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Excessive Daytime Sleepiness and Sleep Disturbances in Patients with Neurological Diseases

Epidemiology and Management

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Abstract

Up to 12% of the general population experience excessive daytime sleepiness (EDS), with increasing prevalence in the elderly. EDS may lead to cognitive impairment, resulting in inattentiveness, poor memory, mood disorders and an increased risk of accidents. As a result, quality of life is reduced in most patients with EDS as well as in their caregiving spouses. There are a variety of causes leading to EDS, including CNS pathology, neurological dysfunction, associated sleep disorders with insufficient or fragmented sleep, and drug therapy. Since EDS accompanies many neurological disorders, such as neurodegenerative and neuromuscular diseases, neurologists should be familiar with the diagnosis, its major causes and with treatment options.

The main focus of this article is on movement disorders, neuromuscular diseases, multiple sclerosis, dementia, cerebrovascular diseases, head and brain trauma, pain and epilepsy. General managment strategies for EDS in all these neurological diseases include sleep hygiene aspects such as extensions of noctural time in bed and frequent naps during the day. Pharmacological treatment is generally achieved with stimulants such as amphetamine, methylphenidate and pemoline, or newer compounds such as modafinil.

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References

  1. Connor J, Whitlock G, Norton R, et al. The role of driver sleepiness in car crashes: a systematic review of epidemiological studies. Accid Anal Prev 2001; 33: 31–41

    PubMed  CAS  Google Scholar 

  2. Asplund R. Daytime sleepiness and napping amongst the elderly in relation to somatic health and medical treatment. J Intern Med 1996; 239: 261–7

    PubMed  CAS  Google Scholar 

  3. American Sleep Disorders Association. International classification of sleep disorders, revised: diagnostic and coding manual. Rochester (NY): American Sleep Disorders Association, 1997

    Google Scholar 

  4. Mahowald MW. Eyes wide shut: the dangers of sleepy driving. Minn Med 2000; 83: 25–30

    PubMed  CAS  Google Scholar 

  5. El-Ad B, Korczyn AD. Disorders of excessive daytime sleepiness: an update. J Neurol Sci 1998; 153: 192–202

    PubMed  CAS  Google Scholar 

  6. Guilleminault C, Brooks SN. Excessive daytime sleepiness: a challenge for the practising neurologist. Brain 2001; 124: 1482–91

    PubMed  CAS  Google Scholar 

  7. Roth T, Roehrs TA. Etiologies and sequelae of excessive daytime sleepiness. Clin Ther 1996; 18: 562–76

    PubMed  CAS  Google Scholar 

  8. Lee KA, Hicks G, Nino-Murcia G. Validity and reliability of a scale to assess fatigue. Psychiatry Res 1991; 36: 291–8

    PubMed  CAS  Google Scholar 

  9. Johns MW. A new method for measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991; 14: 540–5

    PubMed  CAS  Google Scholar 

  10. Hoddes E, Zarcone V, Smythe H, et al. Quantification of sleepiness: a new approach. Psychophysiology 1973; 10: 431–6

    PubMed  CAS  Google Scholar 

  11. Weaver TE, Laizner AM, Evans LK, et al. An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep 1997; 20: 835–43

    PubMed  CAS  Google Scholar 

  12. Richardson GS, Carskadon MA, Flagg W, et al. Excessive daytime sleepiness in man: multiple sleep latency measurement in narcoleptic and control subjects. Electroencephalogr Clin Neurophysiol 1978; 45: 621–7

    PubMed  CAS  Google Scholar 

  13. Mitler MM, Krishnareddy SG, Browman CP. Maintenance of wakefulness test: a polysomnographic technique for evaluating treatment efficacy in patients with excessive somnolence. Electroencephalogr Clin Neurophysiol 1982; 53: 658–61

    PubMed  CAS  Google Scholar 

  14. Bennett LS, Stradling JR, Davies RJ. A behavioural test to assess daytime sleepiness in obstructive sleep apnea. J Sleep Res 1997; 16: 142–5

    Google Scholar 

  15. Wilhelm B, Wilhelm H, Lüdtke H, et al. Pupillographic assessment of sleepiness in sleep-deprived healthy subjects. Sleep 1998; 21: 258–65

