P49-S Head rolling in adults: Case report finding in a sleep polissomnographic study

Head rolling is a rhythmic movement of sleep and is defined by the third International Classification of Sleep Disorders as repetitive, stereotyped and rhythmic movements involving large muscle groups, such as head and neck, and occur predominantly in the early stages of the NREM sleep. Its more frequently to happen in infants and its more prevalent during early 9 months of life, in most cases resolve in the 2nd or 3rd year of life. It has rare persistence rate from the 5th year of life. It has been postulated that rhythmic movements of sleep are a calming technique used by children to combat insomnia. The pathophysiology of persistence in adulthood, as well as the association with other sleep diseases, it’s quietly unknown. We present a 63 year old male, with a past history of multiple vascular risk factors, HIV infection and suspected OSAS. Level 1 nocturnal polysomnography (PSG) showed rhythmic movements of the head in wakefulness/drowsiness, with no paroxysmal activity recorded on EEG leads, without OSAS criteria and a marked decrease in sleep efficiency of (31.7%) with an increase of sleep latency (5 h 28 min). Although Head Rolling is common in children, its persistence or onset in adulthood is very rare and may constitute a sleep disorder if associated with poor sleep quality and efficiency or injury to the patient. Differential diagnosis with epilepsy, motor related sleep disorders or co-occurrence with other sleep diseases explains the importance of performing PSG with supplemental EEG channels in these patients.