SleepPhysiology, Investigations,

and Medicine

Sleep Physiology, Investigations, and Medicine

Edited by

Michel Billiard Hopital Gui de Chauliac Montpellier, France

Translated by Angela Kent

Springer Science+Business Media, LLC

Library of Congress Cataloging-in-Publieation Data

Sommeil normal et pathologique. EngIish Sleep: physiology, investigations, and medicine/edited by Miehel BiIliard: translated by

Angela Kent. p. ; em.

Includes bibliographieal referenees and index. ISBN 978-1-4613-4970-9 ISBN 978-1-4615-0217-3 (eBook) DOI 10.1007/978-1-4615-0217-3

1. Sleep disorders. 2. Sleep. 1. BiIIiard, M. (Michel) II. Title. [DNLM: 1. Sleep Disorders-pathology. 2. Sleep-physiology. WM 188 0697 2oo3a]

RC547.S65713 2003 616.8' 498-de21

2002043453

Published with the help of the Freneh Ministere de la Culture-Centre national du livre

Original French edition: Le sommeil normal et pathologique: Troubles du sommeil et de l'eveil © Masson, Paris, 1994, 1998.

ISBN 978-1-4613-4970-9

©2oo3 Springer Science+Business Media N ew York Originally published by Kluwer Academic/Plenum Publishers, New York in 2003 Softcover reprint ofthe hardcover Ist edition 2003 http://www.wkap.com

1098765432

A C.LP. record for this book is available from the Library of Congress

AII rights reserved

No part of this book may be reproduced, stored in a retrieval system, or transmitted in any forrn Of by any means, electronic, mechanical, photocopying, microfilming, record ing, or otherwise, without written permission from the Publisher with the exeeption of any material supplied specificaIly for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work

Permissions for books published in Europe: permissions@wkap.nl Permissions for books published in the United States of America: permissions@wkap.com

This book is dedicated to my wife Annickand to my children Beatrice and Patrick

Contributors

JoeUe Adrien, fNSERM U 288, Faculte de Medecine Pitie Salpetriere , 91 Boulevard de I'H6pital, 75013Paris, France

Michael S. Aldrich (deceased), Sleep Disorders Center, Department of Neurology, UH 8820, Box 0117,1500 East Medical Center Drive, Ann Arbor, MI 48109-0117, USA

Alain Autret, Clinique Neurologique, H6pital Bretonneau, 2 Boulevard Tonnele, 37044 Tours Cedex, France

Michel Averous, Service d'Urologie, H6pital Lapeyronie, 371 Avenue Doyen Gaston Giraud, 34295Montpellier Cedex 5, France

Michel Baldy-Moulinier, Service d'Explorations Fonctionnelles et Epileptologie. H6pital Gui de Chauliac,80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France

Domien Beersma, RUG, Zoological Laboratory. PO Box 14,9750 AA Haren, The Netherlands

Alain Besset, fNSERM , EMI-9930 , H6pitalla Colombiere, 39 Avenue Charles Flahaut , 34293 Montpellier,Cedex 5 and Service de Neurologie B, H6pital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295Montpellier, Cedex 5, France

Michel Billiard, Service de Neurolog ie B, H6pital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295Montpellier Cedex 5, France

Donald L. Bliwise, Sleep Disorders Center, Emory University Medical School, WMB - Suite 6000, Atlanta,GA 30322, USA

Diane Boivin , Center for Study and Treatment of Circadian Rhythms , Douglas Hospital Research Centre,Department of Psychiatry, McGill University, 6875 La Salle Boulevard, suite F-1127, Verdun, Quebec, H4HIR3 , Canada

Urbain Calvet, Clinique Saint Jean du Languedoc, 20 Route de Revel, 31077 Toulouse Cedex , France

Bertrand Carlander, Service de Neurologie B, H6pital Gui de Chauliac , 80 Avenue Augustin Fliche, 34295Montpellier, Cedex 5, France

Julie Carrier, Sleep Disorders Center, Emory University Medical School , WMB-Suite 6000 , Atlanta, GA30322, USA

Ari Chaouat, Service de Pneumologie, H6pital de Hautepierre, 67098 Strasbourg Cedex, France

vii

viii Sleep: Physiology, Investigations, and Medicine

Marie-Josephe Challamel, Service d'Explorations Neurologiques, Centre Hospitalier Lyon Sud, Batiment3B, 69495 Pierre Benite Cedex, France