    PubMed  CAS  Google Scholar 

  16. Meier-Ewert K. Abnorme Tagesschläfrigkeit: Ansätze zu einer Typologie. Ther Umsch 1991; 48: 746–50

    PubMed  CAS  Google Scholar 

  17. Mackworth NH. Vigilance. Advancement Sci 1957; 53: 389–93

    Google Scholar 

  18. Johns MW. Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the Epworth sleepiness scale: failure of the MSLT as a gold standard. J Sleep Res 2000; 9: 5–11

    PubMed  CAS  Google Scholar 

  19. Happe S, Pirker W, Sauter C, et al. Successful treatment of excessive daytime sleepiness in Parkinson’s disease with modafinil. J Neurol 2001; 248: 632–4

    PubMed  CAS  Google Scholar 

  20. Nieves AV, Lang AE. Treatment of excessive daytime sleepiness in patients with Parkinson’s disease with modafinil. Clin Neuropharmacol 2002; 25: 111–4

    PubMed  CAS  Google Scholar 

  21. Damian MS, Gerlach A, Schmidt F, et al. Modafmil for excessive daytime sleepiness in myotonic dystrophy. Neurology 2001; 56: 794–6

    PubMed  CAS  Google Scholar 

  22. Rammohan KW, Rosenberg JH, Lynn DJ, et al. Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study. J Neurol Neurosurg Psychiatry 2002; 72(2): 179–83

    PubMed  CAS  Google Scholar 

  23. Parkes JD, Tarsy D, Marsden CD, et al. Amphetamines in the treatment of Parkinson’s disease. J Neurol Neurosurg Psychiatry 1975; 38: 232–7

    PubMed  CAS  Google Scholar 

  24. Van der Meche FG, Bogaard JM, van der Sluys JC, et al. Daytime sleep in myotonic dystrophy is not caused by sleep apnoea. J Neurol Neurosurg Psychiatry 1994; 57: 626–8

    PubMed  Google Scholar 

  25. Miyamoto T, Miyamoto M, Suga T, et al. Methylphenidate hydrochloride for excessive daytime sleepiness in a patient with myotonic dystrophy. Psychiatry Clin Neurosci 2002; 56: 271–2

    PubMed  Google Scholar 

  26. Happe S, Trenkwalder C. Movement disorders in sleep: Parkinson’s disease and restless legs syndrome. Biomed Tech (Berl) 2003 Mar; 48(3): 62–7

    CAS  Google Scholar 

  27. Chokroverty S. Sleep and degenerative neurologic disorders. Neurol Clin 1996; 4: 807–26

    Google Scholar 

  28. Fish DR, Sawyers D, Allen PJ, et al. The effect of sleep on the dyskinetic movements of Parkinson’s disease, Gilles de la Tourette syndrome, Huntington’s disease, and torsion dystonia. Arch Neurol 1991; 48: 210–4

    PubMed  CAS  Google Scholar 

  29. Rothenberger A, Kostanecka T, Kinkelbur J, et al. Sleep and Tourette syndrome. In: Cohen DJ, Goetz CG, Jankovic J, editors. Tourette syndrome. Philadelphia (PA): Lippincott Williams and Wilkins, 2001: 245–59

    Google Scholar 

  30. Boeve BF, Silber MH, Ferman TJ, et al. Association of REM sleep behavior disorder and neurodegenerative disease may reflect an underlying synucleinopathy. Mov Disord 2001; 16: 622–30

    PubMed  CAS  Google Scholar 

  31. Eisensehr I, Lindeiner H, Jäger M, et al. REM sleep behavior disorder in sleep-disordered patients with versus without Parkinson’s disease: is there a need for polysomnography? J Neurol Sci 2001; 186:7–11

    PubMed  CAS  Google Scholar 

  32. Tandberg E, Larsen JP, Karlsen K. Excessive daytime sleepiness and sleep benefit in Parkinson’s disease: a community based study. Mov Disord 1999; 14: 922–7

