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Non-REM Parasomnias

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Essentials of Sleep Medicine

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Abstract

Parasomnias include a wide variety of movements, sensory phenomena, and behaviors that occur near or during sleep. These events can range from the benign normal variant of sleep talking to dramatic and occasionally violent events that may harm the patient or others. In addition to assortment of behaviors, these events offer an excellent opportunity to better understand the mechanisms of the sleep state and show us the mechanisms involved in the boundary and differentiation of each sleep state. Many of these parasomnias have their own unique pathology. Some events are the hallmark of other sleep disorders, whereas others may indicate a defect in a specific neuronal pathway. For the astute clinician the parasomnia is the window to understanding the underlying pathology, its drivers, and possible therapies.

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References

  1. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.

    Google Scholar 

  2. Provini F, Tinuper P, Bisulli F, Lugaresi E. Arousal disorders. Sleep Med. 2011;12(Suppl 2):S22–6. https://doi.org/10.1016/j.sleep.2011.10.007.

    Article  PubMed  Google Scholar 

  3. Denis D, French CC, Gregory AM. A systematic review of variables associated with sleep paralysis. Sleep Med Rev. 2018;38:141–57. PMID: 28735779. https://doi.org/10.1016/j.smrv.2017.05.005.

    Article  PubMed  Google Scholar 

  4. Stefani A, Holzknecht E, Högl B. Clinical neurophysiology of REM parasomnias. Handb Clin Neurol. 2019;161:381–96.

    Article  PubMed  Google Scholar 

  5. Gieselmann A, Ait Aoudia M, Carr M, Germain A, Gorzka R, Holzinger B, Kleim B, Krakow B, Kunze AE, Lancee J, Nadorff MR, Nielsen T, Riemann D, Sandahl H, Schlarb AA, Schmid C, Schredl M, Spoormaker VI, Steil R, van Schagen AM, Wittmann L, Zschoche M, Pietrowsky R. Aetiology and treatment of nightmare disorder: state of the art and future perspectives. J Sleep Res. 2019;28:e12820.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gaudreau H, Joncas S, Zadra A, Montplaisir J. Dynamics of slow-wave activity during the NREM sleep of sleepwalkers and control subjects. Sleep. 2000;23:755–60.

    Article  CAS  PubMed  Google Scholar 

  7. Desjardins M, Carrier J, Lina J, et al. EEG functional connectivity prior to sleepwalking: evidence of interplay between sleep and wakefulness. Sleep. 2017;40:zsx024.

    Article  PubMed Central  Google Scholar 

  8. Heidbreder A, Stefani A, Brandauer E, et al. Gray matter abnormalities of the dorsal posterior cingulate in sleep walking. Sleep Med. 2017;36:152–5.

    Article  PubMed  Google Scholar 

  9. Gibbs SA, Proserpio P, Terzaghi M, et al. Sleep-related epileptic behaviors and non-REM-related parasomnias: insights from stereo-EEG. Sleep Med Rev. 2016;25:4–20.

    Article  PubMed  Google Scholar 

  10. Januszko P, Niemcewicz S, Gajda T, et al. Sleepwalking episodes are preceded by arousal-related activation in the cingulate motor area: EEG current density imaging. Clin Neurophysiol. 2016;127(1):530–6.

    Article  PubMed  Google Scholar 

  11. Bassetti C, Vella S, Donati F, et al. SPECT during sleepwalking. Lancet. 2000;356(9228):484–5.

    Article  CAS  PubMed  Google Scholar 

  12. Oliviero A, Della Marca G, Tonali PA, et al. Functional involvement of cerebral cortex in adult sleepwalking. J Neurol. 2007;254(8):1066–72.

    Article  CAS  PubMed  Google Scholar 

  13. Labelle MA, Dang-Vu TT, Petit D, Desautels A, Montplaisir J, Zadra A. Sleep deprivation impairs inhibitory control during wakefulness in adult sleepwalkers. J Sleep Res. 2015;24:658–65.

