Objective daytime sleepiness in patients with somnambulism or sleep terrors

Neurology. 2014 Nov 25;83(22):2070-6. doi: 10.1212/WNL.0000000000001019. Epub 2014 Oct 29.

Abstract

Objective: To objectively measure daytime sleepiness and to assess for clinical and polysomnographic determinants of mean sleep latency in adult patients with somnambulism (sleepwalking [SW]) or sleep terrors (ST) compared with controls.

Methods: Thirty drug-free adult patients with primary SW or ST, and age-, sex-, and body mass index-matched healthy controls underwent a standardized clinical interview, completed questionnaires including the Epworth Sleepiness Scale, and underwent one night of video polysomnography followed by the Multiple Sleep Latency Test (MSLT).

Results: Excessive daytime sleepiness defined as Epworth Sleepiness Scale score >10 was reported in 66.7% of patients and 6.7% of controls. The temporal pattern of sleep latencies in individual MSLT trials differed between patients and controls, with progressive increased sleep latency in patients across the trials in contrast to a "U curve" for controls. We did not find between-group differences regarding the mean sleep latency on the 5 MSLT trials, but did observe reduced sleep latencies in patients for the first 2 trials. Despite increased slow-wave sleep disruptions found in patients (i.e, more micro-arousals and hypersynchronous high-voltage delta waves arousals), we did not find polysomnographic characteristic differences when comparing sleepy patients for either subjective or objective daytime sleepiness on the MSLT compared with alert patients.

Conclusion: Excessive daytime sleepiness is a common complaint in subjects with SW or ST and shorter sleep latencies in the early morning hours. Despite an increased slow-wave sleep fragmentation found in these patients, we did not identify any association with the level of daytime sleepiness.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Disorders of Excessive Somnolence / diagnosis*
  • Disorders of Excessive Somnolence / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Night Terrors / diagnosis*
  • Night Terrors / physiopathology*
  • Polysomnography / methods
  • Somnambulism / diagnosis*
  • Somnambulism / physiopathology*
  • Young Adult