    PubMed  CAS  Google Scholar 

  33. Factor SA, McAlarney T, Sanchez-Ramoz JR, et al. Sleep disorders and sleep effect in Parkinson’s disease. Mov Disord 1990; 5: 280–5

    PubMed  CAS  Google Scholar 

  34. Tan EK, Lum SY, Fook-Chong SM, et al. Evaluation of somnolence in Parkinson’s disease: comparison with age- and sex-matched controls. Neurology 2002; 58: 465–8

    PubMed  CAS  Google Scholar 

  35. O’Suilleabhain PE, Dewey Jr RB. Contributions of dopaminergic drugs and disease severity to daytime sleepiness in Parkinson disease. Arch Neurol 2002; 59: 986–9

    PubMed  Google Scholar 

  36. Frucht S, Rogers J, Greene P, et al. Falling asleep at the wheel: motor vehicle mishaps in persons taking pramipexole and ropinirole. Neurology 1999; 52: 1908–10

    PubMed  CAS  Google Scholar 

  37. Ryan M, Slevin JD, Wells A. Non-ergot dopamine agonist-induced sleep attacks. Pharmacotherapy 2000; 20: 724–6

    PubMed  CAS  Google Scholar 

  38. Pal S, Bhattacharya KF, Agapito C, et al. A study of excessive daytime sleepiness and its clinical significance in three groups of Parkinson’s disease patients taking pramipexole, cabergoline and levodopa mono and combination therapy. J Neural Transm 2001; 108:71–7

    PubMed  CAS  Google Scholar 

  39. Happe S, Berger K. The association of dopamine agonists with daytime sleepiness, sleep problems and quality of life in patients with Parkinson’s disease: a prospective study. J Neurol 2001; 248: 1062–7

    PubMed  CAS  Google Scholar 

  40. Chaudhuri KR, Pal S, Bridgman K, et al. Achieving 24-hour control of Parkinson’s disease symptoms: use of objective measures to improve nocturnal disability. Eur Neurol 2001; 46 Suppl. 1: 3–10

    PubMed  Google Scholar 

  41. Happe S, Berger K. The association between caregiver burden and sleep disturbances in partners of patients with Parkinson’s disease. Age Ageing 2002; 31: 349–54

    PubMed  Google Scholar 

  42. Karlsen KH, Larsen JP, Tandberg E, et al. Influence of clinical and demographic variables on quality of life in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999; 66: 431–5

    PubMed  CAS  Google Scholar 

  43. Schenck C, Hurwitz T, Mahowald M. REM sleep behavior disorder: an update on a series of 96 patients and a review of the world literature. J Sleep Res 1993; 2: 224–31

    PubMed  Google Scholar 

  44. Olson EJ, Boeve BF, Silber MH. Rapid eye movement sleep behavior disorder: demographic, clinical and laboratory findings in 93 cases. Brain 2000; 123: 331–9

    PubMed  Google Scholar 

  45. Voderholzer U, Müller N, Haag C, et al. Periodic limb movements during sleep are a frequent finding in patients with Gilles de la Tourette’s syndrome. J Neurol 1997; 244: 521–6

    PubMed  CAS  Google Scholar 

  46. Tarajanovic NN, Shapiro CM, Sandor P. REM sleep behaviour disorder in patients with Tourette’s syndrome [abstract]. Sleep Res 1997; 26: 524

    Google Scholar 

  47. Cohrs S, Rasch T, Altmeyer S, et al. Decreased sleep quality and increased sleep related movements in patients with Tourette’s syndrome. J Neurol Neurosurg Psychiatry 2001; 70: 192–7

    PubMed  CAS  Google Scholar 

  48. Glaze DG, Frost Jr JD, Jankovic J. Sleep in Gilles de la Tourette’s syndrome: disorder of arousal. Neurology 1983; 33: 586–92

    PubMed  CAS  Google Scholar 

  49. Jankovic J, Rohaidy H. Motor, behavioral and pharmacologic findings in Tourette’s syndrome. Can J Neurol Sci 1987; 14: 541–6

    PubMed  CAS  Google Scholar 

  50. Ziemann U, Paulus W, Rothenberger A. Decreased motor inhibition in Tourette’s disorder: evidence from transcranial magnetic stimulation. Am J Psychiatry 1997; 154: 1277–84

