Most patients with panic disorders have experienced panic attacks not only during the daytime but also at night (Staner 2003). It is reported that early treatment of these sleep disorders could prevent development of delirium (Hatta et al. It is frequently observed that elderly patients manifest nocturnal insomnias, sleep-wake cycle disturbance, and nightmares before delirium (Hatta et al. ![]() Possible hyperactive delirium could sometimes turn out to be ictal/postictal delirium caused by epileptic seizures. Hyperactive delirium requires prompt clinical treatment. I also argue that it is imperative to develop a novel approach based on sleep epileptology (Chiba 2019), a field which targets the interface between sleep medicine and epileptology to uncover the pathophysiology behind ABDS.ĭelirium has transient consciousness disturbance as its cardinal symptom, frequently observed in inpatients at general hospitals (10–82%) (Inouye et al. In this paper, I propose a clinical-practice based classification of the underlying diseases of ABDS and present perspectives from some of the best research on pathophysiological relations between parasomnias and epilepsy, both representing typical ABDS. In short, ABDS may severely affect the quality of life (QOL) of patients and their families (Breen et al. Due to ABDS, patients and their bed partners can even get hurt, which sometimes requires forensic psychiatric evidence/decisions (Ingravallo et al. ![]() ABDS tend to result in functional disorders in various situations that include a patient’s family life, social life, career plan, and school life. ABDS cause inadequate sleep quantity and quality at night, which in turn causes excessive daytime sleepiness. Patients suffer from ABDS not only at night. Only a few patients take V-PSG ii) the number of medical specialists who can accurately diagnose ABDS is still low. On the doctor side, i) although video-polysomnography (V-PSG) using full-montage electroencephalography (EEG) is a highly regarded test, it requires a lot of time and money. On the patient side, i) since ABDS are rarely observed (or video recorded), patients have little or no subjective information about the symptoms (it is also often the case that nobody else notices them) ii) patients do not have a medical examination until they realize disadvantages in social life, or experience trauma caused by ABDS. Abnormal behaviors during sleep (ABDS) can range across a wide spectrum, from simple and minor motor activities (e.g., paroxysmal arousals, limb myoclonus) to complex and intense behaviors (e.g., wandering, talking, screaming, hyperactivity, violence).ĭiagnosis of ABDS is difficult for the following reasons (Breen et al.
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