Eichelberger H, Lindo RO, Rodriguez AJ. Differential diagnosis of sleep laughter: A case report and literature review.
Sleep Med 2023;
110:231-234. [PMID:
37647714 DOI:
10.1016/j.sleep.2023.08.018]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/31/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023]
Abstract
Sleep laughter is a relatively common phenomenon. It is classically seen during REM sleep, which is associated with dreams, and may be a component of REM sleep without atonia (RWA) as seen in cases of REM sleep behavior disorder (RBD). However, repetitive laughter episodes during NREM or during sleep-wake transition have not been described in the literature. We present a case of paroxysmal laughter out of drowsiness and NREM sleep, occurring almost every night, prompting evaluation for a possible seizure disorder. Multiple tests were unrevealing, including brain magnetic resonance imaging, polysomnogram, multiple sleep latency test and electroencephalogram. However, despite the lack of diagnostic certainty, this case provoked a discussion of key factors distinguishing parasomnia from seizure, which is useful for all physicians who may be faced with a case of unusual behavior in sleep. This case highlights the challenges that are encountered when trying to classify certain unusual sleep-related paroxysmal events.
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