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Multifactorial Causation and Therapy of Sleep Disorders

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 September 2026 | Viewed by 652

Editor


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Guest Editor
Institute of Behavioural Sciences, Semmelweis University, H-1089 Budapest, Hungary
Interests: sleep; parasomnias; epilepsy; neurology

Special Issue Information

Dear Colleagues,

The more we know and the better we understand sleep disorders, the more they seem to infiltrate neurology, slowly and gradually resulting in the emergence of a “sleep-neurology”.

Narcolepsy—highlighting the complex ways of sleep regulation unknown before the discovery of orexins and pointing to the ensemble of genetics, autoimmunity, and epigenetics as sleep-changing factors—is a typical example. Understanding the mechanism of cataplexy and its links with orexins and emotional (amygdalar) influences sees across to REM sleep behavior disorder (RBD), closely associating it with Parkinsonian conditions, mainly synucleinopathies. RBD heralds them, preceding them by years, thus paving the way for prevention—identifying the persons developing those debilitating conditions. Even insomnia has major neurological aspects—insomnia with a fronto-basal tumor, insomnia due to sleep-related painful erection, or restless legs syndrome. Insomnia—the lack of periods of slow-wave sleep—seems to cause cognitive loss in two ways at least: the decrease in slow-wave-related plasticity and the weakening of brain-wash resulting in the accumulation and deposition of harmful metabolites and proteins in the brain, such as amyloid-beta, the driver and promoter of Alzheimer’s disease. NREM parasomnias, once considered mysterious or results of purely psychological and personality changes, present now as examples of sleep-state dissociations where the exact brain localization—with the anterior cingulate cortex in center—is being investigated.

The changes in respiration during sleep make another big chapter. The stridor of patients with multisystem atrophy is a life-threatening condition related to vocal cord palsy due to olivo-ponto-cerebellar degeneration. Obstructive sleep apnea syndrome is now much more than an abnormality due to physical alterations of the upper airways, and the often neglected sleep-breathing abnormalities, pseudo-central sleep apneas of myasthenia, or respiration changes in conditions of the cervical spine may need a complex somnology–respiratory–neurology approach.

Dr. Anna Szûcs
Guest Editor

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Keywords

  • sleep disorders
  • narcolepsy
  • sleep-neurology
  • REM sleep behavior disorder
  • sleep apneas

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Published Papers (1 paper)

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Research

11 pages, 704 KB  
Article
Spectral Features of Heart Rate Variability in Williams Syndrome During Sleep
by Bence Schneider, Ferenc Gombos, Ilona Kovács and Róbert Bódizs
J. Clin. Med. 2026, 15(11), 4317; https://doi.org/10.3390/jcm15114317 - 3 Jun 2026
Viewed by 368
Abstract
Background: This study analyzed spectral alterations of heart rate variability (HRV) in Williams syndrome (WS) during sleep, taking into account the multi-fractal properties of RR-interval spectra, including effects of aging and sleep structure. Methods: Using ECG recordings of 20 subjects with WS and [...] Read more.
Background: This study analyzed spectral alterations of heart rate variability (HRV) in Williams syndrome (WS) during sleep, taking into account the multi-fractal properties of RR-interval spectra, including effects of aging and sleep structure. Methods: Using ECG recordings of 20 subjects with WS and matched typically developing (TD) controls, fractal and oscillatory spectral components of RR-intervals were computed. The fractal component was parametrized with a piecewise-linear function, allowing a breakpoint and separate slope and intercept values in the lower- and higher-frequency domains. The dominant peak frequency and prominence were extracted from the LF (0.04–0.15 Hz) and HF (0.15–0.4 Hz) bands. Results: Strong WS/TD group differences were found in the breakpoint frequency, high domain slope, intercept and HF peak prominence. The LF peak frequency showed a slight age-dependent decrease only in TD, and reduced values in WS independent of age. Principal component analysis identified a main fractal component describing typical alterations in the spectrum in WS, which exhibited sleep-structure associations. Conclusions: The broken power-law model successfully characterized the fractal component of RR-interval spectra, capturing altered cardiac regulation in WS, while suggesting the fractal parameters as possible biomarkers of the degree of general autonomic deregulation. Full article
(This article belongs to the Special Issue Multifactorial Causation and Therapy of Sleep Disorders)
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