    PubMed  CAS  Google Scholar 

  51. Butler IJ, Doslow SH, Sieger WE, et al. Biogenic amine metabolism in Tourette syndrome. Ann Neurol 1979; 6: 37–9

    PubMed  CAS  Google Scholar 

  52. Mendelson WB, Caine ED, Goyer P, et al. Sleep in Gilles de la Tourette syndrome. Biol Psychiatry 1980; 15: 339–43

    PubMed  CAS  Google Scholar 

  53. Bollen EL, den Heijer JC, Ponsioen C, et al. Respiration during sleep in Huntington’s chorea. J Neurol Sci 1988; 84: 63–8

    PubMed  CAS  Google Scholar 

  54. Hansotia P, Wall R, Berendes J. Sleep disturbances and severity of Huntington’s disease. Neurology 1985; 34: 1672–4

    Google Scholar 

  55. Wiegand M, Möller AA, Lauer CJ, et al. Nocturnal sleep in Huntington’s disease. J Neurol 1991; 238: 203–8

    PubMed  CAS  Google Scholar 

  56. Feigin A, Kiebertz K, Shoulson I. Treatment of Huntington’s disease and other choreic disorders. In: Kurlan R, editor. Treatment of movement disorders. Philadelphia (PA): JB Lippincott, 1994: 337–64

    Google Scholar 

  57. Fish DR, Allen PJ, Sawyers D. Sleep spindles in torsion dystonia. Arch Neurol 1990; 47: 216–8

    PubMed  CAS  Google Scholar 

  58. Fish DR, Sawyers D, Smith SJ, et al. Motor inhibition from the brainstem is normal in torsion dystonia during REM sleep. J Neurol Neurosurg Psychiatry 1991; 54: 140–4

    PubMed  CAS  Google Scholar 

  59. Jankel WR, Niedermeyer E, Graf M, et al. Polysomnography of torsion dystonia. Arch Neurol 1984; 41: 1081–3

    PubMed  CAS  Google Scholar 

  60. Bressman SB. Dystonia update. Clin Neuropharmacol 2000; 23: 239–51

    PubMed  CAS  Google Scholar 

  61. Montplaisir J, Boucher S, Poirier G, et al. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord 1997; 12: 61–5

    PubMed  CAS  Google Scholar 

  62. Lavigne GJ, Montplaisir JY. Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. Sleep 1994; 17: 739–43

    PubMed  CAS  Google Scholar 

  63. Phillips B, Young T, Finn L, et al. Epidemiology of restless legs symptoms in adults. Arch Intern Med 2000; 160: 2137–41

    PubMed  CAS  Google Scholar 

  64. Rothdach AJ, Trenkwalder C, Haberstock J, et al. Prevalence and risk factors of RLS in an elderly population: the MEMO Study. Neurology 2000; 54: 1064–8

    PubMed  CAS  Google Scholar 

  65. Ancoli-Israel S, Kripke DM, Klauber MR, et al. Periodic limb movements in sleep in community dwelling elderly. Sleep 1991; 14: 496–500

    PubMed  CAS  Google Scholar 

  66. Walters AS, Hickey K, Maltzman J, et al. A questionnaire study of 138 patients with restless legs syndrome: the ‘night walkers’ survey. Neurology 1996; 46: 92–5

    PubMed  CAS  Google Scholar 

  67. Hening W, Allen R, Earley C, et al. The treatment of restless legs syndrome and periodic limb movement disorder. Sleep 1999; 22: 970–99

    PubMed  CAS  Google Scholar 

  68. Earley CJ, Connor JR, Beard JL, et al. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology 2000; 54: 1698–700

    PubMed  CAS  Google Scholar 

  69. Banno K, Delaive K, Walld R, et al. Restless legs syndrome in 218 patients: associated disorders. Sleep Med 2000; 1: 221–9

