Sleep and comorbid neurologic disorders.

PURPOSE OF REVIEW An understanding of the impact of sleep on neurologic disorders, and the impact of neurologic disorders on sleep, provides fresh opportunities for neurologists to improve the quality of life and functioning of their patients. RECENT FINDINGS Sleep-disordered breathing (SDB) is a risk factor for cerebrovascular disease and should be considered in all TIA and stroke patients. Sleep disorders can amplify nociception and worsen headache disorders; and some headaches, including those related to SDB and hypnic headache, are sleep specific. REM sleep behavior disorder may be an early sign of neurodegenerative disease. Focal lesions of almost any etiology (eg, multiple sclerosis and CNS malignancies) in the hypothalamus, basal forebrain, or brainstem may result in sleep disturbance, sleepiness, and insomnia. Sleep-related hypoventilation and fatigue are common in neuromuscular disease. SDB and epilepsy are mutually facilitatory, and poor sleep can exacerbate epilepsy. SUMMARY Continued surveillance for sleep disorders by neurologists is rewarded by new treatment avenues in their patients with the possibility of improved clinical outcomes.