Parasomnias Associated with Disordered Arousal from Slow-Wave Sleep: Mechanism of Occurrence and Neurophysiological Characteristics

  • A. V. ZakharovEmail author
  • I. E. Poverennova
  • V. A. Kalinin
  • E. V. Khivintseva

This article discusses the current state of parasomnias associated with disorders of arousal from slow-wave sleep. The clinical picture and diagnosis of the condition are evaluated in detail. The stress is placed on the mechanisms producing types of parasomnias and characteristic changes in the CNS. The challenge of neurophysiological changes preceding the different linical signs of parasomnia and the concept of the local sleep as a physiological basis of parasomnias associated with disorders of arousal from slow-wave sleep is discussed, and current therapeutic approaches to these forms of parasomnia are assessed.


sleep parasomnias associated with disorders of arousal from slow-wave sleep electroencephalography pathogenesis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    M. J. Sateia, “International Classification of Sleep Disorders – Third Edition,” Chest, 146, No. 5, 1387–1394 (2014), Scholar
  2. 2.
    R. Lopez, I. Jaussent, S. Scholz, et al., “Functional impairment in adult sleepwalkers: a case-control study,” Sleep, 36, 345–351 (2013), Scholar
  3. 3.
    D. Petit, M. Pennestri, J. Paquet, et al., “Childhood sleepwalking and sleep terrors: a longitudinal study of prevalence and familial aggregation,” JAMA Pediatr., 169, 653–658 (2015), Scholar
  4. 4.
    R. Lopez, I. Jaussent, and Y. Dauvilliers, “Pain in sleepwalking: a clinical enigma,” Sleep, 38, 1693–1698 (2015), Scholar
  5. 5.
    G. Uguccioni, J.-L. Golmard, A. N. de Fontreaux, et al., “Fight or flight? Dream content during sleepwalking/sleep terrors versus rapid eye movement sleep behavior disorder,” Sleep Med., 14, 391–398 (2013), Scholar
  6. 6.
    N. Di Fabio, R. Poryazova, M. Oberholzer, et al., “Sleepwalking, REM sleep behaviour disorder and overlap parasomnia in patients with Parkinson’s disease,” Eur. Neurol., 70, 297–303 (2013), Scholar
  7. 7.
    Y. Dauvilliers, I. Arnulf, and E. Mignot, “Narcolepsy with cataplexy,” Lancet, 369, 499–511 (2007), Scholar
  8. 8.
    N. Limousin, C. Dehais, O. Gout, et al., “A brainstem inflammatory lesion causing REM sleep behavior disorder and sleepwalking (para somnia overlap disorder),” Sleep Med., 10, 1059–1062 (2009), Scholar
  9. 9.
    C. A. Kushida, A. A. Clerk, C. M. Kirsch, et al., “Prolonged confusion with nocturnal wandering arising from NREM and REM sleep: a case report,” Sleep, 18, 757–764 (1995), Scholar
  10. 10.
    M. Puligheddu, P. Congiu, I. Laccu, et al., “Overlap parasomnia disorder in a case of Creutzfeldt–Jakob disease,” Sleep Med., 36, 75–77 (2017), Scholar
  11. 11.
    L. Nobili, M. Ferrara, F. Moroni, et al., “Dissociated wake-like and sleep-like electrocortical activity during sleep,” Neuroimage, 58, 612–619 (2011), Scholar
  12. 12.
    L. Nobili, “Local aspects of sleep: observations from intracerebral recordings in humans,” Prog. Brain Res., 199, 219–232 (2012), Scholar
  13. 13.
    A. Zadra, A. Desautels, D. Petit, and J. Montplaisir, “Somnambulism: clinical aspects and pathophysiological hypotheses,” Lancet Neurol., 12, 285–294 (2013), Scholar
  14. 14.
    G. Uguccioni, O. Pallanca, J. L. Golmard, et al., “Is sleep-related verbal memory consolidation impaired in sleepwalkers?” J. Sleep Res., 24, 197–205 (2015), Scholar