    PubMed  Google Scholar 

  70. Machtey I, Tiqwa P. Restless legs syndrome: a metabolic disorder [letter]? Arch Intern Meds 1996; 156: 2386

    PubMed  CAS  Google Scholar 

  71. Ondo W, Tan EK, Mansoor J. Rheumatologic serologies in secondary restless legs syndrome. Mov Disord 2000; 15: 321–3

    PubMed  CAS  Google Scholar 

  72. Lugaresi E, Coccagna G, Tassinari CA, et al. Polygraphic data on motor phenomena in the restless legs syndrome. Riv Neurol 1965; 35: 550–61

    PubMed  CAS  Google Scholar 

  73. Atlas Task Force of the American Sleep Disorders Association. Recording and scoring of leg movements. Sleep 1993; 16: 748–59

    Google Scholar 

  74. Montplaisir J, Nicolas A, Godbout R, et al. Restless legs syndrome and periodic limb movement disorder. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. Philadelphia (PA): WB Saunders, 2000: 742–52

    Google Scholar 

  75. Kazenwadel J, Pollmacher T, Trenkwalder C, et al. New actigraphic assessment method for periodic leg movements (PLM). Sleep 1995; 18: 689–97

    PubMed  CAS  Google Scholar 

  76. Michaud M, Lavigne G, Desautels A, et al. Effects of immobility on sensory and motor symptoms of restless legs syndrome. Mov Disord 2002; 17: 112–5

    PubMed  Google Scholar 

  77. Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institute of Health. Sleep Med 2003; 4(2): 101–19

    Google Scholar 

  78. Hornyak M, Kotterba S, Trenkwalder C. Indications for performing polysomnography in the diagnosis and treatment of restless legs syndrome. Somnologie 2001; 5: 159–62

    Google Scholar 

  79. Becker PM, Jamieson AO, Brown WD. Dopaminergic agents in restless legs syndrome and periodic limb movements of sleep: response and complications of extended treatment in 49 cases. Sleep 1993; 16: 713–6

    PubMed  CAS  Google Scholar 

  80. Chesson AL, Wise M, Davila D, et al. Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder: an American Academy of Sleep Medicine Report. Standards of Practice Committee of the Academy of Sleep Medicine. Sleep 1999; 22: 961–8

    Google Scholar 

  81. Walters AS. Toward a better definition of restless legs syndrome: the International Restless Legs Syndrome Study Group. Mov Disord 1995; 10: 634–42

    PubMed  CAS  Google Scholar 

  82. Lauerma H, Markkula J. Treatment of restless legs syndrome with tramadol: an open study. J Clin Psychiatry 1999; 60: 241–4

    PubMed  CAS  Google Scholar 

  83. Walters AS, Wagner ML, Hening WA, et al. Successful treatment of the idiopathic restless legs syndrome in a randomized double-blind trial of oxycodone versus placebo. Sleep 1993; 16: 327–32

    PubMed  CAS  Google Scholar 

  84. Walters AS, Winkelmann J, Trenkwalder C, et al. Long-term follow-up on restless legs syndrome patients treated with opioids. Mov Disord 2001; 16: 1105–9

    PubMed  CAS  Google Scholar 

  85. Montagna P, Sassoli de Bianchi L, Zucconi M, et al. Clonazepam and vibration in restless legs syndrome. Acta Neurol Scand 1984; 69: 428–30

    PubMed  CAS  Google Scholar 

  86. Telstad W, Sorensen O, Larsen S, et al. Treatment of the restless legs syndrome with carbamazepine: a double blind study. BMJ 1984; 288: 444–6

    PubMed  CAS  Google Scholar 

  87. Happe S, Klösch G, Saletu B, et al. Treatment of idiopathic restless legs syndrome (RLS) with gabapentin. Neurology 2001; 57: 1717–9

    PubMed  CAS  Google Scholar 

  88. Garcia-Borruguero D, Larrosa O, de la Llave Y, et al. Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study. Neurology 2002; 59: 1573–9

    Google Scholar 

  89. Guilleminault C, Stoohs R, Quera-Salva MA. Sleep-related obstructive and nonobstructive apneas and neurologic disorders. Neurology 1992; 42 (6 Suppl.): 53–60

    PubMed  CAS  Google Scholar 

  90. George CF. Neuromuscular disorders. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 2nd ed. Philadelphia (PA): WB Saunders Company, 1994: 776–81

