New research suggests somnambulism, or sleepwalking, is a potentially serious condition that can lead to violent behaviors and affect health-related quality of life.
“What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences of sleepwalking episodes should not be ignored,” said Yves Dauvilliers, M.D., Ph.D., the study’s principal investigator.
Sleepwalking is a sleep disorder that affects up to four percent of adults. It involves complex behaviors that occur during arousals from non-rapid eye movement (NREM) sleep.
Researchers discovered almost a quarter of sleepwalkers did so every night, while 43.5 percent were sleepwalking weekly.
During an episode of sleepwalking the brain is partially awake, resulting in complex behaviors, and partially in NREM sleep with no conscious awareness of actions.
A positive history of violent sleep-related behaviors was found in 58 percent, including 17 percent who experienced at least one episode involving injuries to the sleepwalker or bed partner that required medical care.
Reported injuries included bruises, nose bleeds and fractures, and one participant had sustained multiple fractures and serious head trauma after jumping out of a third-floor window.
The study involved a prospective case-control study of 100 adult patients in whom primary sleepwalking was diagnosed from June 2007 to January 2011. The age of the sleepwalkers ranged from 18 to 58 years with a median age of 30. Results were compared with 100 healthy control subjects.
According to the authors, this is the largest prospective cohort study on adult sleepwalkers seen in a clinic. It utilized face-to-face clinical interviews, standardized questionnaires, and objective assessment by polysomnography to investigate the clinical characteristics, consequences and comorbidities of sleepwalking.
Researchers discovered triggering factors that increased both the frequency and severity of episodes were reported in 59 percent of the episodes. Precipitating factors related mainly to stressful events, strong positive emotions, sleep deprivation, and less frequently to drug or alcohol intake or intense evening physical activity.
All of these factors promote increased slow wave sleep (SWS) and NREM sleep instability.
“Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life,” said Dauvilliers. “The burden of sleepwalking in adults needs to be highlighted and emphasized.”
The study appears in the journal SLEEP.