Prevalence and comorbidity of nocturnal wandering in the US adult general population

Abstract

Objective: To assess the prevalence and comorbid conditions of nocturnal wandering with abnormal state of consciousness (NW) in the American general population. Methods:Cross-sectional study conducted with a representative sample of 19,136 noninstitutionalized individuals of the US general population Ն18 years old. The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental, and organic disorders (DSM-IV-TR; International Classification of Sleep Disorders, version 2; International Classification of Diseases-10).Results: Lifetime prevalence of NW was 29.2% (95% confidence interval [CI] 28.5%-29.9%). In the previous year, NW was reported by 3.6% (3.3%-3.9%) of the sample: 1% had 2 or more episodes per month and 2.6% had between 1 and 12 episodes in the previous year. Family history of NW was reported by 30.5% of NW participants. Individuals with obstructive sleep apnea syndrome (odds ratio [OR] 3.9), circadian rhythm sleep disorder (OR 3.4), insomnia disorder (OR 2.1), alcohol abuse/dependence (OR 3.5), major depressive disorder (MDD) (OR 3.5), obsessivecompulsive disorder (OCD) (OR 3.9), or using over-the-counter sleeping pills (OR 2.5) or selective serotonin reuptake inhibitor (SSRI) antidepressants (OR 3.0) were at higher risk of frequent NW episodes (Ն2 times/month). Conclusions:With a rate of 29.2%, lifetime prevalence of NW is high. SSRIs were associated with an increased risk of NW. However, these medications appear to precipitate events in individuals with a prior history of NW. Furthermore, MDD and OCD were associated with significantly greater risk of NW, and this was not due to the use of psychotropic medication. These psychiatric associations imply an increased risk due to sleep disturbance. Neurology ® 2012;78:1583-1589

Demographic, Clinical and Polysomnographic Characteristics of Childhood- and Adult-Onset Sleepwalking in Adults

“…The profile of subjects with AO-SW differs from that of those with CO-SW. We confirmed previous reports that nearly 40% of individuals with SW had a family history of such a disorder [6]. However, in the subgroup analysis, not surprisingly, familial occurrence was significantly more frequent in the CO-SW compared to the AO-SW group.…”

“…In our cohort, as in previous studies [18, 19], there were more males among sleepwalkers. This does not necessarily reflect an association of SW with gender [6] but possibly differences in the referral rates, which are likely due to the fact that male sleepwalkers have more frequent violent episodes than female sleepwalkers.…”

“…Among adult sleepwalkers, approximately 13% develop this sleep disturbance during adulthood [5]. The overall prevalence of SW in adulthood is about 4% [6]. …”

EEG Functional Connectivity Prior to Sleepwalking: Evidence of Interplay Between Sleep and Wakefulness

“…1,2 Most behavioral episodes are characterized by misperception and relative unresponsiveness to the environment, mental confusion, perceived threat or agitation, and variable retrograde amnesia. 2 Sleepwalking is far more common in adults than commonly acknowledged, affecting up to 4% of adults, 3 and represents a leading cause of sleep-related violence and self-injury. 4,5 Despite its high prevalence and its well-described clinical characterization, the pathophysiology of the disorder remains poorly understood.…”

Sleep-related movement disorders and disturbances of motor control

“…RLS). Sleep-related bruxism (SB) [3,4] 10-20% Highest frequency in children (14-20%) The prevalence is not associated with sex and decreases with age Parental history of SB predicted SB severity PLMS [5] 5-20% Rare below the age of 30-40 years Common in sleep disordered breathing and narcolepsy Very common (70-90%) in RLS Sleep paralysis [6] 5-15% More common in narcolepsy (50%) and in psychiatric patients (30%) Sleepwalking [7][8][9][10][11] 5-15% Typically affects children (peak age 10-12 years) but it can persist or appear de novo in adulthood Lower frequency (1-5%) in adults The prevalence of childhood sleepwalking increases with the degree of parental history of sleepwalking. Among adult sleepwalkers 13% report an onset in adulthood RLS [12,13] 1-10% Rare in children More common in uremia, iron deficiency, pregnancy (10-30%) Variable prevalence in the general population among countries Sleep terrors [7] 1-5% Typical age-of-onset during the early childhood (peak of prevalence at 1.5 years).…”