Catherine Charpentier, Service de Pneumologie, Hopital de Hautepierre, 67098 Strasbourg Cedex, France

Bruno Claustrat, Service de Radiopharrnacie et de Radioanalyse, Hopital Neuro-Cardiologique, B.P. Lyon­Monchat 69394, Lyon Cedex 03, France

Giorgio Coccagna, Istituto di Clinica Neurologica, Universita degli Studi di Bologna, Via Ugo Foscolo, 7,40123 Bologna, Italia

Emmanuelle Corruble, Service de Psychiatrie, Centre Hospitalier Universitaire Bicetre, 78 rue du GeneralLeclerc, 94275 Le Kremin Bicetre, France

Louis Crampette, Service ORL et Chirurgie Cervico-Faciale, Hopital Gui de Chauliac, 80 Avenue AugustinFliche, 34295 Montpellier Cedex 5, France

Natali Darchia, I. Beritashvili Institute of Physiology, Department of Neurobiology of Sleep-WakefulnessCycle, 14 Gotua Street, 380060 Tbilisi, Georgia

Yves Dauvilliers, Service de Neurologie B, Hopital Gui de Chauliac, 80 Avenue Augustin Fliche, 34295Montpellier Cedex 5, France

Joseph De Koninck, School of Psychology, University of Ottawa, PO Box 450, Ottawa, Ontario, KIN 6X9,Canada

Philippe Ducrotte, Service de Gastro-Enterologie, Hopital Charles Nicolle, 76031 Rouen Cedex, France

Luigi Ferini-Strambi, Centro del Sonno, IRCCS H San Raffaele, Via Stamira d'Ancona 20,20127 Milano,Italia

Patricia Franco, Clinique Pediatrique, Hopital Universitaire des Enfants Reine Fabiola, Universite Libre deBruxelles, Avenue J.J . Crocq 15, B-1020 Bruxelles, Belgique

Philippe Gajdos, Service de Reanimation Medicale et d'Explorations Fonctionnelles, Hopital RaymondPoincare, 92380 Garches, France

Lucile Garma, Federation des Pathologies du Sommeil. Hopital Pitie-Salpetriere, 47-83 Boulevard del'Hopital, 75651 Paris Cedex 13, France

Francoise Goldenberg, Laboratoire de Physiologie et d'Explorations Fonctionnelles, Hopital Henri-Mondor,51 Avenue du Marechal de Lattre de Tassigny, 940 I0 Creteil Cedex, France

Jean Grenier, Centre National de Formation en Sante. Hopital Montfort, 713, Chemin Montreal, Ottawa,Ontario, KIK OT2, Canada

Jose Grosswasser, Clinique Pediatrique, Hopital Universitaire des Enfants Reine Fabiola, Universite Librede Bruxelles, Avenue J.J. Crocq 15, B-1020 Bruxelles, Belgique

Christian Guilleminault, Sleep Disorders Clinic, Stanford University Medical Center, 701 Welch Road,Suite 2226, Palo-Alto, CA 94304, USA

Irma Gvilia , I. Beritashvili Institute of Physiology, Department of Neurobiology of Sleep-WakefulnessCycle, 14 Gotua Street, 380060, Tbilissi, Georgia

Contributors ix

Edouard Hirsch, Service de Neurologie, Neuropsychologie et Explorations Foncrionnelles des Epilepsies,Hopitaux Universitaires, I Place de l'Hopital, BP 426,67091 Strasbourg Cedex, France

Andre Kahn, Clinique Pediatrique, Hopital Universitaire des Enfants Reine Fabiola, Universite Libre deBruxelles, Avenue J.J.Crocq 15, B-1020 Bruxelles, Belgique

Myriam Kerkhofs, Laboratoire de Sommeil, Centre Hospitalier Univesitaire de Charleroi, Hopital A. Vesale,Rue de Gozee 706,6110 Montigny-le-Tilleul, Belgique

Romain Kessler, Service de Pneumologie, Hopital de Hautepierre, 67098 Strasbourg Cedex, France

