Neurological Sleep Disorders Unit

The Neurological Sleep Disorders Unit treats patients with persistent sleep difficulties, excessive daytime sleepiness or sleep-wake cycle disorders that require a specialist neurological assessment. It intervenes when sleep ceases to be restorative and begins to affect concentration, mood, work performance or general health.

Neurological assessment of sleep disorders

Sleeping poorly over a prolonged period does not simply mean getting less rest. Fragmented, insufficient or non-restorative sleep can affect concentration, memory, mood, work performance and general health.

The Unit treats people with persistent difficulties falling asleep or staying asleep, frequent awakenings, daytime sleepiness, irregular sleep patterns or abnormal behaviour whilst sleeping.

A specialist assessment is particularly recommended when symptoms persist, interfere with daily life, do not improve with basic measures, or may be related to a neurological, respiratory, medical or psychological condition.

Which neurological sleep disorders are studied

The Unit carries out the assessment and differential diagnosis of the main sleep disorders related to brain function, the regulation of the sleep-wake cycle and the mechanisms that maintain alertness during the day.

The conditions treated include:

• Chronic insomnia.

• Excessive daytime sleepiness.

• Hypersomnia and narcolepsy.

• Circadian rhythm disorders.

• Restless legs syndrome.

• Periodic limb movements during sleep.

• Sleepwalking and other parasomnias.

• REM sleep behaviour disorder.

• Fragmented or non-restorative sleep.

• Sleep disturbances associated with neurological disorders.

The assessment helps to distinguish a primary sleep disorder from a sleep disturbance secondary to another medical condition, the effects of certain medicines, changes in sleep schedules, or emotional and behavioural factors.

Specialist diagnosis and sleep assessment

The diagnostic process begins with a detailed clinical consultation. We analyse symptoms, sleep patterns, instances of waking, naps, daytime alertness, daily routines, treatments used and the possible presence of other medical conditions.

A sleep diary or information from the person sharing the bed with the patient may also be requested, particularly where there are movements, vocalisations or nocturnal behaviours that the patient does not recall.

Depending on the symptoms and clinical suspicion, the assessment may be supplemented with various tests.

Overnight polysomnography

Polysomnography records brain activity, eye movements, muscle tone, breathing, heart rate and other physiological parameters during sleep.

It enables analysis of sleep architecture, determines how long each phase lasts, and identifies awakenings, abnormal movements, respiratory disturbances or behaviours that may go unnoticed during the night.

Multiple sleep latency test

The multiple sleep latency test measures how easily a person falls asleep during several scheduled sleep opportunities throughout the day.

It is mainly used in the investigation of excessive daytime sleepiness and when narcolepsy or other central hypersomnia disorders are suspected.

Actigraphy

Actigraphy records periods of activity and rest over several days or weeks using a device similar to a watch.

It is particularly useful for studying actual sleep schedules, circadian rhythm disorders and differences between the patient’s perception and their objective sleep pattern.

Other supplementary tests

Depending on the individual case, blood tests, neurophysiological studies, clinical scales, wakefulness maintenance tests or other investigations aimed at identifying the cause of the symptoms may be recommended.

Each result is interpreted within the context of the individual’s clinical presentation. A single test does not always suffice on its own to explain a sleep problem, which often has multiple causes.

Personalised treatment for sleep disorders

Treatment is determined once the type of disorder, its cause and any factors that may be perpetuating it have been identified.

Depending on the diagnosis, the treatment plan may include sleep education, rescheduling of daily routines, specific measures to regulate the circadian rhythm, cognitive behavioural therapy for insomnia, or medication where clinically indicated.

For disorders requiring medication, the expected benefit, duration of treatment, potential interactions and necessary follow-up are assessed on an individual basis.

The aim is not merely to reduce a specific symptom, but to promote a more stable sleep pattern, improve daytime functioning and address the factors preventing restful sleep.

Coordination with other specialities

Some sleep problems require a coordinated approach. Where snoring, breathing pauses, airway obstruction or other signs consistent with a respiratory disorder are present, the assessment may be carried out in conjunction with Pulmonology, Otorhinolaryngology or Oral and Maxillofacial Surgery.

Collaboration with Psychiatry, Psychology, Cardiology, Endocrinology or other specialities may also be necessary when sleep is affected by concomitant conditions.

This model allows the neurological assessment of sleep to be integrated into a broader diagnosis, without attributing all symptoms to a single cause.

Clinical follow-up and gradual recovery of sleep

Many sleep disorders require gradual adjustments. Therefore, once treatment has begun, a follow-up programme tailored to each patient’s needs is established.

These follow-up appointments enable us to assess the progression of insomnia or sleepiness, review sleep schedules, analyse tolerance to treatment and modify therapeutic measures where necessary.

From the very first consultation, sufficient time is set aside to understand the patient’s sleep pattern, explain the findings and address any queries regarding the diagnosis and the available options.

Information is presented clearly to facilitate informed decision-making and encourage continuity of treatment.

When to request a sleep assessment

A specialist assessment may be recommended in situations such as:

• Difficulty sleeping for several weeks or months.

• Frequent or excessively early awakenings.

• A feeling that sleep is not restorative.

• Drowsiness that makes it difficult to work, study or drive.

• An irresistible urge to sleep during the day.

• Persistently irregular sleep patterns.

• Uncomfortable movements in the legs when lying down.

• Sleepwalking, vocalisations or complex behaviours during sleep.

• Sudden movements associated with vivid dreams.

• Sleep disturbances in people with a neurological condition.

Drowsiness whilst driving, sudden episodes of loss of muscle tone or nocturnal behaviours posing a risk of injury require urgent medical assessment.