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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.
GLOSSARY
- AHI=
- apnea–hypopnea index;
- BDI=
- Beck Depression Inventory;
- EDS=
- excessive daytime sleepiness;
- ESS=
- Epworth Sleepiness Scale;
- HSDWA=
- hypersynchronous high-voltage delta waves arousal;
- ISI=
- Insomnia Severity Index;
- MSLT=
- Multiple Sleep Latency Test;
- NREM=
- non-REM;
- PLM=
- periodic limb movements;
- PLMS=
- periodic limb movements during sleep;
- PSG=
- polysomnography;
- ST=
- sleep terrors;
- SW=
- sleepwalking;
- SWS=
- slow-wave sleep
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received January 14, 2014.
- Accepted in final form August 28, 2014.
- © 2014 American Academy of Neurology
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