    Google Scholar 

  91. Barthlen GM. Nocturnal respiratory failure as an indication of non-invasive ventilation in the patient with neuromuscular disease. Respiration 1997; 64 (1 Suppl.): 35–8

    PubMed  Google Scholar 

  92. Culebras A. Sleep and neuromuscular disorders. Neurol Clin 1996; 1: 791–805

    Google Scholar 

  93. Amino A, Shiozawa Z, Nagasaka T, et al. Sleep apnoea in well-controlled myasthenia gravis and the effect of thymectomy. J Neurol 1998; 245: 77–80

    PubMed  CAS  Google Scholar 

  94. Kryger MH. Restrictive lung diseases. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 2nd ed. Philadelphia (PA): WB Saunders Company, 1994: 769–75

    Google Scholar 

  95. Giubilei F, Antonini G, Bastianello S, et al. Excessive daytime sleepiness in myotonic dystrophy. J Neurol Sci 1999; 164: 60–3

    PubMed  CAS  Google Scholar 

  96. Van Hilten JJ, Weggeman M, van der Velde EA, et al. Sleep, excessive daytime sleepiness and fatigue in Parkinson’s disease. J Neural Transm 1993; 5: 235–44

    Google Scholar 

  97. Barthlen GM, Lange DJ. Unexpectedly severe sleep and respiratory pathology in patients with amyotrophic lateral sclerosis. Eur J Neurol 2000; 7: 299–302

    PubMed  CAS  Google Scholar 

  98. Quera-Salva MA, Guilleminault C, Chevret S, et al. Breathing disorders during sleep in myasthenia gravis. Ann Neurol 1992; 31: 86–92

    PubMed  CAS  Google Scholar 

  99. Stepansky R, Weber G, Zeitlhofer J. Sleep apnea and cognitive dysfunction in myasthenia gravis. Acta Med Austriaca 1997; 24: 128–31

    PubMed  CAS  Google Scholar 

  100. Steljes DG, Kryger MH, Kirk BW, et al. Sleep in postpolio syndrome. Chest 1990; 98(1): 133–40

    PubMed  CAS  Google Scholar 

  101. Filippi M, Rocca MA, Colombo B, et al. Functional magnetic resonance imaging correlates of fatigue in multiple sclerosis. Neuroimage 2002; 15: 559–67

    PubMed  CAS  Google Scholar 

  102. Rossini PM, Pasqualetti P, Pozzilli C, et al. Fatigue in progressive multiple sclerosis: results of a randomized, double-blind, placebo-controlled, crossover trial of oral 4-aminopyridine. Mult Scler 2001;7: 354–8

    PubMed  CAS  Google Scholar 

  103. McGaffigan S, Bliwise DL. The treatment of sundowning: a selective review of pharmacological and nonpharmacological studies. Drugs Aging 1997; 10: 10–7

    PubMed  CAS  Google Scholar 

  104. Ancoli-Israel S, Klauber MR, Gillin JC, et al. Sleep in non-institutionalised Alzheimer’s patients. Aging (Milano) 1994; 6: 451–8

    CAS  Google Scholar 

  105. Cardinali DP, Brusco LI, Liberczuk C, et al. The use of melatonin in Alzheimer’s disease. Neuroendocrinol Lett 2002; 23 Suppl. 1: 20–3

    PubMed  CAS  Google Scholar 

  106. Pollack CP, Stokes PE. Circadian rest-activity in demented and non-demented older community residents and their caregivers. J Am Geriatr Soc 1997; 45: 446–52

    Google Scholar 

  107. Bader GG, Turesson K, Wallin A. Sleep related breathing and movement disorders in healthy elderly and demented subjects. Dementia 1996; 7: 279–87

    PubMed  CAS  Google Scholar 

  108. Grace JB, Walker MP, McKeith IG. A comparison of sleep profiles in patients with dementia with Lewy bodies and Alzheimer’s disease. Int J Geriatr Psychiatry 2000; 15: 1028–33

    PubMed  CAS  Google Scholar 

  109. Cibula JE, Eisenschenk S, Gold M, et al. Progressive dementia and hypersomnolence with dream-enacting behavior: oneiric dementia. Arch Neurol 2002; 59: 630–4

