Amit Chopra1, Rikinkumar S Patel2, Nisha Baliga3, Anoop Narahari4, Piyush Das5. 1. Psychiatry and Behavioral Health Institute, Department of Sleep Medicine, Allegheny Health Network, Pittsburgh, PA, United States. Electronic address: Amit.CHOPRA@ahn.org. 2. Department of Psychiatry, Griffin Memorial Hospital, Norman, OK, United States. 3. Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States. Electronic address: Nisha.P.Baliga@hitchcock.org. 4. Psychiatry and Behavioral Health Institute, Allegheny Health Network, Pittsburgh, PA, United States. Electronic address: anoop.narahari@ahn.org. 5. Department of Sleep Medicine, CentraCare, MN, United States. Electronic address: Piyush.Das@centracare.com.
Abstract
BACKGROUND: Sleep walking (SW) is a parasomnia behavior characterized by repetitious occurrence of ambulation during a partial arousal from non-rapid eye movement (NREM) sleep. Sleep-related eating (SRE) is one of the complex sleep behaviors that may accompany SW. Emerging evidence suggests that NREM parasomnias can be associated with atypical antipsychotic medication use. METHODS: We present a case series (n = 5) and a systematic review of the literature of cases of SW, with or without SRE (n = 23), associated with atypical antipsychotic use. RESULTS: Twenty-eight cases of SW, with and without SRE, with a mean age of 44.8 years (S.D. = 15.04) and a male predominance (75%; n = 21) were identified. Quetiapine was the most commonly implicated medication with SW and SRE (n = 14). Remission from SW/SRE was noted in all cases with measures including antipsychotic dosage reduction, discontinuation of medication, switching to an alternate medication, and use of continuous positive airway pressure (CPAP) for comorbid obstructive sleep apnea (OSA) treatment. CONCLUSIONS: Sleep walking (SW), with or without sleep related eating (SRE), can be a rare but reversible side effect associated with use of atypical antipsychotics. More research is warranted to elucidate the mechanisms underlying SW and SRE associated with atypical antipsychotic use.
BACKGROUND: Sleep walking (SW) is a parasomnia behavior characterized by repetitious occurrence of ambulation during a partial arousal from non-rapid eye movement (NREM) sleep. Sleep-related eating (SRE) is one of the complex sleep behaviors that may accompany SW. Emerging evidence suggests that NREM parasomnias can be associated with atypical antipsychotic medication use. METHODS: We present a case series (n = 5) and a systematic review of the literature of cases of SW, with or without SRE (n = 23), associated with atypical antipsychotic use. RESULTS: Twenty-eight cases of SW, with and without SRE, with a mean age of 44.8 years (S.D. = 15.04) and a male predominance (75%; n = 21) were identified. Quetiapine was the most commonly implicated medication with SW and SRE (n = 14). Remission from SW/SRE was noted in all cases with measures including antipsychotic dosage reduction, discontinuation of medication, switching to an alternate medication, and use of continuous positive airway pressure (CPAP) for comorbid obstructive sleep apnea (OSA) treatment. CONCLUSIONS: Sleep walking (SW), with or without sleep related eating (SRE), can be a rare but reversible side effect associated with use of atypical antipsychotics. More research is warranted to elucidate the mechanisms underlying SW and SRE associated with atypical antipsychotic use.
Authors: Diane Merino; Alexandre O Gérard; Elise K Van Obberghen; Nouha Ben Othman; Eric Ettore; Bruno Giordana; Delphine Viard; Fanny Rocher; Alexandre Destere; Michel Benoit; Milou-Daniel Drici Journal: J Clin Med Date: 2022-07-04 Impact factor: 4.964