Adult chronic sleepwalking and its treatment based on polysomnography

Abstract

Adult sleepwalking affects 2.5% of the general population and may lead to serious injuries. Fifty young adults with chronic sleepwalking were studied prospectively. Clinical evaluation, questionnaires from patients and bed partners, and polysomnography were obtained on all subjects in comparison with 50 age-matched controls. Subjects were examined for the presence of psychiatric anxiety, depression and any other associated sleep disorder. Isolated sleepwalking or sleepwalking with psychiatric disorders was treated with medication. All other patients with other sleep disorders were treated only for their associated problem. Prospective follow-up lasted 12 months after establishment of the most appropriate treatment. Patients with only sleepwalking, treated with benzodiazepines, dropped out of follow-up testing and reported persistence of sleepwalking, as did patients with psychiatric-related treatment. Chronic sleepwalkers frequently presented with sleep-disordered breathing (SDB). All these patients were treated only for their SDB, using nasal continuous positive airway pressure (CPAP). All nasal CPAP-compliant patients had control of sleepwalking at all stages of follow-up. Non-compliant nasal CPAP patients had persistence of sleepwalking. They were offered surgical treatment for SDB. Those successfully treated with surgery also had complete resolution of sleepwalking. Successful treatment of SDB, which is frequently associated with chronic sleepwalking, controlled the syndrome in young adults.

Treatments for somnambulism in adults: Assessing the evidence

“…Authors concluded that treating any comorbid SDB also resolved sleepwalking in young adults. 22 • Four reports of large mixed case series included patients with sleepwalking but did not report all outcomes separately for the sleep walking patients. One series included 61 patients treated with clonazepam, 28 of them having night terrors/sleep walking, and 83.6% of the 61 were reported as achieving "rapid and sustained control".…”

Parasomnia and Dissociative Disorders

“…Informed consent forms were collected with signatures. (1)(2)(3)(4) to determine mild, moderate or severe symptomatology of each dissociative disorder symptoms. Each of the five symptoms has a severity scale of 4 and maximum score is 20.…”

“…Although parasomnia is frequently seen during childhood, it subsides in the adulthood. Reduced N3 phase Sleep and Central Nervous System (CNS) maturation with age can be the reason behind the decreased parasomnia incidence in adulthood [1][2][3]. Although there are limited number of studies, parasomnia in the adulthood is mostly related to psychiatric diseases and medical conditions [2].…”

“…Reduced N3 phase Sleep and Central Nervous System (CNS) maturation with age can be the reason behind the decreased parasomnia incidence in adulthood [1][2][3]. Although there are limited number of studies, parasomnia in the adulthood is mostly related to psychiatric diseases and medical conditions [2]. Studies on defining the correlation between psychiatric disorder and parasomnia in adulthood are insufficient.…”

Disorders of Arousal

“…In a study by Guilleminault et al, four out of five subjects placed on clonazepam had limited results at 3 months follow-up, reporting only a decrease in the frequency of sleepwalking events under particularly high daytime stress [63]. Cases of remission after treatment with olanzapine [64] and biperiden [65] have been reported.…”