Citation

Oudiette D, Leu S, Pottier M, Buzare MA, Brion A, Arnulf I. Sleep 2009; 32(12): 1621-1627.

Affiliation

Sleep Disorders Unit, Pitié-Salpêtriere Hospital, APHP UMR 975, CRICM, and Paris 6 University, Paris, France.

Copyright

(Copyright © 2009, American Academy of Sleep Medicine, Publisher Associated Professional Sleep Societies)

DOI

unavailable

PMID

20041586

PMCID

PMC2786034

Abstract

BACKGROUND: Sleep terrors and sleepwalking are described as arousals from slow wave sleep with no or poor mental recollection. OBJECTIVE: To characterize the mental content retrospectively associated with sleep terrors or sleepwalking. SETTING: University Hospital. DESIGN: Controlled prospective cohort. PARTICIPANTS: Forty-three patients referred for severe sleepwalking/sleep terrors (age: 26 +/- 7 y, 46% men, 5 with sleep terrors only, 8 with sleepwalking only, and 30 with both), matched with 25 healthy control subjects. INTERVENTION: Thirty-eight of the 43 patients (88%) underwent an interview about the frequency, time, behaviors, and mental content associated with the episodes of sleepwalking and sleep terrors, whenever they occurred over a lifetime. The mental contents were classified for complexity (Orlinski score), and for characters, emotions, fortune/misfortune, and social interactions (Hall and Van de Castle categories). Patients and control subjects underwent an overnight video-polysomnogram. RESULTS: Seventy-one percent of the patients reported at least 1 dreamlike mentation associated with the sleepwalking/sleep terrors episode. The dreamlike mentation action corresponded with the observed behavior. A total of 106 dreamlike mentations were collected (mean: 3 +/- 3.4 dreamlike mentations/patient, range 0-17). Most (95%) dreamlike mentations consisted of a single visual scene. These dreamlike mentations were frequently unpleasant, with aggression in 24% (the dreamer being always the victim), misfortune in 54%, and apprehension in 84%. The patients with dream mentations reported more severe daytime sleepiness. CONCLUSION: Short, unpleasant dreamlike mentations may occur during sleepwalking/sleep terrors episodes, suggesting that a complex mental activity takes place during slow wave sleep. Sleepwalking may thus represent acting out of the corresponding dreamlike mentation.

Language: en