Sleep Walking Underestimated, Serious Condition

Adult sleepwalking is a serious and underestimated condition that can result in violent behaviors, excessive daytime sleepiness, fatigue, or other conditions that affect quality of life (QOL), according to a  new study. In fact, 57.9% of participants in the study Functional impairment in adult sleepwalkers: A case-control study, published this week in the journal SLEEP, reported violent or dangerous sleep-related behaviors that affected themselves (31.2%) or their bed partners (45.8%).

“The presence of somnambulism should not be neglected in adults,” said Yves Dauvilliers, MD, of the department of neurology, Gui-de-Chauliac Hospital, Montpellier, France, and the study's senior author. “This condition should be considered a serious disease that needs to be assessed and managed by a sleep specialist in conjunction with a primary care physician.”

According to Dauvilliers, there is little research that fully assesses the daytime and nighttime symptoms of sleepwalkers together with psychological assessments. In this study, she and her colleagues collected data on 140 adult sleepwalkers.

All participants underwent one night of video polysomnography, participated in clinical interviews, and completed questionnaires. Data on daytime and nighttime functioning, psychological health and health-related quality of life were compared with a group of 100 sex-matched and age-matched controls.

At the time of the study, 22.8% of participants reported daily sleepwalking; 43.5% reported weekly episodes. Smaller percentages of participants experienced sleepwalking episodes only a few nights per year, but participated in sleep evaluations due to the intensity of the episodes.

Although the median age of participants was 31.3 years, the median onset of sleepwalking was age 9 years. In addition, almost 25% of participants indicated that the frequency of sleepwalking episodes had increased as they aged. A familial history of sleepwalking was reported by 56.6% of participants.

Daylight disruption
Sleepwalking had significant effects on daytime functioning. Excessive daytime sleepiness occurred in 42.2% of sleepwalking participants compared with only 11% of control participants (P<.001). After adjustment for factors such as Insomnia Severity Scores, Beck Depression Inventory scores and fatigue scores, sleepwalking participants had a 35% increased risk for excessive daytime sleepiness compared with controls (95% CI, 1.07-1.70).

Sleepwalking participants also reported higher levels of insomnia, depressive symptoms, anxiety, and alterations in health-related QOL.

In their discussion of the results, the researchers acknowledged that study participants, who had been referred to a sleep clinic, may not reflect those affected in the general population. They concluded that, “Further nighttime and daytime polysomnographic studies are needed to determine whether daytime functional impairment was linked to slow wave sleep disruption, and whether they can be reversed through management of the disease per se.”

Source:

Lopez R, Jaussent I, Scholz S, et al. Functional impairment in adult sleepwalkers: a case-control study. SLEEP. 2013;36:345-351.