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REM Sleep Behavior Disorder

Restless Legs Syndrome in Adult Primary Care

Author/s: 
Mathur A, Bhat A, Gohar A

Restless Legs Syndrome (RLS) or Willis‑Ekbom Disease is a sensorimotor condition marked by an irresistible need to move the legs, typically accompanied by uncomfortable sensations that peak during periods of rest and disrupt nightly sleep. Early identification in primary care is essential, as timely intervention can dramatically improve the patient's quality of life. Diagnosis relies on a focused clinical history, guided by targeted questions that explore symptom timing, triggers, and relief measures. Management begins with non‑pharmacological strategies, such as optimizing sleep hygiene and correcting iron deficiency, before progressing to pharmacologic options like gabapentinoids or dopamine agonists when needed. By combining lifestyle modifications with tailored medication plans, clinicians can effectively reduce symptoms and improve sleep quality.

Keywords 
Restless Legs Syndrome Dopamine Agonists Sleep Hygiene Sleep Quality Leg quality of life

Disorders of Arousal in adults: new diagnostic tools for clinical practice

Author/s: 
Loddo, G, Lopez, R, Cilea, R, Dauvillers, Y, Provini, F

Disorders of Arousal  (DOA) are mental and motor behaviors arising from NREM sleep. They comprise a spectrum of manifestations of increasing intensity from confusional arousals to sleep terrors to sleepwalking.

Although DOA in childhood are usually harmless, in adulthood they are often associated with injurious or violent behaviors to the patient or others. Driving motor vehicles, suspected suicide, and even homicide or attempted homicide have been described during sleepwalking in adults. Furthermore, adult DOA need to be differentiated from other sleep disorders such as Sleep-related Hypermotor Epilepsy or REM Sleep Behavior Disorder.

Although many aspects of DOA have been clarified in the last two decades there is still a lack of objective and quantitative diagnostic criteria for DOA.

Recent advances in EEG analysis and in the semiological characterization of DOA motor patterns have provided a better definition of DOA diagnosis.

Our article focuses on the DOA diagnostic process describing accurately the newest DOA clinical, EEG and video-polysomnographic tools in order to aid clinicians in DOA assessment.

Keywords 
disorder of arousal sleepwalking sleep terrors confusional arousals EEG Video-polysomnography Diagnostic Criteria Motor Patterns Slow-wave sleep fragmentation index
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