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Sleep talking is one of the most common altered nocturnal behaviours in the whole population. It does not represent a pathological condition and consists in the unaware production of vocalisations during sleep. Although in the last few decades we have experienced a remarkable increase in knowledge about cognitive processes and behavioural manifestations during sleep, the literature regarding sleep talking remains dated and fragmentary. We first provide an overview of historical and recent findings regarding sleep talking, and we then discuss the phenomenon in the context of mental activity during sleep. It is shown that verbal utterances, reflecting the ongoing dream content, may represent the unique possibility to access the dreamlike mental experience directly. Furthermore, we discuss such phenomena within a cognitive theoretical framework, considering both the atypical activation of psycholinguistic circuits during sleep and the implications of verbal 'replay' of recent learning in memory consolidation. Despite current knowledge on such a common experience being far from complete, an in-depth analysis of sleep talking episodes could offer interesting opportunities to address fundamental questions on dreaming or information processing during sleep. Further systematic polysomnographic and neuroimaging investigations are expected to shed new light on the manifestation of the phenomenon and related aspects. [ABSTRACT FROM AUTHOR]

Sleep disorders are frequent and can have serious consequences on patients' health and quality of life. While some sleep disorders are more challenging to treat, most can be easily managed with adequate interventions. We review the main diagnostic features of 6 major sleep disorders (insomnia, circadian rhythm disorders, sleep-disordered breathing, hypersomnia/narcolepsy, parasomnias, and restless legs syndrome/periodic limb movement disorder) to aid medical practitioners in screening and treating sleep disorders as part of clinical practice. [ABSTRACT FROM AUTHOR]

Objective: As Franz Kafka, one of the most important writers of the 20th century, suffered from severe chronic insomnia disorder and inadequate sleep hygiene that impaired his quality of life, we speculated that sleep disorders would be found in his narrative works.Methods: We read Kafka's complete literary works looking for references to sleep and sleep disorders, excluding insomnia.Results: In Kafka's works, sleeping well and for a long time was used as an allegory of having a pleasant life. We found that some of his characters were disturbed by excessive daytime sleepiness and sleep attacks, circadian rhythm sleep-wake disorders, sleep-related hallucinations, sleep symptoms in the context of heart failure and abnormal sleep behaviors (eg, sleep-talking, sleep-crying, sleep-laughing and dream-enacting motor manifestations). Kafka also recalled a dream where bruxism occurred.Conclusion: Kafka's narrative works contain characters suffering from a wide variety of sleep disorders which in some cases represent autobiographical elements but not in others indicating that he was an astute observer of people, sleep and its disorders. The inclusion of characters suffering from sleep disorders was used by Kafka as a literary resource to enrich his texts. [ABSTRACT FROM AUTHOR]

Abstract: major issues of differentiating epileptic and non-epileptic paroxysmal phenomena of sleep are presented in this article. Quality differentiation is possible in case of good knowledge of semiology of sleep-related epileptic seizure types and epileptic syndromes. Difficulties in identification can lead to further diagnostic mistakes. Parasomnias are the most frequently encountered non-epileptic paroxysmal events in sleep, which are related to both non-rapid-eye movement (NREM) sleep and rapid-eye movement (REM) sleep. NREM-sleep parasomnias are otherwise referred to as arousal disorders. They could be mistaken for frontal lobe epilepsy seizures, which predominantly occur at night and are not readily accompanied by epileptiformabnormalities on EEG. Other sleep phenomena also should be considered in differentiating nocturnal epilepsies. Obstructive sleep apnea, periodic leg movements in sleep and some sleep episodes sometimes are expressed with a pattern hardly distinguishable from epileptic seizures. Complex approach and appropriate diagnostic algorithm would further help clinicians in this field to better assess any given situation.

