Psychological Treatment for Sleepwalking: two case reports

Conway, S.G.; Coelho, Lucíola de Castro; Lopes-Conceição, Maria Cecília; Hachul, Helena; Tufik, Sérgio

doi:10.1590/s1807-59322011000300028

Cited by 16 publications

(8 citation statements)

References 28 publications

(44 reference statements)

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“…7 We expect that not only the emotional character of the frightening visual image, 2 but the traumatic experience itself could be one of the triggers of NREM parasomnias. Future studies are needed to recognize the mechanisms through which psychological confl icts act on sleepwalking, which may help identify the best treatment protocol.…”

Section: Discussionmentioning

confidence: 99%

“…6 This assumption is supported by effi cient psychotherapy in our patient and in those cases described formerly, measured by reduced frequency and severity of episodes. 7 We expect that not only the emotional character of the frightening visual image, 2 but the traumatic experience itself could be one of the triggers of NREM parasomnias. Future studies are needed to recognize the mechanisms through which psychological confl icts act on sleepwalking, which may help identify the best treatment protocol.…”

Section: Discussionmentioning

confidence: 99%

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Adult NREM Parasomnia Associated with Lancinating Throat Pain

Bušková

Šonka

2014

Journal of Clinical Sleep Medicine

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We report the case of a 30-year-old woman presenting with dangerous nocturnal NREM episodes with the clinical feature of lancinating throat pain. We hypothesize that the pain may have represented sensory hallucination analogous to commonly recognized visual images associated with NREM parasomnias. This case is also unusual for probable psychological triggers that could play a role in the pathogenesis of the disease, as evidenced by successful psychotherapy. Keywords: NREM parasomnia, pain, psychotherapy Citation: Bušková J, Šonka K. Adult NREM parasomnia associated with lancinating throat pain. J Clin Sleep Med 2014;10(8):925-926. http://dx.doi.org/10.5664/jcsm.3974 C A S E R E P O R T SN REM parasomnias are arousal disorders emerging during slow wave sleep characterized by greatly variable behavioral and emotional expression.1 These episodes are usually followed by amnesia, but a minority of adult patients recall complex mental activity immediately before and during episodes.2 Thus far, only one case of such an episode associated with pain perception has been described. 3 We report a case of severe NREM parasomnia manifested by the previously unreported feature of lancinating throat pain. REPORT OF CASEThe patient is a 30-year-old, healthy young woman with a high school education, now on maternity leave with her fi rst child. She has suffered from "calm somnambulism" since childhood with no other medical history.Her husband arranged a consultation in our sleep clinic with regard to dangerous behavior exhibited by his wife while asleep. The episodes typically occurred within the fi rst two hours of sleep, and presented with sudden sat up straight in bed and somniloquy that suggestively corresponded to dreamlike visual images. At the beginning of the episode that prompted consultation, the subject began to dream that she was swallowing various indigestible objects (such as scissors, socks, dogs, needles, worms, pet hair), accompanied by terribly unpleasant subjective feelings and lancinating throat pain. She experienced this sensation so dramatically that she spent some time sitting up in bed vigorously trying to remove the object from her throat with her hands until she choked and gagged, injuring her throat, with pain persisting for a week. She was confused for several minutes after the episode and repeatedly asked her husband to remove the object from her throat. There was no identifi ed biopsychosocial trigger for these episodes from the preceding day.The last of these sporadic episodes involved a potential threat to their daughter. Their two-year-old daughter was sleeping with her parents as she had infl uenza. The episode started around midnight. The subject suddenly sat upright in bed, grabbed her daughter and forcibly opened her mouth, trying to insert her fi ngers into her mouth. Her husband acted quickly to protect their daughter. When he succeeded in waking his wife, she said that she had dreamt that her daughter swallowed a coin. She was not sure whether or not it was a dream for an entire day fol...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adult NREM Parasomnia Associated with Lancinating Throat Pain

Bušková

Šonka

2014

Journal of Clinical Sleep Medicine

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“…Psychological therapies are used in patients who do not wish to take medication, experience unpleasant side effects, those who wish to engage in therapy in combination with medication, or in those who do not find medication useful. Psychological therapies are especially useful in those whose episodes are triggered by stress or other emotional and psychological problems, which may be determined through psychological evaluation with the use of personality and symptom scales, as well as psychotherapy [98]. Clinical experience and case reports show that psychotherapy [98], behavioural and cognitive-behavioural therapy [99], mindfulness-based stress reduction [84], and hypnotherapy [100] improve the symptoms and manifestations of NREM parasomnias in some patients, but not others.…”

Section: Psychological Therapymentioning

confidence: 99%

Adult NREM Parasomnias: An Update

2018

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Our understanding of non-rapid eye movement (NREM) parasomnias has improved considerably over the last two decades, with research that characterises and explores the causes of these disorders. However, our understanding is far from complete. The aim of this paper is to provide an updated review focusing on adult NREM parasomnias and highlighting new areas in NREM parasomnia research from the recent literature. We outline the prevalence, clinical characteristics, role of onset, pathophysiology, role of predisposing, priming and precipitating factors, diagnostic criteria, treatment options and medico-legal implications of adult NREM parasomnias.

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“…Psychotherapy [16,17], relaxation therapy [18], and hypnosis [19] have also received anecdotal support in the literature as treatments for parasomnias. A 2007 study examining the effect of 1 to 2 sessions of hypnosis on 36 patients aged 6 to 71 (four of them children) demonstrated improvement in 45.4 % at 1-month follow-up and 40.5 % at 5-year follow-up [20].…”

Section: Psychological Therapiesmentioning

confidence: 99%