Martina Kreutzer, Sleep Disorders Clinic, Stanford University Medical Center, 701 Welch Road, Suite2226, Palo-Alto, CA 94304, USA

Jean Krieger, Service d'Explorations Fonctionnelles du Systeme Nerveux et de Pathologie du Sommeil,Hopitaux Universitaires, I Place de l'Hopital, BP 426, 67091 Strasbourg Cedex, France

Odile Lapierre, Centre d'Etude du Sommeil, Departement de Psychiatrie, Hopital du Sacre-Ceeur, 5400Boulevard Gouin Ouest, Montreal, Quebec H4J lC5 , Canada

Damien Leger , Centre de Sommeil, Service de Physiologie, Hotel-Dieu de Paris, 1 Place du Parvis Notre­dame, 75181 Paris Cedex 04, France

Frederic Lofaso, Service de Reanimation Medicale et Explorations Fonctionnelles. Hopital RaymondPoincare, 92380 Garches, France

Elio Lugaresi, Istituto di Clinica Neurologica, Universita degli Studi di Bologna, Via Ugo Foscolo 7, 40123Bologna, ltalia

Christian Marescaux, Service de Neurologie, Neuropsychologie et Explorations Fonctionnelles desEpilepsies, Hopitaux Universitaires, I Place de l'Hopital , BP 426, 67091 Strasbourg Cedex, France

Bruno Maton, Service de Neurologie, Neuropsychologie et Explorations Fonctionnelles des Epilepsies,Hopitaux Universitaires, 1 Place de I'Hopital , BP 426, 67091 Strasbourg Cedex, France

Emmanuel MigDot, Stanford University Center for Narcolepsy, 701 Welch Road B, basement, room 145,Palo-Alto CA 94304-5742, USA

Harvey Moldofsky, Sleep Disoders Clinic of the Centre for Sleep and Chronobiology Ltd, 340 CollegeStreet, Suite 580, Toronto, Ontario, M5T 3A9, Canada

Pasquale Montagna, Istituto di Clinica Neurologica, Universita degli Studi di Bologna, Via Ugo Foscolo 7,40123 Bologna, ltalia

Jaime M. Monti, Departemento de Farmacologia y Terapeutica, Hospital de Clinicas, 2833/602 J.Zudanez, 11300 Montevideo, Uruguay

Jacques Montplaisir, Centre d'Etude du Sommeil, Departement de Psychiatrie, Hopital du Sacre-Ceeur, 5400Boulevard Gouin Ouest, Montreal, Quebec, H4J !C5, Canada

Charles Morin, Ecole de Psychologie, Universite Laval, Sainte-Fey, Quebec, GIX 4V4, Canada.

Gassam Mroue, Service de Reanimation Medicale et Explorations FonctionneIles. Hopital RaymondPoincare, 92380 Garches, France

x Sleep: Physiology, Investigations, and Medicine

Yvonne Navelet, Explorations Fonctionnelles du Systeme Nerveux , Centre Hospitalier Universitaire Bicetre,78 rue du General Leclerc, 94275 Le Kremlin Bicetre Cedex, France

Alain Nicolas, Unite de Sommeil, Unite Clinique de Psychiatrie Biologique , Hopital du Vinatier , 95Boulevard Pinel, 69677 Bron Cedex, France

Thomas Penzel, Schlafinedizinisches Labor. Klinik fiir Innere Medizin, Klinikum der Philipps-Universitat,Baldingerstrasse I, D-35033 Marburg, Deutschland

Jiirg H. Peter, Schlafinedizinisches Labor. Klinik fiir Innere Medizin, Klinikum der Philipps-Universitat ,Baldingerstrasse I, D-35033 Marburg, Deutschland

Rosa Peraita Adrados, Unidad de Sueno, Hospital Gregorio Maranon, CIDr. Esquerdo, 46. 28007, Madrid,Espana

Maria-Antonia Quera-Salva, Unite de Sommeil, Hopital Raymond Poincare, 104 Boulevard RaymondPoincare , 92380 Garches, France

Jean-Claude Raphael, Service de Reanimation Medicale et Explorations Fonctionnelles, H6pital RaymondPoincarre , 92380 Garches, France.