Objective: To assess the prevalence of parasomnias in relation to presence and severity of obstructive sleep apnea (OSA). We hypothesized higher parasomnia prevalence with higher OSA severity.Methods: The sample comprised 4,372 patients referred to a Norwegian university hospital with suspicion of OSA (mean age 49.1 years, 69.8% males). OSA was diagnosed and categorized by standard respiratory polygraphy (type 3 portable monitor). The patients completed a comprehensive questionnaire prior to the sleep study, including questions about different parasomnias during the last 3 months. Pearson chi-square tests explored differences according to the presence and severity of OSA. Furthermore, logistic regression analyses with the parasomnias as dependent variables and OSA severity as predictor were conducted (adjusted for sex, age, marital status, smoking, and alcohol consumption).Results: In all, 34.7% had apnea-hypopnea index (AHI)

To the best of our knowledge, we report here for the first time a case of exploding head syndrome (EHS) that caused repeating panic attacks. A 62-year-old woman experienced a sudden sensation of a loud noise just before going to sleep. The frequency of these episodes rapidly increased to multiple times per night, and she soon began to fear sleep, which led to the occurrence of nighttime panic attacks. She was diagnosed with EHS at our sleep clinic, and clonazepam was prescribed accompanied by reassurance about the benign nature of this syndrome. The intensity of the loud noise gradually reduced, and her fear of sleep and panic attacks disappeared at around the same time. In this report, we argue the importance of gaining further knowledge about EHS, including that about complicating psychiatric symptoms and that about its treatment. [ABSTRACT FROM AUTHOR]

Background: Sleep insufficiency and disturbances affect the physical, cognitive, and emotional well-being of children., Objective: To perform a narrative review on common sleep problems and disorders encountered in primary care for children and adolescents., Methods: A search of English literature in the Pubmed and Google Scholar databases published from 1 January 2000 till 31 October 2021 was conducted with the keywords "sleep problem" or "sleep disorder" and "child" or "adolescent". Findings in the relevant articles and cross-references were compiled., Results: Sleep duration and habits of children vary widely across countries with different cultural backgrounds. There is robust evidence to support the promotion of positive bedtime routines and sleep hygiene as prevention and management of sleep problems. 15-70% of parents reported their children having sleep problems or disturbances. Common sleep complaints include difficulty in initiation or maintenance of sleep, abnormal behaviors or movements, snoring or abnormal breathing, and excessive daytime sleepiness. Comprehensive sleep history and a sleep diary are the first steps for evaluation. Home video and actigraphy may be used as preliminary tools to confirm the history. Referrals to a sleep specialist for polysomnography and other tests are needed, if suspecting specific sleep disorders, such as obstructive sleep apnea and narcolepsy, needs timely intervention. Common sleep disorders in different age groups encountered in primary care are reviewed with clinical features, indications for evaluation, and treatment options summarized., Conclusion: Screening for sleep problems shall be an integral part of each child's health care visit. It is important to evaluate the impact of common sleep problems and identify specific sleep disorders for early intervention to prevent long-term adverse outcomes., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

n this article the author reconstructed and generalized the religious and philosophical aspects of Christian criticism of psychoanalytic methodology of dreams interpretation. The research opens an occult specifics of a psychoanalytic oneurocritics. There is a consideration of a concept how such factors as «cocaine promotion» affects Freudian theory of dreams, a freemasonry and cabalism. The article reveals that Christian ekzegetics of dreams is essentially opposite to psychoanalytic interpretation of dreaming experience. The author makes a hypothesis of before-Freud unity of psychiatric and Christian approaches to interpretation of dreams and an orientation of psychoanalysis on destruction of this unity. The assumption of spiritual and psychological danger of application of psychoanalytic approach of dreams interpretation in psychological work is reasonable. The author comes to a conclusion that the Freudian methodology of dreams interpretation has been developed with the purposes of introduction of anti-Christian occult psychology in the theory and practice of medical and psychiatric activity and elimination of Christian vicarial psychotherapy.Purpose. The research objective consists of retrospective reconstruction of the main critical aspects of the psychoanalytic concept of dreams presented in Christian approach to ekzegetics of dreams.Methodology. Method of this research is a comparative analysis of Christian and psychoanalytic approaches of understanding the nature and essence of dreaming process and its interpretation.Results. Results of research can be used as in the scientific purposes of critical genera-lization and studying of the theoretical model of a dream developed by psychoanalysis and in educational activity where students can compare Christian and psychoanalytic approaches.Practical implementation: psychology, philosophy history, sociology, theological researches.