    Article  PubMed  Google Scholar 

  14. Di Gennaro G, Autret A, Mascia A, et al. Night terrors associated with thalamic lesion. Clin Neurophysiol. 2004;115(11):2489–92.

    Article  PubMed  Google Scholar 

  15. Daftary AS, Walker JM, Farney RJ. NREM sleep parasomnia associated with Chiari I malformation. J Clin Sleep Med. 2011;7(5):526–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Giuliano L, Fatuzzo D, Mainieri G, La Vignera S, Sofia V, Zappia M. Adult-onset sleepwalking secondary to hyperthyroidism: polygraphic evidence. J Clin Sleep Med. 2018;14(2):285–7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Labelle M, Desautels A, Montplaisir J, Zadra A. Psychopathologic correlates of adult sleepwalking. Sleep Med. 2013;14:1348–55.

    Article  PubMed  Google Scholar 

  18. Ohayon MM, Guilleminault C, Priest RG. Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders. J Clin Psychiatry. 1999;60:268–76.

    Article  CAS  PubMed  Google Scholar 

  19. Howell MJ. Parasomnias: an updated review. Neurotherapeutics. 2012;9(4):753–75.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Goodwin JL, Kaemingk KL, Fregosi RF, et al. Parasomnias and sleep disordered breathing in Caucasian and Hispanic children – the Tucson children’s assessment of sleep apnea study. BMC Med. 2004;2:14.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lundetræ RS, Saxvig IW, Pallesen S, Aurlien H, Lehmann S, Bjorvatn B. Prevalence of parasomnias in patients with obstructive sleep apnea. A registry-based cross-sectional study. Front Psychol. 2018;9:1140.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Stallman HM, Kohler M, White J. Medication induced sleepwalking: a systematic review. Sleep Med Rev. 2018;37:105–13. PMID: 28363449. https://doi.org/10.1016/j.smrv.2017.01.005.

    Article  PubMed  Google Scholar 

  23. Fois C, Wright MA, Sechi GP, et al. The utility of polysomnography for the diagnosis of NREM parasomnias: an observational study over 4 years of clinical practice. J Neurol. 2015;262(2):385–93.

    Article  PubMed  Google Scholar 

  24. Pilon M, Montplaisir J, Zadra A. Precipitating factors of somnambulism: impact of sleep deprivation and forced arousals. Neurology. 2008;70(24):2274–5.

    Article  Google Scholar 

  25. Pressman MR. Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med Rev. 2007;11(1):5–30.

    Article  PubMed  Google Scholar 

  26. Attarian H. Treatment options for parasomnias. Neurol Clin. 2010;28(4):1089–106.

    Article  PubMed  Google Scholar 

  27. Schenck CH, Mahowald MW. Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med. 1996;100(3):333–7.

    Article  CAS  PubMed  Google Scholar 

  28. Cooper AJ. Treatment of coexistent night-terrors and somnambulism in adults with imipramine and diazepam. J Clin Psychiatry. 1987;48:209–10.

    CAS  PubMed  Google Scholar 

  29. Balon R. Sleep terror disorder and insomnia treated with trazodone: a case report. Ann Clin Psychiatry. 1994;6:161–3.

    Article  CAS  PubMed  Google Scholar 

  30. Wilson SJ, Lillywhite AR, Potokar JP, et al. Adult night terrors and paroxetine. Lancet. 1997;350:185.

    CAS  PubMed  Google Scholar 

  31. Ekambaram V, Maski K. Non-rapid eye movement arousal parasomnias in children. Pediatr Ann. 2017;46(9):e327–31. https://doi.org/10.3928/19382359-20170814-01.

