Adrenergic reactions during N3 sleep arousals in sleepwalking and sleep terrors: The chicken or the egg?

Ledard, Nahema; Artru, Emilie; Sayago, Patricia Colmenarez; Redolfi, Stefania; Carrillo-Solano, Marisol; Arnulf, Isabelle

doi:10.1111/jsr.12946

Cited by 6 publications

(6 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another study under normal sleep conditions showed that arousals during slow-wave sleep in 38 predisposed individuals were associated with an abrupt heart rate acceleration ( 18 ). A similar finding was found for motor arousals during slow-wave sleep associated with sleepwalking or sleep terrors in 20 participants, with arousals being preceded by an abrupt heart rate acceleration ( 20 ). Overall, our present findings suggest that this activation prior to episode occurrence does not appear to extend to entire periods of slow-wave sleep.…”

Section: Discussionsupporting

confidence: 71%

“…Therefore, investigating autonomic nervous system functioning in sleepwalkers following a period of sleep deprivation may provide insights into the neural pathophysiological mechanisms involved in sleepwalkers' slow-wave sleep regulation. A few studies having measured heart rate in sleepwalkers found autonomic changes suggestive of an abrupt sympathetic activation before episodes, including during slow-wave sleep ( 18 – 20 ). These preliminary reports suggest that autonomic dysfunctions might play a role in pathophysiology of sleepwalking.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Autonomic Modulation During Baseline and Recovery Sleep in Adult Sleepwalkers

et al. 2021

View full text Add to dashboard Cite

Sleepwalking has been conceptualized as deregulation between slow-wave sleep and arousal, with its occurrence in predisposed patients increasing following sleep deprivation. Recent evidence showed autonomic changes before arousals and somnambulistic episodes, suggesting that autonomic dysfunctions may contribute to the pathophysiology of sleepwalking. We investigated cardiac autonomic modulation during slow-wave sleep in sleepwalkers and controls during normal and recovery sleep following sleep deprivation. Fourteen adult sleepwalkers (5M; 28.1 ± 5.8 years) and 14 sex- and age-matched normal controls were evaluated by video-polysomnography for one baseline night and during recovery sleep following 25 h of sleep deprivation. Autonomic modulation was investigated with heart rate variability during participants' slow-wave sleep in their first and second sleep cycles. 5-min electrocardiographic segments from slow-wave sleep were analyzed to investigate low-frequency (LF) and high-frequency (HF) components of heart rate spectral decomposition. Group (sleepwalkers, controls) X condition (baseline, recovery) ANOVAs were performed to compare LF and HF in absolute and normalized units (nLF and nHF), and LF/HF ratio. When compared to controls, sleepwalkers' recovery slow-wave sleep showed lower LF/HF ratio and higher nHF during the first sleep cycle. In fact, compared to baseline recordings, sleepwalkers, but not controls, showed a significant decrease in nLF and LF/HF ratio as well as increased nHF during recovery slow-wave sleep during the first cycle. Although non-significant, similar findings with medium effect sizes were observed for absolute values (LF, HF). Patterns of autonomic modulation during sleepwalkers' recovery slow-wave sleep suggest parasympathetic dominance as compared to baseline sleep values and to controls. This parasympathetic predominance may be a marker of abnormal neural mechanisms underlying, or interfere with, the arousal processes and contribute to the pathophysiology of sleepwalking.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Autonomic Modulation During Baseline and Recovery Sleep in Adult Sleepwalkers

et al. 2021

View full text Add to dashboard Cite

show abstract

“…All HNIV sequences and time‐synchronized video recordings associated with N3 sleep interruptions during the VPSG were visually inspected by a single scorer (R.L.). Events characterized by sudden motor behaviours (raising the head or torso, sitting in bed or standing) and/or vocal or facial manifestations of confusion/disorientation, surprise or fear were defined as parasomniac episodes (Cataldi et al, 2022; Joncas et al, 2002; Ledard et al, 2019; Lopez et al, 2018), and were classified according to three clinical subtypes: (1) sleepwalking episodes when associated with ambulation; (2) sleep terror episodes characterized by abrupt arousals with expression of fear and/or screaming; (3) the parasomniac episodes that did not correspond to sleepwalking or sleep terror were classified as confusional arousals. The frequency of parasomniac episodes during the HNIV was estimated using: (1) the mean number of episodes (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…All HNIV sequences and time-synchronized video recordings associated with N3 sleep interruptions during the VPSG were visually inspected by a single scorer (R.L.). Events characterized by sudden motor behaviours (raising the head or torso, sitting in bed or standing) and/or vocal or facial manifestations of confusion/disorientation, surprise or fear were defined as parasomniac episodes (Cataldi et al, 2022;Joncas et al, 2002;Ledard et al, 2019;Lopez et al, 2018), and were classified according to three clinical subtypes:…”

