The Course and Character of Sleepwalking in Adulthood: A Clinical and Polysomnographic Study

Abstract

To describe characteristics of adult sleepwalking (potential triggers and correlates with polysomnography), 52 patients were interviewed regarding their sleepwalking episodes and underwent video-polysomnography on two consecutive nights. Sleepwalking history averaged 12 years and frequent episodes (more than once per week) occurred in 62%. Higher frequency was associated with earlier onset of sleepwalking (p < 0.005) and 53.8% reported dangerous sleepwalking behavior. The most common self-reported triggers were sleep deprivation and stressful events, while no specific trigger was reported in 37% of patients. More awakening from slow-wave sleep was associated with a higher frequency of sleepwalking episodes (p < 0.001). A longer history of sleepwalking was associated with more sleepwalking episodes, even without the presence of sleep comorbidities or other known precipitating factors.

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

“…Stress was mentioned by almost two-thirds of them and sleep deprivation, anxiety and alcohol consumption were also frequently reported. Interestingly, full moon was reported by 25% of our patients as a trigger factor, suggesting a periodic occurrence of the episodes, whereas in previous studies, it was rarely mentioned [9] or not mentioned at all. In our cohort, as in previous studies [18, 19], there were more males among sleepwalkers.…”

“…Lopez et al [7] reported that subjects with late-onset (subjects older than 9 years) primary SW (subjects with comorbidities were excluded) had lower incidence of violent behaviours and were more prone to worsening of their SW over time compared to those with early-onset SW [7]. However, in another cohort, Bušková et al[9] found no association between age at onset of SW with violent and injurious behaviour.…”

“…Commonly reported trigger factors for SW include sleep deprivation and stress [9]. In addition, subjects with a longer history of SW reported more frequent episodes of SW [9]. Lam et al [10] showed a higher prevalence of AO-SW in a psychiatric outpatient cohort compared to the general population.…”

“…In contrast, Labelle et al [8] reported that there was no association between adult SW and clinically significant levels of depression or anxiety and even if present, these symptoms had little impact on the phenomenological features of SW. Commonly reported trigger factors for SW include sleep deprivation and stress [9]. In addition, subjects with a longer history of SW reported more frequent episodes of SW [9].…”

Sleep-related movement disorders and disturbances of motor control

“…Sleepwalkers are difficult to be awakened and there is usually no recall of the episodes. Self-injuries [63,64] and rarely even homicidal, filicidal, and suicidal episodes are possible [65]. Sleepwalkers have a higher frequency of other parasomnias (sleep terrors, confusional arousals, enuresis, sleeptalking, bruxism), nocturnal eating (somnophagia), and abnormal sexual behavior during sleep [66].…”