    Article  PubMed  Google Scholar 

  32. Castelnovo A, Lopez R, Proserpio P, Nobili L, Dauvilliers Y. NREM sleep parasomnias as disorders of sleep-state dissociation. Nat Rev Neurol. 2018;14(8):470–81. https://doi.org/10.1038/s41582-018-0030-y.

    Article  PubMed  Google Scholar 

  33. Drakatos P, Leschziner G. Diagnosis and management of nonrapid eye movement-parasomnias. Curr Opin Pulm Med. 2019;25(6):629–35. https://doi.org/10.1097/MCP.0000000000000619.

    Article  PubMed  Google Scholar 

  34. Bargiotas P, Arnet I, Frei M, Baumann CR, Schindler K, Bassetti CL. Demographic, clinical and polysomnographic characteristics of childhood- and adult-onset sleepwalking in adults. Eur Neurol. 2017;78(5–6):307–11. https://doi.org/10.1159/000481685.

    Article  PubMed  Google Scholar 

  35. Stallman HM, Kohler M. Prevalence of sleepwalking: a systematic review and meta-analysis. PLoS One. 2016;11(11):e0164769. Published 2016 Nov 10. https://doi.org/10.1371/journal.pone.0164769.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Baldini T, Loddo G, Sessagesimi E, et al. Clinical features and pathophysiology of disorders of arousal in adults: a window into the sleeping brain. Front Neurol. 2019;10:526. Published 2019 May 17. https://doi.org/10.3389/fneur.2019.00526.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ellington E. It's not a nightmare: understanding sleep terrors. J Psychosoc Nurs Ment Health Serv. 2018;56(8):11–4. https://doi.org/10.3928/02793695-20180723-03.

    Article  PubMed  Google Scholar 

  38. Auger RR. Sleep-related eating disorders. Psychiatry (Edgmont). 2006;3(11):64–70.

    Google Scholar 

  39. Komada Y, Takaesu Y, Matsui K, et al. Comparison of clinical features between primary and drug-induced sleep-related eating disorder. Neuropsychiatr Dis Treat. 2016;12:1275–80. Published 2016 May 26. https://doi.org/10.2147/NDT.S107462.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Chiaro G, Caletti MT, Provini F. Treatment of sleep-related eating disorder. Curr Treat Options Neurol. 2015;17(8):361. https://doi.org/10.1007/s11940-015-0361-6.

    Article  PubMed  Google Scholar 

  41. Inoue Y. Sleep-related eating disorder and its associated conditions. Psychiatry Clin Neurosci. 2015;69(6):309–20. https://doi.org/10.1111/pcn.12263.

    Article  PubMed  Google Scholar 

  42. Winkelman JW, Herzog DB, Fava M. The prevalence of sleep-related eating disorder in psychiatric and non-psychiatric populations. Psychol Med. 1999;29:1461–6.

    Article  CAS  PubMed  Google Scholar 

  43. Santin J, Mery V, Elso MJ, Retamal E, Torres C, Ivelic J, Godoy J. Sleep-related eating disorder: a descriptive study in Chilean patients. Sleep Med. 2014;15(2):163–7.

    Article  PubMed  Google Scholar 

  44. McGrane IR, Leung JG, St Louis EK, Boeve BF. Melatonin therapy for REM sleep behavior disorder: a critical review of evidence. Sleep Med. 2015;16(1):19–26. https://doi.org/10.1016/j.sleep.2014.09.011.

    Article  PubMed  Google Scholar 

  45. Barone DA, Henchcliffe C. Rapid eye movement sleep behavior disorder and the link to alpha-synucleinopathies. Clin Neurophysiol. 2018;129(8):1551–64. https://doi.org/10.1016/j.clinph.2018.05.003.

    Article  PubMed  PubMed Central  Google Scholar 

  46. St Louis EK, Boeve BF. REM sleep behavior disorder: diagnosis, clinical implications, and future directions. Mayo Clin Proc. 2017;92(11):1723–36. https://doi.org/10.1016/j.mayocp.2017.09.007.

