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Somnambulism

Updated : February 13, 2024





Background

Somnambulism often called sleepwalking, refers to undesired acts like walking that appear during sudden but restricted arousals from slow-wave sleep during NREM (non-rapid eye movement). Somnambulism is linked to a variety of different sleep disorders.

Somnambulism is distinguished by the capacity or inability to remember dream detail, simple or complicated motions that correspond to a dream, and less awareness of one’s surroundings.

Somnambulism has been linked to other sleep disorders, including bruxism (teeth grinding), confusional arousals, childhood night terrors, rhythmic movement disorders, and somniloquy (sleep talking), as well as daytime weariness and behavioral and emotional concerns in children.

Epidemiology

The epidemiology of this illness remains unclear. The prevalence of sleepwalking in children is substantially higher than in adults.

According to Stallman and colleagues’ systematic review and meta-analysis, the estimated lifetime prevalence of sleepwalking is 6.9%, with no significant difference in lifetime sleepwalking incidents between adults and children.

Sleepwalking is most common in children but can persist into adulthood or develop unexpectedly in adults. According to research, only a few individuals begin sleepwalking, and adult-onset somnambulism is typically connected with drugs and neurological illnesses.

Anatomy

Pathophysiology

Research indicates that sleepwalking individuals have lower cerebral blood flow in the parietal and frontal regions. Furthermore, reduced perfusion in the prefrontal cortex, dorsolateral, and insula is associated with clinical symptoms of somnambulistic episodes.

Alteration in localized cerebral blood flow patterns reported in sleepwalking patients during resting-state wakefulness may be connected to functional impairments observed in these individuals throughout the day.

Etiology

Some patients have shown evidence of a hereditary propensity to sleepwalking. Monozygotic twins are more likely than dizygotic twins to experience somnambulism. DQB1 genes may have a role in motor abnormalities during sleep since more Whites with somnambulism are discovered to be positive for the DQB1*0501 gene than Whites who do not experience somnambulism.

Some studies have also suggested that sleepwalking has an autosomal dominant mode of inheritance with little penetrance. Antibiotics, benzodiazepines, anticonvulsants, lithium, antidepressants, selective serotonin reuptake inhibitors, antipsychotics, tricyclic antidepressants and quinine, and beta-blockers have all been documented to induce episodes of sleepwalking in individuals with no history of somnambulism.

The benzodiazepine receptor zolpidem, in particular, has been significantly linked to sleepwalking even without prior experience. Sleepwalking is promoted in susceptible persons by prolonged sleep loss, significantly more than 24 hours. When sleep deprivation is followed by sleepwalking, the activities become more explicit and complicated. In a few cases, hyperthyroidism has also been linked to sleepwalking.

Genetics

Prognostic Factors

Most individuals with somnambulism have a fair prognosis. However, it can also result in personal injury (for example, falling from a building or stepping through a glass panel) and embarrassing circumstances.

Sleepwalking behavior in children normally improves by puberty and does not require any therapies or drugs.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK559001/

Somnambulism

Updated : February 13, 2024




Somnambulism often called sleepwalking, refers to undesired acts like walking that appear during sudden but restricted arousals from slow-wave sleep during NREM (non-rapid eye movement). Somnambulism is linked to a variety of different sleep disorders.

Somnambulism is distinguished by the capacity or inability to remember dream detail, simple or complicated motions that correspond to a dream, and less awareness of one’s surroundings.

Somnambulism has been linked to other sleep disorders, including bruxism (teeth grinding), confusional arousals, childhood night terrors, rhythmic movement disorders, and somniloquy (sleep talking), as well as daytime weariness and behavioral and emotional concerns in children.

The epidemiology of this illness remains unclear. The prevalence of sleepwalking in children is substantially higher than in adults.

According to Stallman and colleagues’ systematic review and meta-analysis, the estimated lifetime prevalence of sleepwalking is 6.9%, with no significant difference in lifetime sleepwalking incidents between adults and children.

Sleepwalking is most common in children but can persist into adulthood or develop unexpectedly in adults. According to research, only a few individuals begin sleepwalking, and adult-onset somnambulism is typically connected with drugs and neurological illnesses.

Research indicates that sleepwalking individuals have lower cerebral blood flow in the parietal and frontal regions. Furthermore, reduced perfusion in the prefrontal cortex, dorsolateral, and insula is associated with clinical symptoms of somnambulistic episodes.

Alteration in localized cerebral blood flow patterns reported in sleepwalking patients during resting-state wakefulness may be connected to functional impairments observed in these individuals throughout the day.

Some patients have shown evidence of a hereditary propensity to sleepwalking. Monozygotic twins are more likely than dizygotic twins to experience somnambulism. DQB1 genes may have a role in motor abnormalities during sleep since more Whites with somnambulism are discovered to be positive for the DQB1*0501 gene than Whites who do not experience somnambulism.

Some studies have also suggested that sleepwalking has an autosomal dominant mode of inheritance with little penetrance. Antibiotics, benzodiazepines, anticonvulsants, lithium, antidepressants, selective serotonin reuptake inhibitors, antipsychotics, tricyclic antidepressants and quinine, and beta-blockers have all been documented to induce episodes of sleepwalking in individuals with no history of somnambulism.

The benzodiazepine receptor zolpidem, in particular, has been significantly linked to sleepwalking even without prior experience. Sleepwalking is promoted in susceptible persons by prolonged sleep loss, significantly more than 24 hours. When sleep deprivation is followed by sleepwalking, the activities become more explicit and complicated. In a few cases, hyperthyroidism has also been linked to sleepwalking.

Most individuals with somnambulism have a fair prognosis. However, it can also result in personal injury (for example, falling from a building or stepping through a glass panel) and embarrassing circumstances.

Sleepwalking behavior in children normally improves by puberty and does not require any therapies or drugs.

https://www.ncbi.nlm.nih.gov/books/NBK559001/

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