Análisis espectral de la variabilidad del ritmo cardíaco y activación cardíaca durante el despertar en el sonambulismo

Parasomnias are abnormal behaviors and/or experiences emanating from or associated with sleep typically manifesting as motor movements of varying semiology. We discuss mainly nonrapid eye movement sleep and related parasomnias in this article. Sleepwalking (SW), sleep terrors (ST), confusional arousals, and related disorders result from an incomplete dissociation of wakefulness from nonrapid eye movement (NREM) sleep. Conditions that provoke repeated cortical arousals, and/or promote sleep inertia, lead to NREM parasomnias by impairing normal arousal mechanisms. Changes in the cyclic alternating pattern, a biomarker of arousal instability in NREM sleep, are noted in sleepwalking disorders. Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after arousal from sleep. SRED is often associated with the use of sedative-hypnotic medications, in particular the widely prescribed benzodiazepine receptor agonists. Compelling evidence suggests that nocturnal eating may in some cases be another nonmotor manifestation of Restless Legs Syndrome (RLS). Initial management should focus upon decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders and eliminating incriminating drugs. Sexsomnia is a subtype of disorders of arousal, where sexual behavior emerges from partial arousal from nonREM sleep. Overlap parasomnia disorders consist of abnormal sleep-related behavior both in nonREM and REM sleep. Status dissociatus is referred to as a breakdown of the sleep architecture where an admixture of various sleep state markers is seen without any specific demarcation. Benzodiazepine therapy can be effective in controlling SW, ST, and sexsomnia, but not SRED. Paroxetine has been reported to provide benefit in some cases of ST. Topiramate, pramipexole, and sertraline can be effective in SRED. Pharmacotherapy for other parasomnias continues to be less certain, necessitating further investigation. NREM parasomnias may resolve spontaneously but require a review of priming and predisposing factors.

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NonREM Disorders of Arousal and Related Parasomnias: an Updated Review

Irfan

Schenck

Howell

2021

Neurotherapeutics

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

Ledard

Artru

Sayago

et al. 2019

Journal of Sleep Research

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Patients with sleepwalking episodes or sleep terrors (SW/ST) exhibit sudden abnormal behaviours arising from sleep, mostly from N3 sleep (American Academy of Sleep Medicine, 2014). Patients usually open their eyes, look around with a confused gaze, sit, stand, walk, talk, scream or flee their bed (Derry, Harvey, Walker, Duncan, & Berkovic, 2009). There is a continuum between the different behavioural patterns of arousal parasomnias. Specifically, the behavioural patterns of non-rapid eye movement (NREM) parasomnias appear with a hierarchical order, with arousal behaviours being the fundamental component, possibly followed by abnormal agitated conduct, which can be further accompanied by distressed emotional manifestations (Derry et al., 2009). Several clinical, polygraphical and brain functional imaging studies support the concept that these behaviours occur during local (primarily thalamo-amygdalo-cingulo-cortical) arousals from N3 sleep, disengaged from the control of the prefrontal and frontal associative cortex

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Objective daytime sleepiness in patients with somnambulism or sleep terrors

2014

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Análisis espectral de la variabilidad del ritmo cardíaco y activación cardíaca durante el despertar en el sonambulismo

Cited by 4 publications

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NonREM Disorders of Arousal and Related Parasomnias: an Updated Review

NonREM Disorders of Arousal and Related Parasomnias: an Updated Review

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

Objective daytime sleepiness in patients with somnambulism or sleep terrors

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