BACKGROUND: Sleep terrors and sleepwalking are described as arousals from slow wave sleep with no or poor mental recollection. OBJECTIVE: To characterize the mental content retrospectively associated with sleep terrors or sleepwalking. SETTING: University Hospital. DESIGN: Controlled prospective cohort. PARTICIPANTS: Forty-three patients referred for severe sleepwalking/sleep terrors (age: 26 +/- 7 y, 46% men, 5 with sleep terrors only, 8 with sleepwalking only, and 30 with both), matched with 25 healthy control subjects. INTERVENTION: Thirty-eight of the 43 patients (88%) underwent an interview about the frequency, time, behaviors, and mental content associated with the episodes of sleepwalking and sleep terrors, whenever they occurred over a lifetime. The mental contents were classified for complexity (Orlinski score), and for characters, emotions, fortune/misfortune, and social interactions (Hall and Van de Castle categories). Patients and control subjects underwent an overnight video-polysomnogram. RESULTS: Seventy-one percent of the patients reported at least 1 dreamlike mentation associated with the sleepwalking/sleep terrors episode. The dreamlike mentation action corresponded with the observed behavior. A total of 106 dreamlike mentations were collected (mean: 3 +/- 3.4 dreamlike mentations/patient, range 0-17). Most (95%) dreamlike mentations consisted of a single visual scene. These dreamlike mentations were frequently unpleasant, with aggression in 24% (the dreamer being always the victim), misfortune in 54%, and apprehension in 84%. The patients with dream mentations reported more severe daytime sleepiness. CONCLUSION: Short, unpleasant dreamlike mentations may occur during sleepwalking/sleep terrors episodes, suggesting that a complex mental activity takes place during slow wave sleep. Sleepwalking may thus represent acting out of the corresponding dreamlike mentation.
BACKGROUND: Sleep terrors and sleepwalking are described as arousals from slow wave sleep with no or poor mental recollection. OBJECTIVE: To characterize the mental content retrospectively associated with sleep terrors or sleepwalking. SETTING: University Hospital. DESIGN: Controlled prospective cohort. PARTICIPANTS: Forty-three patients referred for severe sleepwalking/sleep terrors (age: 26 +/- 7 y, 46% men, 5 with sleep terrors only, 8 with sleepwalking only, and 30 with both), matched with 25 healthy control subjects. INTERVENTION: Thirty-eight of the 43 patients (88%) underwent an interview about the frequency, time, behaviors, and mental content associated with the episodes of sleepwalking and sleep terrors, whenever they occurred over a lifetime. The mental contents were classified for complexity (Orlinski score), and for characters, emotions, fortune/misfortune, and social interactions (Hall and Van de Castle categories). Patients and control subjects underwent an overnight video-polysomnogram. RESULTS: Seventy-one percent of the patients reported at least 1 dreamlike mentation associated with the sleepwalking/sleep terrors episode. The dreamlike mentation action corresponded with the observed behavior. A total of 106 dreamlike mentations were collected (mean: 3 +/- 3.4 dreamlike mentations/patient, range 0-17). Most (95%) dreamlike mentations consisted of a single visual scene. These dreamlike mentations were frequently unpleasant, with aggression in 24% (the dreamer being always the victim), misfortune in 54%, and apprehension in 84%. The patients with dream mentations reported more severe daytime sleepiness. CONCLUSION: Short, unpleasant dreamlike mentations may occur during sleepwalking/sleep terrors episodes, suggesting that a complex mental activity takes place during slow wave sleep. Sleepwalking may thus represent acting out of the corresponding dreamlike mentation.
Authors: Yves Dauvilliers; Ronald B Postuma; Luigi Ferini-Strambi; Isabelle Arnulf; Birgit Högl; Raffaele Manni; Tomoyuki Miyamoto; Wolfgang Oertel; Maria Livia Fantini; Monica Puligheddu; Poul Jennum; Karel Sonka; Marco Zucconi; Smeranda Leu-Semenescu; Birgit Frauscher; Michele Terzaghi; Masayuki Miyamoto; Marcus Unger; Alex Desautels; Christina Wolfson; Amélie Pelletier; Jacques Montplaisir Journal: Neurology Date: 2013-05-08 Impact factor: 9.910
Authors: Anna Castelnovo; Brady A Riedner; Richard F Smith; Giulio Tononi; Melanie Boly; Ruth M Benca Journal: Sleep Date: 2016-10-01 Impact factor: 5.849
Authors: Anna Heidbreder; Birgit Frauscher; Thomas Mitterling; Matthias Boentert; Anja Schirmacher; Paul Hörtnagl; Harald Schennach; Christina Massoth; Svenja Happe; Geert Mayer; Peter Young; Birgit Högl Journal: J Clin Sleep Med Date: 2016-04-15 Impact factor: 4.062