Neurological conditions associated with parasomnias

Abstract

In this chapter, we review common neurological disorders in both children and adults that present and/or are associated with nocturnal parasomnias. The presentation of parasomnias with conditions such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), migraine, Tourette’s syndrome, and dementias is often multifactorial; medications, changes in environment, pain, stress, immobility, comorbid psychiatric symptoms, and/or underlying sleep disorders may induce parasomnias in patients in both childhood and adulthood. Parasomnias may also be related to intrinsic sleep architectural abnormalities seen in these neurological diseases. For instance, instability of NREM sleep in children with ADHD may contribute to sleep fragmentation leaving more opportunities for parasomnias to occur during the night. For each disorder discussed, we present the current literature on associated sleep disturbances and highlight presentation of parasomnias. The pathophysiology of parasomnias among these disorders is still speculative but spans etiologies such as neurodegeneration of specific neural substrates to alterations of neurophysiology during sleep. While there is no current literature on how parasomnias influence daytime functioning, clinically the patients report increased fatigue and sleepiness which may exacerbate core neurological symptoms.