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Hefnawy MT, Amer BE, Amer SA, Moghib K, Khlidj Y, Elfakharany B, Mouffokes A, Alazzeh ZJ, Soni NP, Wael M, Elsayed ME. Prevalence and Clinical Characteristics of Sleeping Paralysis: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e53212. [PMID: 38425633 PMCID: PMC10902800 DOI: 10.7759/cureus.53212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
Sleep paralysis (SP) is a mixed state of consciousness and sleep, combining features of rapid eye movement (REM) sleep with those of wakefulness. The exact cause of SP is unknown, and its prevalence varies among the studies. We aim to identify SP's global prevalence, the affected population's characteristics, and the SP's clinical picture. We searched three databases (PubMed, Scopus, and Web of Science (WoS)) using a unique search strategy to identify eligible studies. All observational studies identifying the prevalence or frequency of sleeping paralysis were included. No exclusions are made based on country, race, or questionnaire. The analysis was performed using the latest version of R software (R Core Team, Vienna, Austria). The analysis included 76 studies from 25 countries with 167,133 participants. The global prevalence of SP was 30% (95% CI (22%, 39%)). There were similar frequencies of isolated SP and SP (33%, 95% CI (26%, 42%), I2 = 97%, P <0.01; 31%, 95% CI (21%, 43%), I2 = 100%, P = 0, respectively). A subgroup analysis showed that the majority of those who experienced SP were psychiatric patients (35%, 95% CI (20%, 55%), I2 = 96%, P <0.01). The prevalence among non-psychiatric patients was among students (34%, 95% CI (23%, 47%), I2 = 100%, P = 0). Auditory and visual hallucinations were reported in 24.25% of patients. Around 4% had only visual hallucinations. Meta-regression showed no association between the frequency of SP and sex. Publication bias was detected among the included studies through visual inspection of funnel plot asymmetry. Our findings revealed that 30% of the population suffered from SP, especially psychiatric patients and students. The majority of SP cases lacked associated hallucinations, while a noteworthy proportion experienced combined visual and auditory hallucinations.
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Affiliation(s)
- Mahmoud T Hefnawy
- Faculty of Medicine, Zagazig University, Zagazig, EGY
- Medical Research Group of Egypt Branch, Negida Academy, Arlington, USA
| | - Basma E Amer
- Faculty of Medicine, Banha University, Banha, EGY
- Medical Research Group of Egypt Branch, Negida Academy, Arlington, USA
| | - Samar A Amer
- Family Medicine, Royal College of General Practice, London, GBR
- Faculty of Public Health and Community Medicine, Zagazig University, Zagazig, EGY
| | | | - Yehya Khlidj
- Faculty of Medicine, University of Algiers Benyoucef Benkhedda, Algiers, DZA
| | - Bahaa Elfakharany
- Faculty of Allied Medical Sciences, Pharos University, Alexandria, EGY
- Medical Research Group of Egypt Branch, Negida Academy, Arlington, USA
| | - Adel Mouffokes
- Internal Medicine, Faculty of Medicine, University of Oran 1 Ahmed Ben Bella, Oran, DZA
| | - Zainab J Alazzeh
- Faculty of Medicine, Jordanian University of Science and Technology, Ar-Ramtha, JOR
| | - Nishant P Soni
- Medicine, Gujarat Medical Education and Research Society Medical College and Hospital, Ahmedabad, IND
| | - Muhannad Wael
- Urology, Saint Joseph Hospital, Jerusalem, PSE
- Faculty of Medicine, An-Najah National University, Nablus, PSE
| | - Mohamed E Elsayed
- Department of Psychiatry, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, DEU
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Zhidik AG, Kozhokaru AB. [Alternative methods of therapy for comorbid sleep disorders as a method of choice in adult patients with epilepsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:42-48. [PMID: 37655409 DOI: 10.17116/jnevro202312308142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
OBJECTIVE Systematization and generalization of data from domestic and foreign literature on alternative methods of treatment of sleep disorders in epilepsy. MATERIAL AND METHODS The search for data from domestic and foreign literary sources was carried out in the electronic databases Medline (PubMed), Scopus, Web of Science, eLibrary, CyberLeninka, Google Scholar. RESULTS The data of modern randomized trials, meta-analyzes on the effectiveness of various non-traditional methods as a method of choice for epilepsy with comorbid sleep disorders have been analyzed. CONCLUSIONS Complementary (alternative) treatments have many advantages over the classical pharmacotherapy of sleep disorders in epilepsy, in the form of non-invasiveness, low incidence of side-effects, ease of use, and lack of a dose-dependent effect. Of course, the targets of most of the above methods are not focused and not very specific, and the sample size is too small to obtain impartial and meaningful clinical conclusions, but this once again emphasizes the urgent need for large-scale clinical trials, which is necessary to develop evidence-based treatments for comorbid sleep disorders in epilepsy.
