Sleep and Movement Disorders
It is a testament to the degree to which the disorders of sleep have caught the attention of the medical community that a specialized book of this kind can now be written. This is not another general text on sleep disorders but one that looks specifically into movement disorders as they are expressed over the sleep and waking states: those which stop in sleep, are precipitated by sleep, or occur in the transition from waking into sleep or in the shift from non-REM to REM sleep.
There is a great deal of interesting material in this book. The chapters are short, easy to read, and written by the most knowledgeable people in the field; yet, as a reader, I wished the editors had put some more organizational threads into this collection. For example, Michael Thorpy writes a 3-page chapter on movement disorders of wake/sleep transitions, noting that head banging and body rocking begin in infancy, then leaps to a discussion of nocturnal leg cramps, which have a greater frequency in older adults. Some 150 pages later there is a chapter by Don Bliwise on aging and sleep disorders.
In addition to the lack of any clear organizing structure, there is also a good deal of redundancy in the chapters. Discussions of periodic limb movements of sleep, the parasomnias, REM behavior disorder, and bruxism appear over and over in chapters written by different groups, many of which cite the same references. There are, in addition, six chapters on restless legs syndrome. Nonetheless, there is a good deal to recommend in this book. In “An Approach to a Patient With Movement Disorders During Sleep and Classification,” the editors provide a very well written overview of the subject that gives a short summary of the clinical entities covered in this volume. The chapter by Malow and Plazzi on nocturnal seizures is worth the price of the book alone. It is beautifully organized and illustrated and includes two useful case histories. It helps to distinguish among the various epilepsies and the distinctions between these and the non-REM parasomnias. Some of the same ground is covered in the chapter by Zucconi. There are also two chapters on sleep in Parkinson’s disease and the relation of this to REM behavior disorder.
For the readers of the Journal, the chapter titled “Psychiatric Aspects of Movement Disorders of Sleep” by Mann, Campbell, Caroff, and Ross may be a bit disappointing. It summarizes what is known about sleep in several psychiatric diagnoses, most of which is inconclusive. However, it also reviews the effects of the major antidepressant and antipsychotic agents in common use on different aspects of sleep as well as the long-term efficacy of clonazepam for the control of REM behavior disorder and the non-REM parasomnias. All in all, the editors have provided a good introduction to the movement disorders of sleep.