Elisabeth Rebuffat, Clinique Pediatrique, H6pital Universitaire Reine Fabiola , Universite Libre de Bruxelles,Avenue J.J.Crocq 15, B-1020 Bruxelles, Belgique

Dominique Samson-Dollfus, Medecine Neonatale et Pediatrique . Pavilion de la Mere et de l'Enfant. HopitalCharles Nicolle. 76031 Rouen Cedex, France

Joanthan B. Santo, Center for Study and Treatment of Circadian Rhythms, Douglas Hospital ResearchCenter , Department of Psychiatry , McGuil University, 6875 La Salle Boulevard, suite F-1127, Verdun,Quebec, H4H lR3 , Canada.

Francois Sellal, Service de Neurologie, Neuropsychologie et Explorations Fonctionnelles des Epilepsies,Hopitaux Universitaires, I Place de I'H6pital, B.P. 426, 67091 Strasbourg Cedex, France

Cesa Scaglione, lstituto di Clinica Neurologica , Universita degli Studi di Bologna, Via U. Foscolo 7, 40123Bologna, ltalia

Salvatore Smirne, Centro del Sonno, lRCCS H San Raffaele, Via Stamira d'Ancona 20,20127 Milano, Italia

Martine Sottiaux, Clinique Pediatrique, Hopital Universitaire Reine Fabiola, Universite Libre de Bruxelles,Avenue J.J.Crocq 15, B-1020 Bruxelles, Belgique

Claudine Sou brie, Service de Pharmacologie, Hopital Pitie-Salpetriere, 47-83 Boulevard de l'Hopital, 75651Paris Cedex 13, France

Mehdi Tafti, HUG, Belle-Idee, Division de Neuropsychiatrie 2, Chemin du Petit-Bel-Air, CH-1225 Chene­Bourg, Suisse

Anne Thibault-Menard, Service de Neurologie, Neuropsychologie et Explorations Fonctionnelles desEpilepsies, H6pitaux Universitaires , I Place de I'H6pital , B.P. 426, 67091 Strasbourg Cedex, France

Michel Tiberge, Service d'Explorations Fonctionnelles du Systeme Nerveux , H6pital Rangueil, I Avenue duProfesseur Jean Poulhes, 31403 Toulouse Cedex 4, France

Contributors xi

Marie-Fran~oise Vecchierini, Service Explorations Fonctionnelles, Centre Hospitalier Universitaire Bichat,46 rue Henri Huchard, 75877 Paris Cedex 18, France

Dominique Warot, Service de Pharmacologie, H6pital Pitie- Salpetriere, 47-83 Boulevard de I'H6pital,75651 Paris Cedex 13, France

Emmanuel Weitzenblum, Service de Pneumologie, H6pital de Hautepierre, 67098 Strasbourg, France

Foreword

The question about the function of sleep remains one of the major challenges scientists are facedwith . Wherein lies the fascination with sleep? I am convinced that it is the necessity for sleep . Noone has failed to experience the overpowering urge to fall asleep after a disturbed night's sleep orafter sleep was curtailed or deprived, especially when our daily activities impose restrictions onmotor activity. The demand of our body and brain to sleep challenges our understanding of why thisis the case, and which are the benefits of a night of profound sleep . Also in animals prolongation ofwaking consistently increases their attempts to fall asleep . It has been stated that sleep is morenecessary to animals than even food! The need for sleep and some insight into the consequences ofthe preceding daily waking activities on subsequent sleep was wonderfully formulated byShakespeare in Othello:

Not poppy nor mandragora,Nor all the drowsy syrups ofthe world,Shall ever medicine thee to that sweet sleepWhich thou owed'st yesterday

It is interesting that the most powerful single intervention which invariably influences sleep in apositive and predictable manner is the prolongation of waking. The activities which people oranimals engage in during the wakefulness episode are secondary in the magnitude of their effects onsleep. More recently, the proposition by Krueger and Obal that sleep is use-dependent and isinitiated at the local neuronal level, perhaps serving to stimulate the use of structures insufficientlyactivated during wakefulness, renewed the interest in addressing the influence of waking activitieson sleep . Their hypothesis is testable, and a new impetus is driving experiments. It has turned outthat when brains of human subjects or animals are regionally activated by specific sensory or motorstimulation, the significant changes during sleep are predominant in the delta range , and are relatedto the stimulated region. Thus, it may be that the EEG is locally enhanced as a consequence ofintense wake-time stimulation. Different parts of the brain seem to be able to sleep with differingintensities! The results stemming from the surge of brain imaging studies complement endeavoursto illustrate and unravel the regional activities in the sleeping brain and relate them to wakingbehaviour. Changes in the waking EEG have been shown to correlate with an increase in sleepinessin the course of extended waking and, surprisingly, they correlate with the subsequent changes insleep . Thus, markers of sleep propensity in the waking EEG are related to the sleep EEG.