    PubMed  Google Scholar 

  110. Foley D, Monjan A, Masaki K, et al. Daytime sleepiness is associated with 3-year incident dementia and cognitive decline in Japanese-American men. J Am Geriatr Soc 2001; 49: 1628–32

    PubMed  CAS  Google Scholar 

  111. Shochat T, Loredo J, Ancoli-Israel S. Sleep disorders in the elderly. Curr Treat Options Neurol 2001; 3: 19–36

    PubMed  Google Scholar 

  112. Boeve BF, Silber MH, Ferman TJ, et al. REM sleep behavior disorder and degenerative dementia. Neurology 1998; 51: 363–70

    PubMed  CAS  Google Scholar 

  113. Ancoli-Israel S, Martin JL, Kripke DF, et al. Effect of light treatment on sleep and circadian rhythms in demented nursing home patients. J Am Geriatr Soc 2002; 50: 282–9

    PubMed  Google Scholar 

  114. Bassetti C, Aldrich MS. Sleep apnea in acute cerebrovascular diseases: final report on 128 patients. Sleep 1999; 22: 217–23

    PubMed  CAS  Google Scholar 

  115. Bassetti Mathis J, Gugger M, et al. Hypersomnia following paramedian thalamic stroke. A report of 12 patients. Ann Neurol 1996; 39: 471–80

    Google Scholar 

  116. Qureshi AI, Giles WH, Croft JB, et al. Habitual sleep patterns and risk for stroke and coronary heart disease: a 10-year follow-up from NHANES I. Neurology 1997; 48: 904–11

    PubMed  CAS  Google Scholar 

  117. Masel BE, Scheibel RS, Kimbark T, et al. Excessive daytime sleepiness in adults with brain injuries. Arch Phys Med Rehabil 2001;82: 1526–32

    PubMed  CAS  Google Scholar 

  118. Guilleminault C, Yuen KM, Gulevich MG, et al. Hypersomnia after head-neck trauma: a medicolegal dilemma. Neurology 2000; 54: 653–9

    PubMed  CAS  Google Scholar 

  119. Guilleminault C, Faull KF, Miles L, et al. Posttraumatic excessive daytime sleepiness: a review of 20 patients. Neurology 1983; 33: 1584–9

    PubMed  CAS  Google Scholar 

  120. Happe S, Zeitlhofer J, Evers S. Schlafgebundene Kopfschmerzen. Wien Klin Wochenschr 2001; 113: 259–65

    PubMed  CAS  Google Scholar 

  121. Beghi E. Adverse reactions to antiepileptic drugs: a multicenter survey of clinical practice. Epilepsia 1996; 27: 323–30

    Google Scholar 

  122. Manni R, Tartara A. Evaluation of sleepiness in epilepsy. Clin Neurophysiol 2000; 111 (2 Suppl.): 111–4

    Google Scholar 

  123. Malow BA, Bowes RJ, Lin X. Predictors of sleepiness in epilepsy patients. Sleep 1997; 20: 1105–10

    PubMed  CAS  Google Scholar 

  124. Vaughan BV, D’Cruz OF, Beech R, et al. Prevalence of sleep complaints in patients with epilepsy: application of the Epworth sleepiness scale [abstract]. J Sleep Res 1997; 25: 453

    Google Scholar 

  125. Manni R, Politini L, Sartori I, et al. Daytime sleepiness in epilepsy patients: evaluation by means of the Epworth sleepiness scale. J Neurol 2000; 247: 716–7

    PubMed  CAS  Google Scholar 

  126. Foldvary N. Sleep and epilepsy. Curr Treat Options Neurol 2002; 4: 129–35

    PubMed  Google Scholar 

  127. Mitler MM, Erman M, Hajdukovic R. The treatment of excessive somnolence with stimulant drugs. Sleep 1993; 16: 203–6

    PubMed  CAS  Google Scholar 

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Happe, S. Excessive Daytime Sleepiness and Sleep Disturbances in Patients with Neurological Diseases. Drugs 63, 2725–2737 (2003). https://doi.org/10.2165/00003495-200363240-00003

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