  • 7 Mahowald M W, Schenck C H. Evolving concepts of human state dissociation.  Arch Ital Biol. 2001;  139 269-300
    PubMedSearch in Google Scholar
  • 8 Mahowald M W, Schenck C H. Parasomnias: sleepwalking and the law.  Sleep Med Rev. 2000;  4 321-339
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 12 Mahowald M W, Schenck C H. NREM parasomnias.  Neurol Clin. 1996;  14 675-696
    CrossrefPubMedSearch in Google 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
    Search in Google Scholar
  • 14 Guilleminault C, Moscovitch A, Leger D. Forensic sleep medicine: nocturnal wandering and violence.  Sleep. 1995;  18 740-748
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 16 Schenck C H, Mahowald M W. Review of nocturnal sleep-related eating disorders.  Int J Eat Disord. 1994;  15 343-356
    PubMedSearch in Google Scholar
  • 17 Rosenfeld D S, Elhajjar A J. Sleepsex: a variant of sleepwalking.  Arch Sex Behav. 1998;  27 269-278
    CrossrefPubMedSearch in Google 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
    Search in 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
    Search in 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    Search in Google Scholar
  • 23 Crisp A H. The sleepwalking/night terrors syndrome in adults.  Postgrad Med J. 1996;  72 599-604
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 27 Balon R. Sleep terror disorder and insomnia treated with trazadone: a case report.  Ann Clin Psychiatry. 1994;  6 161-163
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 29 Kellerman J. Behavioral treatment of night terrors in a child with acute leukemia.  J Nerv Ment Dis. 1979;  167 182-185
    PubMedSearch in Google Scholar
  • 30 Gutnik B D, Reid W H. Adult somnambulism: two treatment approaches.  Nebr Med J. 1982;  67 309-312
    PubMedSearch in Google Scholar
  • 31 Reid W H, Ahmed I, Levie C A. Treatment of sleepwalking: a controlled study.  Am J Psychother. 1981;  35 27-37
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 33 Tobin Jr J D. Treatment of somnambulism with anticipatory awakening.  J Pediatr. 1993;  122 426-427
    PubMedSearch in Google Scholar
  • 34 Jouvet M, Delorme F. Locus coeruleus et sommeil paradoxal.  C R Seances Soc Biol Fil. 1965;  159 895-899
    PubMedSearch in Google Scholar
  • 35 Ohayon M M, Caulet M, Priest R G. Violent behavior during sleep.  J Clin Psychiatry. 1997;  58 369-376
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    Search in 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 43 Besset A. Effect of antidepressants on human sleep.  Adv Biosci. 1978;  21 141-148
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 46 Akindele M O, Evans J I, Oswald I. Mono-amine oxidase inhibitors, sleep and mood.  Electroencephalogr Clin Neurophysiol. 1970;  29 47-56
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 50 Schutte S, Doghramji K. REM behavior disorder seen with venlafaxine (Effexor).  Sleep Research. 1996;  25 364
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 52 Stolz S E, Aldrich M S. REM sleep behavior disorder associated with caffeine abuse.  Sleep Research. 1991;  20 341
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 62 Plazzi G, Corsini R, Provini F et al.. REM sleep behavior disorders in multiple system atrophy.  Neurology. 1997;  48 1094-1097
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    Search in 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 75 Mahowald M W, Schenck C H. Status dissociatus-a perspective on states of being.  Sleep. 1991;  14 69-79
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 81 Schenck C H, Mahowald M W. REM parasomnias.  Neurol Clin. 1996;  14 697-720
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 84 Aldrich M S, Jahnke B. Diagnostic value of video-EEG polysomnography.  Neurology. 1991;  41 1060-1066
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    Search in 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
    Search in Google Scholar
  • 88 DeRoeck J, Van Hoof E, Cluydts R. Sleep-related expiratory groaning: a case report.  Sleep Res. 1983;  12 237
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 91 Kempenaers C, Bouillon E, Mendlewicz J. A rhythmic movement disorder in REM sleep: a case report.  Sleep. 1994;  17 274-279
    PubMedSearch in Google Scholar
  • 92 Gagnon P, De Koninck J. Repetitive head movements during REM sleep.  Biol Psychiatry. 1985;  20 176-178
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 97 Welch K M, Cutrer F M, Goadsby P J. Migraine pathogenesis.  Neurology. 2003;  60(suppl 2) S9-S14
    PubMedSearch in Google Scholar
  • 98 Dexter J D, Weitzman E D. The relationship of nocturnal headaches to sleep stage patterns.  Neurology. 1970;  20 513-518
    PubMedSearch in Google Scholar
  • 99 Dexter J D, Riley T L. Studies in nocturnal migraine.  Headache. 1975;  15 51-62
    CrossrefPubMedSearch in Google Scholar
  • 100 Kayed K, Godtlibsen O B, Sjaastad O. Chronic paroxysmal hemicrania. IV. “REM sleep locked” nocturnal headache attacks.  Sleep. 1978;  1 91-95
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 102 Sahota P K, Dexter J D. Sleep and headache syndromes: a clinical review.  Headache. 1990;  30 80-84
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 107 Sand T, Hagen K, Schrader H. Sleep apnoea and chronic headache.  Cephalalgia. 2003;  23 90-95
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 110 Pearce J MS. Clinical features of the exploding head syndrome.  J Neurol Neurosurg Psychiatry. 1989;  52 907-910
    CrossrefPubMedSearch in Google Scholar
  • 111 Sachs C, Svanborg E. The exploding head syndrome: polysomnographic recordings and therapeutic suggestions.  Sleep. 1991;  14 263-266
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 113 Pearce J MS. Exploding head syndrome.  Headache. 2001;  41 602-603
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 115 Jacome D E. Exploding head syndrome and idiopathic stabbing headache relieved by nifedipine.  Cephalalgia. 2001;  21 617-618
    CrossrefPubMedSearch in Google Scholar
  • 116 Gould J D, Silberstein S D. Unilateral hypnic headache: a case study.  Neurology. 1997;  49 1749-1751
    PubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 118 Raskin N H. The hypnic headache syndrome.  Headache. 1988;  28 534-536
    CrossrefPubMedSearch in Google 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
    PubMedSearch in Google Scholar
  • 120 Dodick D W, Mosek A C, Campbell J K. The hypnic (“alarm clock”) headache syndrome.  Cephalalgia. 1998;  18 152-156
    CrossrefPubMedSearch in Google Scholar
  • 121 Ivanez V, Soler R, Barreiro P. Hypnic headache syndrome: a case with good response to indomethacin.  Cephalalgia. 1998;  18 225-226
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 123 Vieira-Dias M, Esperanca P. Hypnic headache: report of two cases.  Headache. 2001;  41 726-727
    CrossrefPubMedSearch in Google 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
    CrossrefPubMedSearch in Google Scholar
  • 125 Evers S, Goadsby P J. Hypnic headache: clinical features, pathophysiology, and treatment.  Neurology. 2003;  60 905-909
    CrossrefPubMedSearch in Google Scholar
  • 126 Sibon I, Ghorayeb I, Henry P. Successful treatment of hypnic headache syndrome with acetazolamide.  Neurology. 2003;  61 1157-1158
    PubMedSearch in Google Scholar
  • 127 Peatfield R C, Mendoza N D. Posterior fossa meningioma presenting as hypnic headache.  Headache. 2003;  43 1007-1008
    CrossrefPubMedSearch in Google Scholar

Mark W MahowaldM.D. 

Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center

701 Park Avenue, Minneapolis

MN 55415