The question I am often confronted with: do fish sleep? - or more recently, do flies really sleep?- how can you tell? , reminds us of the uncertainty of defining sleep. It also reflects the increasingawareness of sleep, its evolution and the lack of knowledge on its function. Despite a long traditionof sleep research in animals, it has only been recently recognised that simple models can advanceour understanding of the essence of sleep . Recent publications have demonstrated the presence ofsleep and sleep regulation in Drosophila, and experimental manipulations revealed similarities inresponse to sleep deprivation and specific drugs such as caffeine in the flies compared to humansand rodents . The inclusion of flies in the repertoire of species considered to sleep is advancing our

xiii

xiv Sleep: Physiology, Investigations. and Medicine

knowledge on this mysterious third of our lives. After many years of major efforts by the sleepcommunity, sleep is gradually finding its way into the curricula of biology, medicine andpsychology. A surge of publications in high-impact journals is addressing issues such as therelationship between sleep, learning and memory, and psychomotor skills, the genetic basis of sleepdisorders, the relationship between circadian rhythms and sleep, e.g. the advanced sleep phasesyndrome. These problems are attracting the attention of other scientists to our field. A newgeneration of young scientists is tackling the questions central to the understanding of sleep and itsdisorders. With the availability and mastery of new and finer methodologies, our knowledge aboutthe physiology of sleep will speedily progress.

Shakespeare was also a master in describing the pains of insomnia:

o sleep, 0 gentle sleep!Nature's soft nurse. how have I frightened thee.That though no more wilt weigh my eyelids downAnd steep my senses in forgetfulness?

Henry IV

The increasing awareness and understanding of sleep disorders and their therapies has raised theinterest of practitioners in topics such as sleep apnea, diagnostics of insomnia, issues related toprescription and use of hypnotics, changes of sleep with aging and the interrelation between thecircadian and sleep-wake dependent drive for sleep. The impact of sleep disorders on health andwell being is receiving increasing recognition. A new area of sleep research has started with theadvances in molecular biology, the neurosciences and biological rhythms. The impetus in sleepresearch gained by the availability of these methods has been complemented with advances in sleepdisorders medicine. The new tools have led to exciting progress in the neurochemical basis and thegenetics of sleep and sleep disorders. The investigation of specific pathologies of sleep, is serving toshed light also on basic physiological mechanisms underlying sleep regulation. A typical example isnarcolepsy: In narcoleptic patients the homeostatic process of sleep regulation is unaffected,whereas especially through the discovery of the changes in the hypocretin-/orexin system innarcoleptic humans, dogs and mice, the understanding of the role of this system in sleep andwakefulness is advancing. A more specific drug therapy for narcolepsy may ensue, and a new era ofhypnotics acting more closely at the physiological level than the ones presently available mayensue. Also the progress in genetics is giving new impetus to enable the understanding of sleepdisorders including narcolepsy, restless legs syndrome, and recently sleep-walking!

Michel Billiard has honoured me by asking me to write the foreword to this English edition ofthe book he first compiled in 1994. It was published first in 1994, and revised in 1998 but wasaccessible only in French. It has now been updated and translated into English. The present versionnot only includes an update of many of the original chapters, which were characterised by theirlarge diversity, but several new topics have been included.

The book is aimed towards a readership interested in sleep medicine and sleep disorders, but willalso be of interest to scientists and medical doctors from other fields. Readers will obtaininformation on a diversity of clinically relevant diagnostic and therapeutic aspects of sleep and itsdisorders.

This is a timely textbook containing interesting and informative chapters which will appeal tosleep specialists and technicians as well as to graduate students.