  15. 15.
    R. Lopez, Y. Shen, S. Chenini, et al., “Diagnostic criteria for disorders of arousal: a videopolysomnographic assessment,” Ann. Neurol., 83, 341–351 (2018), Scholar
  16. 16.
    O. Jaar, M. Pilon, J. Carrier, et al., “Analysis of slow-wave activity and slow-wave oscillations prior to somnambulism,” Sleep, 33, 1511–1516 (2010), Scholar
  17. 17.
    R. Perrault, J. Carrier, A. Desautels, et al., “Electroencephalographic slow waves prior to sleepwalking episodes,” Sleep Med., 15, 1468–1472 (2014), Scholar
  18. 18.
    C. Guilleminault, D. Poyares, F. A. Aftab, and L. Palombini, “Sleep and wakefulness in somnambulism: a spectral analysis study,” J. Psychosom. Res., 51, No. 2, 411–416 (2001), Scholar
  19. 19.
    C. H. Schenck, J. A. Pareja, A. L. Patterson, and M. W. Mahowald, “Analysis of polysomnographic events surrounding 252 slow-wave sleep arousals in thirty-eight adults with injurious sleepwalking and sleep terrors,” J. Clin. Neurophysiol., 15, 159–166 (1998), Scholar
  20. 20.
    A. Zadra, M. Pilon, S. Joncas, et al., “Analysis of postarousal EEG activity during somnambulistic episodes,” J. Sleep Res., 13, 279–284 (2004), Scholar
  21. 21.
    P. Januszko, S. Niemcewicz, T. Gajda, et al., “Sleepwalking episodes are preceded by arousal-related activation in the cingulate motor area: EEG current density imaging,” Clin. Neurophysiol., 127, 530–536 (2016), Scholar
  22. 22.
    A. Castelnovo, B. A. Riedner, R. F. Smith, et al., “Scalp and source power topography in sleepwalking and sleep terrors: a high-density EEG study,” Sleep, 39, 1815–1825 (2016), Scholar
  23. 23.
    V. V. Vyazovskiy, U. Olcese, E. C. Hanlon, et al., “Local sleep in awake rats,” Nature, 472, 443–447 (2011), Scholar
  24. 24.
    F. De Carli, P. Proserpio, E. Morrone, et al., “Activation of the motor cortex during phasic rapid eye movement sleep,” Ann. Neurol., 79, 326–330 (2016), Scholar
  25. 25.
    M. E. Desjardins, J. Carrier, J. M. Lina, et al., “EEG functional connectivity prior to sleepwalking: Evidence of interplay between sleep and wakefulness,” Sleep, 40, No. 4, zsx024 (2017),
  26. 26.
    A. Heidbreder, A. Stefani, E. Brandauer, et al., “Gray matter abnormalities of the dorsal posterior cingulate in sleep walking,” Sleep Med., 36, 152–155 (2017), Scholar
  27. 27.
    C. Bassetti, S. Vella, F. Donati, et al., “SPECT during sleepwalking,” Lancet, 356, 484–485 (2000), Scholar
  28. 28.
    M. E. Desjardins, A. A. Baril, J. P. Soucy, et al., “Altered brain perfusion patterns in wakefulness and slow-wave sleep in sleepwalkers,” Sleep, 41, No. 5, zsy039 (2018),
  29. 29.
    T. T. Dang-Vu, A. Zadra, M. A. Labelle, et al., “Sleep deprivation reveals altered brain perfusion patterns in somnambulism,” PLoS One, 10, e0133474 (2015), Scholar
  30. 30.
    C. H. Schenck, J. A. Pareja, A. L. Patterson, and M. W. Mahowald, “Analysis of polysomnographic events surrounding 252 slow-wave sleep arousals in thirty-eight adults with injurious sleepwalking and sleep terrors,” J. Clin. Neurophysiol., 15, 159–166 (1998), Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • A. V. Zakharov
    • 1
    Email author
  • I. E. Poverennova
    • 1
  • V. A. Kalinin
    • 1
  • E. V. Khivintseva
    • 1
  1. 1.Samara Sate Medical UniversityRussian Ministry of HealthSamaraRussia

Personalised recommendations