    Article  PubMed  Google Scholar 

  47. Porter VR, Avidan AY. Clinical overview of REM sleep behavior disorder. Semin Neurol. 2017;37(4):461–70. https://doi.org/10.1055/s-0037-1605595.

    Article  PubMed  Google Scholar 

  48. Zhou J, Zhang J, Du L, Li Z, Li Y, Lei F, Wing YK, Kushida CA, Zhou D, Tang X. Characteristics of early- and late-onset rapid eye movement sleep behavior disorder in China: a case-control study. Sleep Med. 2014;15(6):654–60.

    Article  PubMed  Google Scholar 

  49. Sharpless BA, Kliková M. Clinical features of isolated sleep paralysis. Sleep Med. 2019;58:102–6. https://doi.org/10.1016/j.sleep.2019.03.007.

    Article  PubMed  Google Scholar 

  50. Ramos DF, Magalhães J, Santos P, Vale J, Santos MI. Recurrent sleep paralysis – fear of sleeping. Rev Paul Pediatr. 2019;38:e2018226. Published 2019 Nov 25. https://doi.org/10.1590/1984-0462/2020/38/2018226.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Sharpless BA. A clinician’s guide to recurrent isolated sleep paralysis. Neuropsychiatr Dis Treat. 2016;12:1761–7. Published 2016 Jul 19. https://doi.org/10.2147/NDT.S100307.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Morgenthaler TI, Auerbach S, Casey KR, et al. Position paper for the treatment of nightmare disorder in adults: an american academy of sleep medicine position paper. J Clin Sleep Med. 2018;14(6):1041–55. Published 2018 Jun 15. https://doi.org/10.5664/jcsm.7178.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Gieselmann A, Ait Aoudia M, Carr M, et al. Aetiology and treatment of nightmare disorder: state of the art and future perspectives. J Sleep Res. 2019;28(4):e12820. https://doi.org/10.1111/jsr.12820.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Simor P, Blaskovich B. The pathophysiology of nightmare disorder: signs of impaired sleep regulation and hyperarousal. J Sleep Res. 2019;28(6):e12867. https://doi.org/10.1111/jsr.12867.

    Article  PubMed  Google Scholar 

  55. Rubin ML, Copeland LA, Kroll-Desrosiers AR, Knittel AG. Demographic variation in the use of prazosin for treatment of sleep disturbance in combat veterans with PTSD. Psychopharmacol Bull. 2020;50:26–35.

    PubMed  PubMed Central  Google Scholar 

  56. Ceriani CEJ, Nahas SJ. Exploding head syndrome: a review. Curr Pain Headache Rep. 2018;22(10):63. Published 2018 Jul 30. https://doi.org/10.1007/s11916-018-0717-1.

    Article  PubMed  Google Scholar 

  57. Sharpless BA. Exploding head syndrome. Sleep Med Rev. 2014;18(6):489–93. https://doi.org/10.1016/j.smrv.2014.03.001.

    Article  PubMed  Google Scholar 

  58. Palikh GM, Vaughn BV. Topiramate responsive exploding head syndrome. J Clin Sleep Med. 2010;6:382–3.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Lysenko L, Bhat S. Melatonin-responsive complex nocturnal visual hallucinations. J Clin Sleep Med. 2018;14(4):687–91. Published 2018 Apr 15. https://doi.org/10.5664/jcsm.7074.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Silber MH, Hansen MR, Girish M. Complex nocturnal visual hallucinations. Sleep Med. 2005;6(4):363–6. https://doi.org/10.1016/j.sleep.2005.03.002.

    Article  PubMed  Google Scholar 

  61. Mishra BR, Sarkar S, Mishra S, Mishra A, Praharaj SK, Nizamie SH. Isolated nocturnal auditory hallucinations: a case report. Gen Hosp Psychiatry. 2011;33(5) https://doi.org/10.1016/j.genhosppsych.2011.04.008.