Irene Tobler, PhDPresident ofthe European Sleep Research Society

Professor ofZoologyUniversity ofZurichZurich. Switzerland

Preface

This is the first edition in English of the book Le Sommei/ Normal et Pathologique published inFrench by Masson (Paris) in 1994, and re-edited in 1998. More than a simple translation of the 1998edition , this constitutes a third edition, having benefited widely from the experience of the first two.It was made possible as a result of a grant for translation allocated by the French Ministry ofCulture, to whom we would like to express our thanks.

The form of presentation has been maintained as five sections : physiology of sleep , diagnosticprocedures, disorders of sleep and wakefulness, medical disorders associated with sleep orworsened during sleep, and sleep as a special circumstance in investigating some medical disorders.However, the chapters are presented independently rather than as sub chapters within the five mainsections , as in the previous editions. Many chapters have been entirely rewritten, by their authors orby new authors , and those which were not rewritten have been updated.

Decision trees for insomnia, hypersomnia and circadian rhythm sleep disorders have been added,not as an attempt to comply with current trends but rather to help doctors in their diagnosticapproach and .in the appropriate use of the various tests and questionnaires available.

The annexes have been enhanced with new questionnaires and their score charts , to provide theclinician with the necessary tools for exploring the princ ipal disorders.

In view of how little time is dedicated to the study of sleep, its physiology and pathology in mostmedical and paramedical schools, the editor's intention is to provide medical students, doctors andother health professionals, with a tool of reference enabling them to focalise their knowledge.

I am deeply grateful to all the European, North and Latin American authors who agreed to sharein this endeavour by sending me their texts ; Professor Irene Tobler, President of the European SleepResearch Society, who kindly agreed to write the Foreword to the present volume; Mrs GailMarkham, Foreign Rights Manager at Masson who engaged in the lengthy administrative procedurerequired for the book to be translated into English; and last but not least , Mrs Angela Kent ,translator of the present volume, who has produced a work of very high quality and with whom ithas been a true pleasure to collaborate.

And finally to all those associated with the publication of this book, the doctors, researchers,psychologists, nurses, French and foreign students, at the Sleep Clinic at Montpellier TeachingHospital, without whose help and stimulation this edition would neither have been poss ible norbrought to a successful conclusion.

Michel Billiard M.D.

xv

Contents

PART 1: PHYSIOLOGY OF SLEEP

1. Normal sleepC. Guilleminault and M. L. Kreutzer

2. Normal sleep in childrenD. Samson-Dollfus

3. Neurobiology of the sleep-wake cycleJ. Adrien

4. The major physiological functions during sleepY. Dauvilliers

5. Models of human sleep regulationD. G. M. Beersma

6. Melatonin and sleep-wake rhythmB. Claustrat

7. Molecular genetics , circadian rhythms and sleepY. Dauvi//iers, M. Tafti, and E. Mignot

8. Mental activities during sleepJ. De Koninck

PART 2: DIAGNOSTIC PROCEDURES

9. PolysornnographyA. Besset

10. Ambulatory systemsT. Penzel and J. H. Peter

11. Guidelines for visual sleep analysisA. Besset

J2. Automatic sleep analysisA. Besset

13. Investigation of vigilance and sleepinessA. Besset

PART 3: DISORDERS OF SLEEP AND WAKEFULNESS

A) INSOMNlAS14. Insomnia: Introduction

N. Darchia and1. Gvilia15. A decision tree approach to the differential diagnosis of insomnia

J. Grenier16. Transient and short term insomnia

R. Peraita Adrados

3

11

31

45

61

71

83

113

127

139

151

159

169

187

191

201

xvii

xviii Sleep: Physiology, Investigations, and Medicine

17. Primary insomniaC. M Morin

18. Insomnia associated with medical disordersM Billiard

19. Insomnia associated with psychiatric disordersL. Garma

20. Insomnia linked to medicationsE. Corruble, D. Warot, and Cl. Soubrie

21. Benzodiazepines and new non-benzodiazepine agentsJ. M Monti

22. Other medications used for insomniaF. Goldenberg

23. Insomnia in children: Clinical aspects and treatmentY. Navelet

24. Sleep and circadian rhythms in normal agingJ. Carrier and D. Bliwise

207

221

227

247

257

269

283

297

B) HYPERSOMNIAS25. Hypersomnias: Introduction 333

M Billiard26. A decision tree approach to the differential diagnosis of hypersomnia 337

