Sleep disorders and the hypothalamus

Sebastiaan Overeem, Raphaële R.L. van Litsenburg, Paul J. Reading

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

9 Citations (Scopus)

Abstract

As early as the 1920s, pathological studies of encephalitis lethargica allowed Von Economo to correctly identify hypothalamic damage as crucial for the profound associated sleep-related symptoms that helped define the condition. Only over the last 3 decades, however, has the key role of the hypothalamus in sleep–wake regulation become increasingly recognized. As a consequence, a close relation between abnormal sleep symptomatology and hypothalamic pathology is now widely accepted for a variety of medical disorders. Narcolepsy is discussed in some detail as the cardinal primary sleep disorder that is caused directly and specifically by hypothalamic pathology, most notably destruction of hypocretin (orexin)-containing neurons. Thereafter, various conditions are described that most likely result from hypothalamic damage, in part at least, producing a clinical picture resembling (symptomatic) narcolepsy. Kleine–Levin syndrome is a rare primary sleep disorder with intermittent symptoms, highly suggestive of hypothalamic involvement but probably reflecting a wider pathophysiology. ROHHAD (rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation) and Prader–Willi syndrome are also covered as hypothalamic syndromes with prominent sleep-related symptoms. Finally, sleep issues in several endocrine disorders are briefly discussed.

Original languageEnglish
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages369-385
Number of pages17
DOIs
Publication statusPublished - Jan 2021

Publication series

NameHandbook of Clinical Neurology
Volume182
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

Keywords

  • Alzheimer's disease
  • Cataplexy
  • Hypersomnia
  • Hypersomnolence
  • Insomnia
  • Kleine–Levin syndrome
  • Lateral hypothalamus
  • Narcolepsy
  • Prader–Willi syndrome
  • REM sleep
  • ROHHAD
  • Tuberomamillary nucleus

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