Violence in sleep

Siclari, Francesca; Khatami, Ramin; Urbaniok, Frank; Nobili, Lino; Mahowald, Mark W.; Schenck, Carlos H.; Bornemann, Michel A. Cramer; Bassetti, Claudio L.

doi:10.1093/brain/awq296

Cited by 120 publications

(36 citation statements)

References 166 publications

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“…Neurological comorbidities were present in 23% of the subjects and were twice more frequent in the AO-SW group compared to subjects with CO-SW. Consequently, more subjects in the AO-SW group exhibited EEG abnormalities. In our cohort, nearly one-third of the subjects reported a psychiatric comorbidity; however, we could not confirm previous reports that psychiatric comorbidities or alcohol abuse are more often in subjects with AO-SW. We confirmed previous reports that violent episodes during SW are more frequently reported by male sleepwalkers [17] which might, at least partially, explain the more frequent referral of male sleepwalkers to our sleep centres. Adults with CO-SW reported less self-injuries, and the episodes of SW were significantly less violent compared to those in adults with AO-SW.…”

Section: Discussionsupporting

confidence: 92%

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

et al. 2017

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Background: Sleepwalking (SW) is found to affect children predominantly, but it can persist or appear de novo even among adults. In this study, we assessed the demographic, clinical and polysomnographic profile, trigger factors and associated comorbidities of adult-onset (AO-SW) and childhood-onset (CO-SW) adult sleepwalkers. Methods: In adult sleepwalkers, a structured clinical interview, a battery of questionnaires, video-polysomnography (v-PSG) and standard electroencephalography (EEG) were performed. Results: Among 63 sleepwalkers, 45% had ≥1 episodes/month, 54% had partial recall of the episodes and 36% reported trigger factors for SW. Almost all subjects reported co-occurring parasomnias. In v-PSG, 4% exhibited episodes of SW, 17% confusional arousals, 21% had an increased apnea-hypopnea-index and 6% exhibited features of an overlap parasomnia disorder. In our cohort, 73% reported CO-SW and 27% AO-SW. In subjects with AO-SW, positive family history for parasomnias was found in 33% (vs. 49% in CO-SW), neurological comorbidities in 44% (vs. 14%), psychiatric comorbidities in 25% (vs. 33%), EEG abnormalities in 50% (vs. 29%). Violence during SW episodes was more frequent in males and in subjects with CO-SW (45% for self-injury and 44% for violent behaviour vs. 33 and 29% respectively in the AO-SW group). Conclusions: Adult SW represents a complex and potentially dangerous condition. The characteristics of AO-SW often differ from those of CO-SW.

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Section: Discussionsupporting

confidence: 92%

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

et al. 2017

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“…This presentation bias could be due to several factors. For example, men were reported to have higher proportion of violent behaviors, in general [32] and sleep-related [33] (during arousal disorders [34], RBD episodes [35], or during epileptic seizures [36]), which may stimulate them to seek medical advice more frequently. Contrary to sleep clinics, in this study, all participants were screened for dream enactment regardless of severity, removing much of this bias.…”

Section: Characteristics Of Rbd Positive Participantsmentioning

confidence: 99%

Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population

Haba‐Rubio

Frauscher

Marques‐Vidal

et al. 2017

Sleep

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Study Objectives: Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia associated with neurodegenerative synucleinopathies. Its prevalence is largely unknown. This study determined the prevalence and characteristics of RBD in the general population using gold-standard polysomnography.Methods: Full polysomnographic data from 1,997 participants (age = 59 ± 11.1 years, 53.6% women) participating in a population-based study (HypnoLaus, Lausanne, Switzerland) were collected. Sleep-related complaints and habits were investigated using various sleep measures including the Munich Parasomnia Screening (MUPS) questionnaire, which includes two questions evaluating complex motor behaviors suggestive of RBD. Full polysomnography was performed at home. For participants screening positive for RBD, muscle activity during REM sleep was quantified to diagnose RBD.Results: Three hundred sixty-eight participants endorsed dream-enactment behavior on either of the two MUPS questions, and 21 fulfilled polysomnographic criteria for RBD, resulting in an estimated prevalence of 1.06% (95% CI = 0.61-1.50), with no difference between men and women. Compared with RBD− participants, RBD+ took more frequently antidepressants and antipsychotics (23.8% vs. 5.4%, p = .005; 14.3% vs. 1.5%, p = .004, respectively) and were more frequently smokers or exsmokers (85% vs. 56.6%, p = .011). On polysomnography, RBD+ had more stage N2 sleep (52 ± 11.5% vs. 46.3 ± 10.2%, p = .024) and less REM sleep (18 ± 6.4% vs. 21.9 ± 6.2%, p = .007), lower apnea-hypopnea index in REM sleep (3.8 ± 5.2 vs. 8.9 ± 13/hour, p = .035), and lower autonomic arousal index (31 ± 14.9 vs. 42.6 ± 19.5/hour, p = .002). Conclusions:In our middle-to-older age population-based sample, the prevalence of RBD was 1.06%, with no difference between men and women. RBD was associated with antidepressant and antipsychotic use and with minor differences in sleep structure.Key words: polysomnography; synucleinopathies; parasomnia; sleep; REM sleep without atonia Statement of SignificanceRapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia frequently associated or preceding neurodegenerative diseases such as synucleinopathies. Its occurrence in the general population is largely unknown. Analyzing data from 1,997 participants to the population-based HypnoLaus study who completed the Munich Parasomnia Screening questionnaire and had a complete polysomnography at home, we estimate the prevalence of RBD at 1.06%, with no significant difference between men and women. RBD was associated with antidepressant and antipsychotic use, and with minor differences in sleep structure. Knowing the prevalence and characteristics of RBD has important implications, as people with RBD can be ideal candidates for neuroprotective approaches, and can help us to better understand the progression of neurodegenerative disorders.

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“…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. Somnambulism has long been conceptualized as a "disorder of arousal" 6 because of the autonomic and motor arousal which propels the patient towards incomplete wakefulness.…”

Section: Introductionmentioning

confidence: 99%

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

Desjardins

Carrier

Lina

et al. 2017

Sleep

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Study Objectives: Although sleepwalking (somnambulism) affects up to 4% of adults, its pathophysiology remains poorly understood. Sleepwalking can be preceded by fluctuations in slow-wave sleep EEG signals, but the significance of these pre-episode changes remains unknown and methods based on EEG functional connectivity have yet to be used to better comprehend the disorder. Methods: We investigated the sleep EEG of 27 adult sleepwalkers (mean age: 29 ± 7.6 years) who experienced a somnambulistic episode during slow-wave sleep. The 20-second segment of sleep EEG immediately preceding each patient's episode was compared with the 20-second segment occurring 2 minutes prior to episode onset. Results: Results from spectral analyses revealed increased delta and theta spectral power in the 20 seconds preceding the episodes' onset as compared to the 20 seconds occurring 2 minutes before the episodes. The imaginary part of the coherence immediately prior to episode onset revealed (1) decreased delta EEG functional connectivity in parietal and occipital regions, (2) increased alpha connectivity over a fronto-parietal network, and (3) increased beta connectivity involving symmetric inter-hemispheric networks implicating frontotemporal, parietal and occipital areas. Conclusions: Taken together, these modifications in EEG functional connectivity suggest that somnambulistic episodes are preceded by brain processes characterized by the co-existence of arousal and deep sleep.

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Violence in sleep

Cited by 120 publications

References 166 publications

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

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

Prevalence and determinants of rapid eye movement sleep behavior disorder in the general population

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

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