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Sleep and Comorbid Neurologic Disorders

Watson, Nathaniel F. MD, MSc; Viola-Saltzman, Mari DO

doi: 10.1212/01.CON.0000427208.13553.8c
Review Articles

Purpose of Review: An understanding of the impact of sleep on neurologic disorders, and the impact of neurologic disorders on sleep, provides fresh opportunities for neurologists to improve the quality of life and functioning of their patients.

Recent Findings: Sleep-disordered breathing (SDB) is a risk factor for cerebrovascular disease and should be considered in all TIA and stroke patients. Sleep disorders can amplify nociception and worsen headache disorders; and some headaches, including those related to SDB and hypnic headache, are sleep specific. REM sleep behavior disorder may be an early sign of neurodegenerative disease. Focal lesions of almost any etiology (eg, multiple sclerosis and CNS malignancies) in the hypothalamus, basal forebrain, or brainstem may result in sleep disturbance, sleepiness, and insomnia. Sleep-related hypoventilation and fatigue are common in neuromuscular disease. SDB and epilepsy are mutually facilitatory, and poor sleep can exacerbate epilepsy.

Summary: Continued surveillance for sleep disorders by neurologists is rewarded by new treatment avenues in their patients with the possibility of improved clinical outcomes.

Address correspondence to Dr Nathaniel F. Watson, Harborview Medical Center, UW Medicine Sleep Center, 325 Ninth Ave, Box 359803, Seattle, WA, 98104, nwatson@uw.edu.

Relationship Disclosure: Dr Watson serves on the Board of Directors for the American Academy of Sleep Medicine and the American Sleep Medicine Foundation. Dr Viola-Saltzman reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Watson and Viola-Saltzman report no disclosures.

Supplemental digital content: Videos accompanying this article are cited in the text as Supplemental Digital Content. Videos may be accessed by clicking on links provided in the HTML, PDF, and iPad versions of this article; the URLs are provided in the print version. Video legends begin on page 165.

© 2013 American Academy of Neurology
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