The article is devoted to the actual problem of modern pediatrics and neurology ― a comprehensive diagnosis and correction of sleep disorders in children. Detail the features of the clinical manifestations of sleep disorders in childhood (insomnia and parasomnia), great attention is paid to sleep apnea syndrome as a risk factor for somatic and psychopathological disorders in children. Highlight the current capabilities of complex instrumental diagnosis of sleep disorders with the use of highly effective methods of polysomnography and pulse oximetry. The actual dimensions as non-drug and drug treatment of sleep disorders in children, taking into account the pathogenetic features of their occurrence. From the standpoint of evidence-based medicine demonstrate efficient methods of herbal medicine, developed on the basis of traditional Chinese recipes, as well as modern nootropics and magnesium preparations. It is shown that sleep disorders in children not only lead to a deterioration of emotional mood, cognitive function, health and school performance, but also are associated with increasing risk of somatic disorders, which determines the need for timely diagnosis and comprehensive differentiated medical and psychological data correction of pathological conditions, taking into account the neurophysiological and biochemical mechanisms of their development, as well as polymorphism of clinical manifestations, in order to increase the effectiveness of treatment and quality of life of patients.

A rare condition characterized by a transient inability to open one or both eyes upon awakening from sleep was first described in 1897. Although less than a handful of papers have been written about this condition since its initial description, a well-defined clinical entity emerges from the available literature. This article reviews the history and clinical features of this unusual condition. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the basal autonomic regulation in patients with obstructive sleep apnea (OSA) showing periodic limb movements in sleep (PLMS) emerging after therapy with continuous positive airway pressure (CPAP).Methods: Data of patients with OSA undergoing a first polysomnography for diagnosis and a second polysomnography for therapy with CPAP were reviewed. Patients with OSA showing PLMS on the first polysomnography were excluded. By using heart rate variability analysis, epochs without any sleep events and continuous effects from the second polysomnography were retrospectively analyzed.Results: Of 125 eligible patients, 30 with PLMS after therapy with CPAP (PLMS group) and 30 not showing PLMS on both polysomnography (non-PLMS group) were randomly selected for the analysis. No significant differences in the demographic characteristics and variables of polysomnographies were identified between the groups. Although one trend of low root mean square of successive differences (RMSSD) between intervals of adjacent normal heart beats (NN intervals) in the PLMS group was observed, patients in the PLMS group had significantly low normalized high-frequency (n-HF) and high-frequency (HF) values, but high normalized low frequency (n-LF) and high ratio of LF to HF (LF/HF ratio). After adjustment for confounding variables, PLMS on the second polysomnography was significantly associated with RMSSD (β = − 6.7587, p = 0.0338), n-LF (β = 0.0907, p = 0.0148), n-HF (β = − 0.0895, p = 0.0163), log LF/HF ratio (β = 0.4923, p = 0.0090), and log HF (β = − 0.6134, p = 0.0199).Conclusions: Patients with OSA showing PLMS emerging after therapy with CPAP may have a basal sympathetic predominance with potential negative cardiovascular effects. [ABSTRACT FROM AUTHOR]

Summary Objective Differential diagnosis between sleep-related epileptic seizures and NREM parasomnia remains challenging. Pathophysiological markers to differentiate both conditions are needed. Activation of autonomic system is present in arousal reactions and epileptic seizures. Our study investigated whether cardiac reactivity differed between arousal disorders and sleep-related seizures. Methods Nocturnal recordings of 50 patients (10 in each group: frontal lobe epilepsy [FLE], temporal lobe epilepsy [TLE], nocturnal terror [NT], confusional arousal [CA], normal arousals [NA]) were retrospectively selected. Timing of the first motor sign and description of behaviours were assessed. Beat-to-beat RR intervals (RRI) as well as heart rate variability were analysed over a period of 60 heartbeats before and after first motor manifestation. The slope and area under the curve (AUC) of RRI were calculated. Results A significant decrease in RRI was observed at the onset of all events. Statistical analysis revealed: lower RRI in TLE than in other groups; higher slope of RRI in FLE than in NA and TLE, and higher AUC in NT and FLE than in TLE, and in NT than in NA. Sleep stage, episode duration, vocalization characteristics, lateralized or abnormal posture, exploratory behaviour differed between epileptic and parasomnia groups. Discussion Analysis of cardiac reactivity seems to be a useful objective tool, together with clinical features, for diagnosing abnormal behaviour during sleep. Cardiac reactivity in TLE could reflect epileptic discharge propagation to brain areas involved in autonomic control, while FLE and NT might involve a strong non-specific activation of the sympathetic system. [ABSTRACT FROM AUTHOR]