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Affiliation(s)
- A G Zhidik
- State Research Center - Burnasyan Federal Medical Biophysical Center, Moscow, Russia
| | - A B Kozhokaru
- State Research Center - Burnasyan Federal Medical Biophysical Center, Moscow, Russia
- Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
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Ohayon M, Pakpour A. Prevalence, incidence, evolution and associated factors of sleep paralysis in a longitudinal study of the US general population. Sleep Med 2022; 98:62-67. [DOI: 10.1016/j.sleep.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/25/2022] [Accepted: 06/05/2022] [Indexed: 10/18/2022]
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Tascón-Arcila J, Rojas-Jiménez S, Cornejo-Sánchez D, Gómez-Builes P, Ucroz-Benavides A, Holguín BM, Restrepo-Arbeláez D, Gómez-Castillo C, Solarte-Mia R, Cornejo-Ochoa W, Pineda-Trujillo N. Differential Clinical Features in Colombian Patients With Rolandic Epilepsy and Suggestion of Unlikely Association With GRIN2A, RBFOX1, or RBFOX3 Gene Variants. J Child Neurol 2021; 36:875-882. [PMID: 34039076 DOI: 10.1177/08830738211015017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Our purpose was to describe the phenotypic features and test for association of genes GRIN2A, RBFOX1 and RBFOX3 with rolandic epilepsy in patients from Colombia. METHODS Thirty patients were enrolled. A structured interview was applied. In addition, saliva samples were collected from the patients and their parents. One polymorphism in each of GRIN2A, RBFOX1 and RBFOX3 genes was tested. RESULTS The average age at onset was 5.3 years. Almost half the sample presented prolonged seizures (>5 minutes); although the majority of the patients presented their seizures only while asleep, over a quarter presented them only while awake. The most frequent comorbidity was the presence of symptoms compatible with attention-deficit hyperactivity disorder (ADHD). Personal history of febrile seizures and parasomnias were equally frequent (20%). Family history of any type of epilepsy was reported in 80% of the patients, followed by migraine (73.3%) and poor academic performance (63.3%). About half the sample reported sleepwalking in parents or sibs. Most patients had received pharmacologic treatment. We found no association of rolandic epilepsy with the single nucleotide polymorphisms tested. CONCLUSIONS Our rolandic epilepsy cohort presents clinical features clearly different from other cohorts. For instance, age at onset is much earlier in our set of patients, and personal and family history of febrile seizures as well as parasomnias are highly prevalent in our sample. No association of rolandic epilepsy with variants at the 3 genes tested was found. This lack of association may reflect the high genetic heterogeneity of the epilepsies.
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Affiliation(s)
- José Tascón-Arcila
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Sara Rojas-Jiménez
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Diana Cornejo-Sánchez
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Paola Gómez-Builes
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Andrea Ucroz-Benavides
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Blear-Maria Holguín
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
| | | | - Christhian Gómez-Castillo
- Sección de Neuropediatria, IPS Universitaria, 27983Universidad de Antioquia UdeA, Medellín, Colombia
| | - Rodrigo Solarte-Mia
- Laboratorio de Correlación Electroclínica, CECLAB. IPS Universitaria, Universidad de Antioquia UdeA, Medellín, Colombia
| | - William Cornejo-Ochoa
- PEDIACIENCIAS, Departamento de Pediatría, Facultad de Medicina, 27983Universidad de Antioquia UdeA, Medellín, Colombia
| | - Nicolas Pineda-Trujillo
- Grupo Mapeo Genético, Departamento de Pediatría, Universidad de Antioquia UdeA, Medellín, Colombia
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Abstract
Electroencephalogram (EEG) recording is essential in the evaluation of complex movement and behaviors during sleep, but in particular for differentiating epileptic versus nonepileptic events. In general, epileptiform discharges occur with greater density in the first few nonerapid eye movement cycles, and approximately 12% to 20% of seizures occur exclusively at night. This review examines the epilepsy types and syndromes whose presentation is strongly influenced by the sleep state, with an appraisal about the role that sleep plays in facilitating seizures, while deleaneatign EEG findings and clinical manifestation. The review will summarize the typical semiology of sleep-related hypermotor seizures and contrasted with those occurring during none/rapid eye movement parasomnias and sleep-related movement disorders.
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Affiliation(s)
- Ting Wu
- Ronald Reagan Medical Center, David Geffen School of Medicine at UCLA, 710 Westwood Plaza, Room 1-240, Los Angeles, CA 90095, USA
| | - Alon Y Avidan
- UCLA Sleep Disorders Center, UCLA Department of Neurology, David Geffen School of Medicine at UCLA, 710 Westwood Boulevard, RNRC, C153, Mail Code 176919, Los Angeles, CA, USA.
| | - Jerome Engel
- UCLA Seizure Disorder Center, Brain Research Institute, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
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Kozhokaru AB, Samoylov AS, Shmyrev VI, Poluektov MG, Orlova AS. [Sleep and wake disorders in epilepsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:68-73. [PMID: 33076648 DOI: 10.17116/jnevro202012009268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To summarize published data on the prevalence, characteristics and diagnostic criteria of sleep disorders in epilepsy. MATERIAL AND METHODS A search of published articles was performed in Medline (Pubmed), Scopus, Web of Science and e-library databases. RESULTS Epidemiologic, clinical and diagnostic aspects of excessive daytime sleepiness, obstructive sleep apnea and central apnea, restless leg syndrome and parasomnias related to slow-wave and REM-sleep in patients with epilepsy were analyzed. CONCLUSIONS Further studies are needed to gain an insight into the complex associations of sleep disorders in epilepsy to optimize diagnostic and treatment approaches and to improve the quality of life in that patient population.
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Affiliation(s)
- A B Kozhokaru
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia.,Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
| | - A S Samoylov
- State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia
| | - V I Shmyrev
- Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
| | - M G Poluektov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A S Orlova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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