M. Billiard27. Insufficient sleep syndrome 341

M. S. Aldrich28. Medication and alcohol dependent sleepiness 347

D. Warot and E. Corruble29. Obstructive sleep apnoea-hypopnea syndrome and upper airway resistance syndrome 357

1.Krieger30. Surgical and prosthetic treatment for sleep apnoea syndrome and upper airway

resistance syndrome 391L. Crampette

31. Narcolepsy 403M. Billiard and Y. Dauvilliers

32. Idiopathic hypersomnia 429M Billiard and A. Besset

33. Recurrent hypersomnias 437M Billiard

34. Other hypersomnias 447M Billiard and B. Carlander

35. Hypersomnia in children 457M 1. Chal/amel

C) CIRCADIAN RHYTHM SLEEP DISORDERS36. Circadian rhythm sleep disorders: Introduction 469

M. Billiard37. A decision tree approach to the differential diagnosis of a circadian rhythm sleep

disorders 471M. Billiard

38. Shift work sleep disorder 473D. Leger

39. Time zone change (jet lag) syndrome 485M. Tiberge

40. Circadian rhythm sleep disorders related to an abnormal escape of the sleep-wake cycle 493D. Boivin and1. Santo

Contents

D) PARASOMNIAS41. Parasomnias

M F. Vecchierini42. Enuresis

M. Averous

PART 4: MEDICAL DISORDERS ASSOCIATED WITH SLEEPOR WORSENED DURING SLEEP

43. SnoringL. Crampette

44. Nocturnal hypoxemia in chronic obstructive pulmonary diseaseE. Weitzenblum, A. Chaouat, C. Charpentier, R. Kessler, and J. Krieger

45. Central alveolar hypoventilation syndromeE. Weitzenblum

46. Sleep breathing abnormalities in neuromuscular diseasesM A. Quera Salva G. Mroue, Ph. Gajdos, J.C Raphael, and F. Lofaso

47. Cardiocirculatory disorders and sleepG. Coccagna and C. Scaglione

48. Restless legs syndrome in wakefulness and periodic leg movements in sleepJ. Montplaisir, A. Nicolas, and O. Lap ierre

49. Abnormal postures and movements during sleepE. Hirsch, B. Maton , F. Sellal, and C. Marescaux

50. Night epilepsiesM. Baldy-Moulinier

51. Sleep-related headachesB. Carlander

52. Fatal familial insomniaE. Lugaresi and P. Montagna

53. Sleep and the gastrointestinal tractP. Ducrotte

54. Sleep and sudden infant death syndromeA. Kahn, J. Groswasser, M Sottiaux, E. Rebuffat, and P. Fran co

55. Sleep related painful erectionsU. Calvet

PART 5: SLEEP AS A SPECIAL CIRCUMSTANCE ININVESTIGATING SOME MEDICAL DISORDERS

56. Mood disorders and sleepM Kerkhofs

57. Sleep and lesions in the central nervous systemA. Autret

58. Sleep as a tool for investigating epilepsiesM Baldy-Moulinier

59. DysautonomiasL. Ferini-Strambi and S. Smirn e

60. Fibromyalgia and chronic fatigue syndrome : the role of sleep disturbancesM Moldofsky

ANNEXESQuestionnaires and scales

1. General questionnaire on sleepMorning Questionnaire

2. Quest ionnaires used in the evaluation of insomnia

XiX

513

545

555

567

577

581

589

599

609

617

629

635

641

649

657

665

673

689

697

703

717718718719

xx Sleep: Physiology, Investigations, and Medicine

Sleep Impairment IndexBeliefs And Attitudes About Sleep ScaleThe Pittsburgh Sleep Quality IndexThe Leeds Sleep Evaluation QuestionnaireThe Beck Depression Inventory

3. Scales used in the evaluation of hypersomniaThe Stanford Sleepiness ScaleThe Karolinska Sleepiness ScaleThe Epworth Sleepiness Scale

4. Questionnaire used in the evaluation of circadian rhythm sleep disorderThe Home and Ostberg Questionnaire

Glossary

Index

719722725730732736736738739740740

745

751