Summary: Research suggests that poor sleep quality is related to the occurrence of sleep paralysis, although the precise relationship between these two variables is unknown. This association has generated interest due to the related possibility that improving sleep quality could help to combat episodes of sleep paralysis. To date, studies examining the association between sleep quality and sleep paralysis have typically measured sleep quality using general measures such as the global score of the Pittsburgh Sleep Quality Index (PSQI). The aim of this study was to increase the precision of our understanding of the relationship between sleep paralysis and other aspects of sleep by investigating associations between different sleep‐related variables and sleep paralysis. Using data from the G1219 twin/sibling study, analyses were performed on 860 individuals aged 22–32 years (66% female). Results showed that two components of the PSQI, sleep latency and daytime dysfunction, were predictors of sleep paralysis. In addition, a number of other sleep‐related variables were related significantly to sleep paralysis. These were: insomnia symptoms, sleep problems commonly related to traumatic experiences, presleep arousal, cognitions about sleep and excessive daytime sleepiness. There was no relationship with sleep‐disordered breathing, diurnal preference or sleeping arrangements. Potential mechanisms underlying these results and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep disorders play a significant role in the care of those with Traumatic Brain Injury (TBI). OBJECTIVE: To provide a literature review on the interaction of sleep and circadian processes on those with TBI. METHODS: A literature review was conducted on PubMed using the following key words and their combination: "Sleep Apnea", "Traumatic Brain Injury", "Circadian", "Parasomnia", "Insomnia", "Hypersomnia", "Narcolepsy", and "Restless Legs". We review the spectrum of traumatic brain injury associated sleep disorders and discuss clinical approaches to diagnosis and treatment. RESULTS: Disordered sleep and wakefulness after TBI is common. Sleep disruption contributes to morbidity, such as the development of neurocognitive and neurobehavioral deficits, and prolongs the recovery phase after injury. Early recognition and correction of these problems may limit the secondary effects of traumatic brain injury and improve neuro recovery/patient outcomes. CONCLUSIONS: A more focused approach to sleep health is appropriate when caring for those with TBI. [ABSTRACT FROM AUTHOR]

Multiple manifestations of sleep disorders may interact with the law, making it important to increase awareness of such interactions among clinicians. Patients with excessive sleepiness may have civil (and in some states criminal) liability if they fall asleep while driving and cause a motor vehicle accident. Employers may be held vicariously liable because of the actions of sleepy employees. Hence, awareness of causes of excessive sleepiness, such as sleep deprivation and OSA, is increasing among trucking, railroad, and other safety-sensitive occupations. Interestingly, litigation related to perioperative complications because of OSA is more frequent than nonoperative issues such as a failure to diagnose OSA. Parasomnia-associated sleep-related violence represents a challenge to clinicians because they may be asked to consider parasomnia as a possible contributing, mitigating, or exculpatory factor in criminal proceedings. Clinicians should also familiarize themselves with the legal and regulatory aspects of running an independent sleep laboratory. Sleep telemedicine practice using 21st century technology has opened novel and unique challenges to existing laws. In this review, we cover the most common interactions between sleep disorders and the law, including the challenges of excessive sleepiness and driving, other legal issues involving patients with OSA, and the liabilities associated with parasomnia disorder. We will also cover some practical legal aspects involving independent sleep laboratories and the field of sleep telemedicine. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of parasomnias in relation to presence and severity of obstructive sleep apnea (OSA). We hypothesized higher parasomnia prevalence with higher OSA severity. Methods: The sample comprised 4,372 patients referred to a Norwegian university hospital with suspicion of OSA (mean age 49.1 years, 69.8% males). OSA was diagnosed and categorized by standard respiratory polygraphy (type 3 portable monitor). The patients completed a comprehensive questionnaire prior to the sleep study, including questions about different parasomnias during the last 3 months. Pearson chi-square tests explored differences according to the presence and severity of OSA. Furthermore, logistic regression analyses with the parasomnias as dependent variables and OSA severity as predictor were conducted (adjusted for sex, age, marital status, smoking, and alcohol consumption). Results: In all, 34.7% had apnea-hypopnea index (AHI) <5 (no OSA), 32.5% had AHI 5-14.9 (mild OSA), 17.4% had AHI 15-29.9 (moderate OSA), and 15.3% had AHI ≥30 (severe OSA). The overall prevalence of parasomnias was 3.3% (sleepwalking), 2.5% (sleep-related violence), 3.1% (sexual acts during sleep), 1.7% (sleep-related eating), and 43.8% (nightmares). The overall parasomnia prevalence was highest in the no OSA group. In the chi-square analyses, including all OSA groups, the prevalence of sleep-related violence and nightmares were inversely associated with OSA severity, whereas none of the other parasomnias were significantly associated with OSA severity. In adjusted logistic regression analyses the odds of sleepwalking was significantly higher in severe compared to mild OSA (OR = 2.0, 95% CI = 1.12–3.55). The other parasomnias, including sleep-related violence and nightmares, were not associated with OSA presence or severity when adjusting for sex and age. Conclusions: We found no increase in parasomnias in patients with OSA compared to those not having OSA. With the exception of sleepwalking, the parasomnias were not associated with OSA severity. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to investigate if prospective memory (PM) is impaired in idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD). RBD is a parasomnia characterized by dream enactment and by REM sleep without muscle atonia. iRBD is considered as the initial stage of neurodegeneration with pathological storage of alpha-synuclein. Method: Sixty iRBD patients with polysomnography-confirmed RBD without parkinsonism and dementia and 30 demographically matched normal controls (NC) were enrolled in the present study. Clinical assessment included Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), dopamine transporter single-photon emission computed tomography (DaT-SPECT) for imaging synapses of dopaminergic neurons in the striatum and a neuropsychological battery with embedded time-based and event-based PM measures. Results: iRBD differed significantly from NC in event-based PM, a number of event-based failures to recall intention and total PM performance (all p < .001) but did not differ in time-based PM and recognition. PM did not contribute to impairment of instrumental activities of daily living in iRBD. Despite being preserved in iRBD in comparison to NC, time-based PM correlated significantly with dopaminergic neuronal loss measured by DaT-SPECT. Conclusions: We show evidence for a differential pattern of PM impairment in iRBD with severe impairment of event-based and concurrent preservation of time-based PM. We theorize that event-based PM impairment in iRBD is caused by severe impairment of retention and recognition mechanisms in episodic memory whereas time-based PM seems to be affected by reduced striatal dopaminergic synapses. [ABSTRACT FROM AUTHOR]

