During the biological night, cognitive capacity and mood regulation are diminished and “reason sleeps” ( Perlis et al., 2016b), probably due to both intrinsic sleep loss and circadian rhythm influences. Disrupted sleep increases the risk for incident and worsening psychiatric illness ( Pigeon et al., 2012 Li et al., 2016 Hertenstein et al., 2019 Zhang et al., 2019 Freeman et al., 2020), and this risk may partially derive from nocturnal wakefulness, which we define as being awake during the circadian or biological night. Based on this evidence, we propose the Mind after Midnight hypothesis in which attentional biases, negative affect, altered reward processing, and prefrontal disinhibition interact to promote behavioral dysregulation and psychiatric disorders.Ĭircadian rhythms influence human physiology and behavior, promoting wakefulness and cognition during the day and reducing cortical activity for sleep at night. This review summarizes the evidence for day-night alterations in maladaptive behaviors, including suicide, violent crime, and substance use, and examines how mood, reward processing, and executive function differ during nocturnal wakefulness. Most studies to-date have examined how fragmented or insufficient sleep affects next-day functioning, but recent work highlights changes in cognition and behavior that occur when someone is awake during the night. Conversely, disrupted sleep involving significant nocturnal wakefulness leads to cognitive and behavioral dysregulation. Sufficient sleep with minimal interruption during the circadian/biological night supports daytime cognition and emotional regulation. 4Department of Neurology, Division of Sleep Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.3Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.2Department of Psychology, Evelyn F Mcknight Brain Institute, University of Arizona, Tucson, AZ, United States.1Sleep and Health Research Program, Department of Psychiatry, University of Arizona College of Medicine-Tucson, Tucson, AZ, United States.Tubbs 1 † Fabian-Xosé Fernandez 2 † Michael A. Classification and evaluation of myoclonus. National Institute of Neurological Disorders and Stroke. In: Bradley and Daroff's Neurology in Clinical Practice. Diagnosis and assessment of Parkinson disease and other movement disorders. In: Aminoff's Neurology and General Medicine. Movement disorders associated with general medical diseases. Parkinson's disease and Lewy body dementia.Nervous system conditions that result in secondary myoclonus include: It is sometimes called secondary myoclonus. Symptomatic myoclonus results from an underlying medical condition. This type of myoclonus occurs as part of an epileptic disorder. In some cases, the cause is hereditary, meaning passed down in families. The cause of essential myoclonus is often unknown. Infant muscle twitching during sleep or after a feeding.Įssential myoclonus occurs on its own, usually without other symptoms and without being related to any underlying illness.Shakes or spasms due to anxiety or exercise.This type of myoclonus occurs in healthy people and rarely needs treatment. It is commonly separated into different types based on what is causing it. Myoclonus may be caused by a variety of underlying problems.
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