Insomnia as a Presenting Symptom of Sleep-Related Movement Disorders, Hypersomnias and Parasomnias

  • Keith J. Nagle
Part of the Current Clinical Neurology book series (CCNEU)


Insomnia can be considered as a symptom and as a diagnosis. A number of sleep disorders have insomnia as a principle presenting symptom. A careful history is needed to assess for the presence of coexisting sleep disorders in patients complaining of poor sleep quality. In this chapter, we will explore the clinical features of three common neurologically based sleep disorders that may have insomnia as a presenting feature: restless legs syndrome (RLS), narcolepsy with or without cataplexy, and parasomnias. Several medications used to treat insomnia may exacerbate the patient’s RLS and paradoxically worsen their insomnia. Montplaiser drew attention to the severe sleep disruption in persons with narcolepsy; findings included an increased number of awakenings, increased wake time after sleep onset, and increased time in stage I sleep. These findings have been replicated to varying degrees in a number of other studies. Finally, the coexistence of several sleep problems is more often the rule than the exception. Patients with multiple components to their impaired sleep quality are common and each may need to be addressed to optimally help these patients.


RLS Narcolepsy Sleep disturbances Parasomnias Antidepressants Trazodone Benzodiazepines 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Keith J. Nagle
    • 1
  1. 1.Department of Neurology, Vermont Regional Sleep CenterUniversity of Vermont College of MedicineBurlingtonUSA

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