Objective: Parasomnias are common in childhood but there is no established treatment for parasomnias. The aim of this study was to (1) report on the outcome of using L-tryptophan to manage parasomnias in children and (2) examine sleep architecture and subjective psychological/sleep symptoms in children with parasomnia.Method: A retrospective analysis was conducted of charts of children (3-18 years old) who underwent polysomnographic testing and were diagnosed with primary parasomnia. Study patients were either prescribed L-tryptophan (daily dose range: 500-4500 mg, mean dose of 2400 mg) to manage their parasomnias or administered no treatment whereby parents/guardians declined treatment. Questionnaires assessing sleep and psychosocial symptoms were administered at the initial clinical consultation and a follow-up parasomnia outcome questionnaire was administered over the phone to parents/guardians.Results: One hundred and sixty-five children (106 boys, 59 girls) received a sleep diagnosis of primary parasomnia. A significantly (p < 0.001) higher proportion (84%) of children taking L-tryptophan experienced improvements in their parasomnia symptoms compared with those (47%) who chose not to use L-tryptophan. Polysomnography revealed that children with parasomnias had an altered sleep architecture based on age-related normative values. Children with a diagnosis of parasomnia were also subjectively more fatigued and endorsed more depressive symptoms.Conclusions: This study finds that parasomnias in children are not benign and that treatment with L-tryptophan provides a favorable outcome. Children diagnosed with parasomnia had altered sleep architecture, were more fatigued, and endorsed depressive symptoms. This study supports the need to diagnose and treat parasomnias in children. [ABSTRACT FROM AUTHOR]

There are many medications that cross the blood-brain barrier affecting the central nervous system and converting the normal patterns of sleep and wakefulness. Some drugs are used to treat special sleep disorders but others can induce sleep disorders (e.g. periodic limb movements during sleep, restless leg syndrome, parasomnia, insomnia) or exacerbate them (e.g. obstructive or central sleep apnea). The most frequent classes of agents used in sleep medicine are: benzodiazepines, nonbenzodiazepines receptor agonists, melatonin and melatonin receptor agonists, antiepileptic drugs, antidepressants, atypical antipsychotics, central stimulants and dopamine agonists. [ABSTRACT FROM AUTHOR]