Section: Behavioural Analysesmentioning

confidence: 99%

Home nocturnal infrared video to record non‐rapid eye movement sleep parasomnias

Lopez

Barateau

Chenini³

et al. 2022

Journal of Sleep Research

View full text Add to dashboard Cite

Summary To assess the feasibility, the acceptability and the usefulness of home nocturnal infrared video in recording the frequency and the complexity of non‐rapid eye movement sleep parasomnias in adults, and in monitoring the treatment response. Twenty adult patients (10 males, median age 27.5 years) with a diagnosis of non‐rapid eye movement parasomnia were consecutively enrolled. They had a face‐to‐face interview, completed self‐reported questionnaires to assess clinical characteristics and performed a video‐polysomnography in the Sleep Unit. Patients were then monitored at home during at least five consecutive nights using infrared‐triggered cameras. They completed a sleep diary and questionnaires to evaluate the number of parasomniac episodes at home and the acceptability of the home nocturnal infrared video recording. Behavioural analyses were performed on home nocturnal infrared video and video‐polysomnography recordings. Eight patients treated by clonazepam underwent a second home nocturnal infrared video recording during five consecutive days. All patients had at least one parasomniac episode during the home nocturnal infrared video monitoring, compared with 75% during the video‐polysomnography. A minimum of three consecutive nights with home nocturnal infrared video was required to record at least one parasomniac episode. Most patients underestimated the frequency of episodes on the sleep diary compared with home nocturnal infrared video. Episodes recorded at home were often more complex than those recorded during the video‐polysomnography. The user‐perceived acceptability of the home nocturnal infrared video assessment was excellent. The frequency and the complexity of the parasomniac episodes decreased with clonazepam. Home nocturnal infrared video has good feasibility and acceptability, and may improve the evaluation of the phenotype and severity of the non‐rapid eye movement parasomnias and of the treatment response in an ecological setting.

show abstract

“…These changes are more marked than those associated to normal arousals or even with post‐apnea arousals. Of interest, while these changes were thought to occur at the exact time of confusional arousal (Schenck et al, 1998), a recent study analysis of instantaneous heart rate indicated that these adrenergic markers started to increase 3–4 s before the behavioural arousal (Ledard et al, 2020). This sequence was observed during N3 interruptions in normal controls too.…”

Section: Polysomnography Video and Brain Functional Imagingmentioning

confidence: 99%

Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: the old and the new

Idir

Oudiette

Arnulf

2022

Journal of Sleep Research

Self Cite

View full text Add to dashboard Cite

Summary Disorders of arousal (DOA) is an umbrella term initially covering classical sleepwalking, sleep terrors, and confusional arousals, and now including a wider spectrum of specialised forms of non rapid eye movement (non REM) parasomnias such as sexsomnia, sleep‐related eating disorder, and sleep‐related choking syndrome. Growing evidence has shown that DOA are not restricted to children but are also prevalent in adults (2%–4% of the adult population). While DOA run in family, genetics studies remain scarce and inconclusive. In addition to the risk of injury on themselves and others (including sexual assaults in sexsomnia), adults with DOA frequently suffer from excessive daytime sleepiness, pain, and altered quality of life. The widespread view of DOA as automatic and amnesiac behaviours has now been challenged by subjective (dream reports) and objective (dream‐enacting behaviours documented on video‐polysomnography) observations, suggesting that sleepwalkers are ‘dream walking’ during their episodes. Behavioural, experiential, cognitive, and brain (scalp electroencephalography [EEG], stereo‐EEG, high density‐EEG, functional brain imaging) data converge in showing a dissociated pattern during the episodes. This dissociated pattern resembles the new concept of local arousal with a wake‐like activation in motor and limbic regions and a preserved (or even increased) sleep intensity over a frontoparietal network. EEG and behavioural criteria supporting the DOA diagnosis with high sensitivity and specificity are now available. However, treatment is still based on controlling priming and precipitating factors, as well as on clinicians’ personal experience with sedative drugs. Placebo‐controlled trials are needed to improve patients’ treatment. DOA deserve more attention from sleep researchers and clinicians.

show abstract

Adrenergic reactions during N3 sleep arousals in sleepwalking and sleep terrors: The chicken or the egg?

Cited by 6 publications

References 38 publications

Autonomic Modulation During Baseline and Recovery Sleep in Adult Sleepwalkers

Autonomic Modulation During Baseline and Recovery Sleep in Adult Sleepwalkers

Home nocturnal infrared video to record non‐rapid eye movement sleep parasomnias

Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: the old and the new

Contact Info

Product

Resources

About