**6. References**

[1] American Thoracic Society (ATS), Sleep apnea, sleepiness and driving risk, Am J Respir Crit Care Med, 1994; 150: 1464-1473

 5 such as depression, anxiety and panic disorders, conduct disorder, personality disorders

<sup>6</sup> such as stroke, cerebral hemorrhage, dementia and Alzheimer's disease

<sup>7</sup> such as hypertension, heart disease / heart infarction

The difference or the improvement after effective nCPAP therapy suggests the need to use this therapy in OSAS patients, possibly to avoid serious impairment in the memory processes and in cognitive performance or to allow the patient not to suffer under the

In the western and eastern industrial countries, the number of sleep disturbed subjects increased over the time. Undiagnosed and untreated, sleep disorders caused on one hand often by subjective suffering among those affected individuals and on the other hand, due to decreased attention and increased daytime fatigue or daytime sleepiness, to an increased risk of accidents in road traffic and workplace (e.g. Peter et al. 1995, Gerdesmeyer et al. 1997,

Sleep Apnea syndromes are common disorders. 1-5% of the population is affected by it (men are about ten times more affected than women). In particular, patients with OSAS suffer in addition to their symptoms often also on a multitude of sequelae, including excessive daytime sleepiness (Büttner et al. 2004e), vigilance decrease (Büttner et al. 2003b, 2004c) and

These performance restrictions or impairments affect the affected subjects, both professionally and in their ability to drive motor vehicles (Findley et al. 1988a/b, 1989b, 1990, 1991, 1995, Mitler et al. In 1988, Cassel et al. 1991a/b, 1993, 1996 , ATS 1994, Gerdesmeyer et al. 1997, Krieger et al. 1997, Randerath et al. 1997, 1998, 2000, Weeß 1997, Weeß et al. 1998a/b, Büttner et al. 2000a/b, Büttner 2001). Consequences of this reduced performance are therefore often accidents or nearly accidents by falling asleep at the wheel. However, other cognitive and mental functions and the quality of life can be affected by

In summary therefore, can be said that sleep disorders and/or sleep diseases are complex disorders which human beings can affect in his totality and in his whole personality. It can therefore affect all physical, mental and spiritual processes. It can lead to lower physical and mental performances; reduce vigilance, impaired attention and concentration. It can affect the quality of life, reduce, limit and/or prevent social contacts and competencies skills, and

A detailed sleep diagnostics and possibly therapy of previously known sleep disorders and/or sleep diseases is therefore essential to prevent complications and comorbidities, to prevent treatment resistance with respect to other physical and mental diseases and to

[1] American Thoracic Society (ATS), Sleep apnea, sleepiness and driving risk, Am J Respir

5 such as depression, anxiety and panic disorders, conduct disorder, personality disorders

sleep disorders (Sleep Apnea Syndrome, Insomnia and/or Narcolepsy).

cause in other psychiatric5, neurological6 and organic7 diseases.

Crit Care Med, 1994; 150: 1464-1473

7 such as hypertension, heart disease / heart infarction

6 such as stroke, cerebral hemorrhage, dementia and Alzheimer's disease

**Conclusion**

**5. Summary** 

daytime consequences of Sleep Apnea Syndrome.

Randerath et al. 1997, 1998, Büttner et al. 2000a/b).

memory disorders (Büttner et al. 2003c/d).

provide effective medical treatment.

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**1. Introduction** 

of Sleep Medicine, 2004).

**2. Causes of parasomnias** 

therapeutic strategies are needed (Young, 2008).

walking in a population study (Oluwole, 2010).

**10** 

*Turkey* 

**Parasomnias** 

*Uskudar University* 

F. Gokben Hizli and Nevzat Tarhan

Sleep is a vital physiological process with important restorative functions. Parasomnias are characterized by undesirable physical or verbal behaviors, such as walking or talking during sleep and occur in association with sleep, specific stages of sleep or sleep-wake transitions. The category of parasomnias comprises some of the most exceptional behavior disorders because complex and apparently purposeful, goal-directed behavior is associated with a deep sleeping brain. Parasomnias occur during REM sleep, any of the four stages of non-REM sleep, and during transitions between sleep and wakefulness. Sleepwalking, sleep terrors, and confusional arousals are associated with non-REM sleep, nightmares and sleep paralysis are associated with REM sleep, while sleep starts and sleep talking are associated

with sleep-wake transitions. Sleep enuresis has been observed with all sleep types.

The International Classification of Sleep Disorders subdivides parasomnias into the following four groups (Table 1): Arousal disorders, sleep-wake transition disorders, rapid eye movement (REM) stage sleep parasomnias, and other parasomnias (American academy

When accompanied with excessive motor activity and other complex motor behaviors, these parasomnias may significantly affect the patient's quality of life and that of the bed partner. Motor behaviors may or may not be restricted to bed but can become dangerous when the subject ambulates or is agitated. The behaviors are inappropriate for the time of occurrence but may seem purposeful or goal directed. Therefore, appropriate diagnostic and

Parasomnias occur due to abnormal transitions between the three primary states of being wake, rapid eye movement (REM) sleep, and non rapid eye movement (NREM) sleep. These different states may overlap or intrude into one another, and it is the overlap of wakefulness and NREM sleep that gives rise to confusional arousals, and the intrusion of REM sleep into

Parasomnias may have genetic basis, but occurrence is usually triggered by heavy physical activity, febrile illness, sleep deprivation, excessive caffeine drinks, hypnotics, and emotional stress. Intake of alcohol increased occurrence of confusional arousal, night terror, and sleepwalking, while heavy intake of caffeinated drink increased occurrence of sleep

waking that produces REM sleep behaviour disorder (Matwiyoff et al, 2010).