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Parasomnia constitutes an important group among the situations that can lead to sleep-related violence scene. Parasomnia attacks are characterized by complex motor behaviors of various degrees, violent behaviors may result in life-threatening and rarely lethal conditions for patients and their relatives. Here is presented a patient with right temporoparietal bone fracture, pneumocephalus and hemotympanum in right ear due to head trauma during a parasomnia attack. The diagnosis could be made by a detailed history taking and polysomnography only after many other investigations. In this context, we aimed to emphasize that not only nocturnal epilepsies, especially frontal lobe epilepsies, but also parasomnia attacks should be kept in mind in differential diagnosis of sleep-related violence. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the prevalence of nightmares and sleep paralysis and their associated factors in the general population in Japan. This study was designed as a cross-sectional sampling survey conducted in November 2007. Subjects were selected randomly from among 300 districts throughout Japan. Data from 8099 people (3748 men and 4351 women) were used. Participants completed a self-reported questionnaire on the frequency of nightmares and sleep paralysis in the previous month. In the total sample, the prevalence (95% confidence interval) of nightmares and sleep paralysis was 3.0% (2.6-3.4%) and 2.4% (2.1-2.8%). As for nightmares, multiple logistic analyses revealed that long sleep duration, use of hypnotic medication, difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, excessive daytime sleepiness, and distress had higher odds ratios. As for sleep paralysis, younger age, smoking, difficulty maintaining sleep, and distress had higher odds ratios. This study revealed the prevalence of nightmares and sleep paralysis among the general Japanese population. The results indicate that nightmares and sleep paralysis are induced by high levels of stress and insomnia symptoms in Japanese adults. Therefore, adequate stress-coping skills, sleep education to raise awareness of the importance of maintaining an appropriate circadian rhythm, and effective treatments for insomnia are required. [ABSTRACT FROM AUTHOR]

Sleep paralysis is a relatively common but under-researched phenomenon. While the causes are unknown, a number of studies have investigated potential risk factors. In this article, we conducted a systematic review on the available literature regarding variables associated with both the frequency and intensity of sleep paralysis episodes. A total of 42 studies met the inclusion criteria. For each study, sample size, study site, sex and age of participants, sleep paralysis measure, and results of analyses looking at the relationship(s) between sleep paralysis and associated variable(s) were extracted. A large number of variables were associated with sleep paralysis and a number of themes emerged. These were: substance use, stress and trauma, genetic influences, physical illness, personality, intelligence, anomalous beliefs, sleep problems and disorders (both in terms of subjective sleep quality and objective sleep disruption), symptoms of psychiatric illness in non-clinical samples (particularly anxiety symptoms), and psychiatric disorders. Sleep paralysis appears to be particularly prevalent in post-traumatic stress disorder, and to a less degree, panic disorder. Limitations of the current literature, directions for future research, and implications for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Background Exploding head syndrome (EHS) is characterized by loud noises or a sense of explosion in the head during sleep transitions. Though relatively common, little is known about its characteristic symptoms or associated features. Methods A cross-sectional study of 49 undergraduates with EHS was performed. A clinical interview established diagnosis. Results The most common accompanying symptoms were tachycardia, fear, and muscle jerks/twitches with the most severe associated with respiration difficulties. Visual phenomena were more common than expected (27%). EHS episodes were perceived as having a random course, but were most likely to occur during wake-sleep transitions and when sleeping in a supine position. Only 11% reported EHS to a professional, and 8% of those with recurrent EHS attempted to prevent episodes. Conclusions EHS episodes are complex (Mean (M) = 4.5 additional symptoms), often multisensorial, and usually associated with clinically-significant fear. They are rarely reported to professionals and treatment approaches are limited. [ABSTRACT FROM AUTHOR]

Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures. The etiology of bruxism is unclear, but the condition has been associated with stress, occlusal disorders, allergies and sleep positioning. Due to its nonspecific pathology, bruxism may be difficult to diagnose. Unfortunately, very little data exists on the subject of a cause-and-effect relationship of bruxism to the point that expert opinions and cautionary approaches are still considered the best available sources for suggesting good practice indicators. The present paper reviewed current concepts on bruxism, etiology, diagnosis and management, underlining its effects on dental structures in an attempt to provide clinically useful suggestions based on scientifically sound data.