  62. Ohayon MM, Priest RG, Caulet M, Guilleminault C. Hypnagogic and hypnopompic hallucinations: pathological phenomena? Br J Psychiatry. 1996;169(4):459–67. https://doi.org/10.1192/bjp.169.4.459.

    Article  CAS  PubMed  Google Scholar 

  63. Harari MD. Nocturnal enuresis. J Paediatr Child Health. 2013;49(4):264–71. https://doi.org/10.1111/j.1440-1754.2012.02506.x.

    Article  PubMed  Google Scholar 

  64. Graham KM, Levy JB. Enuresis [published correction appears in Pediatr Rev. 2009 Sep;30(9):369]. Pediatr Rev. 2009;30(5):165–73. https://doi.org/10.1542/pir.30-5-165.

    Article  PubMed  Google Scholar 

  65. Kuwertz-Bröking E, von Gontard A. Clinical management of nocturnal enuresis. Pediatr Nephrol. 2018;33(7):1145–54. https://doi.org/10.1007/s00467-017-3778-1.

    Article  PubMed  Google Scholar 

  66. Singh S, Kaur H, Singh S, Khawaja I. Parasomnias: a comprehensive review. Cureus. 2018;10:e3807. PMID: 30868021.

    PubMed  PubMed Central  Google Scholar 

  67. Pressman M, Mahowald M, Schenck C, et al. Alcohol-induced sleepwalking or confusional arousal as a defense to criminal behavior: a review of scientific evidence, methods and forensic considerations. J Sleep Rev. 2007;16:198–212.

    Article  Google Scholar 

  68. Papadimitriou GN, Linkowski P. Sleep disturbance in anxiety disorders. Int Rev Psychiatry. 2005;17:229–36.

    Article  PubMed  Google Scholar 

  69. Khachiyants N, Trinkle D, Son SJ, Kim KY. Sundown syndrome in persons with dementia: an update. Psychiatry Investig. 2011;8:275–87.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Kushida CA, Littner MR, Morgenthaler T, et al. Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep. 2005;28:499–521.

    Article  PubMed  Google Scholar 

  71. Schenck CH, Boyd JL, Mahowald MW. A parasomnia overlap disorder involving sleepwalking, sleep terrors, and REM sleep behavior disorder in 33 polysomnographically confirmed cases. Sleep. 1997;20:972–81.

    Article  CAS  PubMed  Google Scholar 

  72. Proserpio P, Loddo G, Zubler F, Ferini-Strambi L, Licchetta L, Bisulli F, Tinuper P, Agostoni EC, Bassetti C, Tassi L, Menghi V, Provini F, Nobili L. Polysomnographic features differentiating disorder of arousals from sleep-related hypermotor epilepsy. Sleep. 2019;42(12):zsz166.

    Google Scholar 

  73. Foldvary N, Caruso AC, Mascha E, et al. Identifying montages that best detect electrographic seizure activity during polysomnography. Sleep. 2000;23:221–9.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of North Carolina, Chapel Hill, NC, USA

    Nathan A. Walker & Bradley V. Vaughn

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  1. Nathan A. Walker
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  2. Bradley V. Vaughn
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Correspondence to Bradley V. Vaughn .

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Editors and Affiliations

  1. Department of Internal Medicine Wayne State University School of Medicine, John D. Dingell VA Medical Center, Detroit, MI, USA

    M. Safwan Badr

  2. Geriatric Research Education and Clinical Center, Veteran Affairs Greater Los Angeles Healthcare System, Department of Medicine David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Jennifer L. Martin

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Walker, N.A., Vaughn, B.V. (2022). Non-REM Parasomnias. In: Badr, M.S., Martin, J.L. (eds) Essentials of Sleep Medicine. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-93739-3_16

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  • DOI: https://doi.org/10.1007/978-3-030-93739-3_16

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