M Billiard

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..One of the most controversial issues is the functional relevance of partial hypocretin defects in these disorders...

..Disorders of awakening secondary to neurologic conditions and to a lesser extent to infectious conditions offer a special opportunity to study the anatomical basis of these disorders. They are granted more space...

..Here, we highlight some of the major challenges for future research in classifying both primary insomnia and insomnia related to or associated with various conditions, and their relevance to primary care...

..Our objective was to reinforce the use of those drugs evaluated in randomized placebo-controlled trials and to reach a consensus, as much as possible, on the use of other available medications...

..hypersomnia without long sleep time, two forms of the same condition or two different conditions? Is there a pathophysiological relationship between narcolepsy without cataplexy and idiopathic hypersomnia without long sleep time?..

..New treatments are currently available or in preparation in the case of narcolepsy...

..However, in the absence of any pharmacological trials of these drugs on RBD in narcoleptic patients, it is difficult to provide guidance other than to recommend conventional treatments of RBD...

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..CONCLUSION: These findings, together with the young age at onset, the recurrence of symptoms, and the frequent infectious precipitating factors, suggest an autoimmune etiology for Kleine-Levin syndrome...

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..Our results suggest that a sexual dimorphism in COMT activity affects the response to modafinil and probably to other dopaminergic stimulants...

..Narcolepsy usually starts around adolescence; however, there is great variability in the clinical presentation of narcolepsy...

..There was profound alteration in the sleep-wake cycle with a clear dissociation in the disappearance of circadian and neuroendocrine rhythms, findings unrelated to abnormalities in the hypocretinergic system...

..To determine the role of CSF hypocretin-1 in narcolepsy with and without cataplexy, Kleine-Levin syndrome (KLS), idiopathic and other hypersomnias, and several neurological conditions...

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..On the other hand a prophylactic treatment with carbamazepine or lithium may be active. Pathophysiology remains unsettled in spite of some evidence of a hypothalamic functional disturbance...

..Side effects (bitter taste, jitteriness, difficulty to concentrate) were reported only with 7.5 mg zopiclone...

..Finally, differential diagnosis needs a broad knowledge of disorders of excessive daytime sleepiness...

..These data show the difficulties of the management and the treatment of this rarely diagnosed disease...

..To measure the effect of age on Multiple Sleep Latency Test (MSLT)characteristics, sleep latency, and number of sleep-onset REM periods (SOREMP) in two large populations of narcoleptic patients with similar genetic backgrounds...

..Feeling on awakening was not modified. An overall benefit was noted by physicians as well as by patients. MWT disclosed a positive effect of modafinil on excessive daytime sleepiness. Cataplexy was not modified...

..We hypothesize that this could reflect an alteration of the homeostatic process of sleep regulation in narcolepsy...

..However a number of other factors could not be taken into consideration, which limits the full significance of these data...

..A trend in favor of a more frequent transmission through mothers than fathers is emphasized...

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..CONCLUSIONS: Sleep architecture in mild SDB subjects is characterized by a high degree of sleep fragmentation resulting in a different time course of SWA and a decreased sleep spindle index when compared to controls...

..All five factors were shown to be independently related to excessive daytime somnolence and were ranked in the following descending order: use of hypnotics, sleep difficulties, irregular sleep-wake schedule, snoring, and hours of sleep...

..An autoimmune process is probable...

..An early treatment with antibiotics could have limited the toxin production explaining both symptomatology and favourable course of the disease...

..In agreement with well-documented pharmacological results in canine narcolepsy, this study reports the first genetic evidence for the critical involvement of the dopaminergic and/or noradrenergic systems in human narcolepsy...

..In conclusion CBT-I improves both subjective and objective sleep quality of sleep. CBT-I may enhance sleep pressure and improve homeostatic sleep regulation...

..The aim of the study was to describe the clinical and polygraphical characteristics of narcoleptics, with and without cataplexy and to assess HLA predisposition across two different ethnic populations...

..Current therapeutic research is oriented towards hypocretin agonists and immunosuppressors...

..The aim of this study is to evaluate the prevalence of insomnia among first-degree relatives of chronic insomniacs and to compare the symptoms between sporadic and familial insomnia...

..The aim of the study was to find out whether there is a seasonality of month of birth in narcoleptic patients...

..15 Mb region of 21q...

..However, other lines of research deserve to be pursued simultaneously, in view of comprehensive advancements in the understanding of narcolepsy...

..Daytime functioning is shown in insomniac patients and compared to other pathologies like sleep apnea. A final section evokes links between some types of night waking and psychological factors...

..The aim of the study was to determine the role of respiratory events, assessed by means of esophageal pressure monitoring, during arousals from slow wave sleep in adult patients with parasomnias...

..CLINICAL DESCRIPTION: In this article, we describe an observation of central sleep apnea syndrome in a female patient receiving an opiate replacement therapy...