New study finds sleepwalking affects health-related quality of life
Sleepwalking, formally known as somnambulism, is a behavior disorder that originates during deep sleep and results in walking or performing other complex behaviors while asleep. Sleepwalking is most often initiated during deep sleep but may occur in the lighter sleep stages or NREM, usually within a few hours of falling asleep, and the sleepwalker may be partially aroused during the episode. The prevalence of sleepwalking in the general population is estimated to be between 1% and 15%, according to the Sleep Foundation.
For this new study researchers from France examined the restorative quality of sleep of sleep and daytime functioning in sleepwalking adult patients in comparison with controls, according to the study’s abstract.
In this prospective-case control study 140 adults sleep walkers participated. Participants had an average age of 30, 55% male, and who were primarily diagnosed with sleep walking from June 2007 to January 2011, at the Sleep Disorders Center, Hôpital-Gui-de Chauliac, Montpellier, France.
Exclusion criteria included a positive clinical history of REM sleep behavior disorder (RBD), a similar parasomnia that involves violent dream-related behaviors emerging during REM sleep.
All participants had a standardized interview and completed a set of questionnaires to assess clinical characteristics of parasomnia, daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and health-related quality of life. Results were compared with those of 100 sex- and age-matched normal controls.
The results showed among the participants 22.3% had daily sleepwalking episodes and 43.5% had weekly episodes.
Familial history of sleepwalking was reported in 56.6% of sleepwalkers and violent sleep related behaviors in 57.9%, including injuries requiring medical care for at least one episode in 17%.
A compelling link was found between sleepwalking and daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and altered quality of life. Early-onset sleepwalkers had higher frequency of violent behaviors and injuries.
Those sleepwalkers who had higher rates of violent behaviors also had a higher rate of sleep terrors and triggering factors was found in 59% of the sleepwalkers. Trigging factors were mainly caused by stressful events, strong positive emotions and sleep deprivation. Triggers less frequently associated sleep walkers included drugs, alcohol intake or intense evening exercise.
Dr. Yves Dauvilliers, MD, PhD, professor of physiology and neurology, Director of Sleep Medicine at Montpellier University Hospital Center, Member of the Healthcare Council and principal investigator of this study commented "We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group.” "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."
In their conclusion the researchers write; “Adult sleepwalking is a potentially serious condition that may induce violent behaviors, self-injury or injury to bed partners, sleep disruption, excessive daytime sleepiness, fatigue, and psychological distress, all of which affect health-related quality of life.”
In closing Dr. Dauvilliers comments "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.” "The burden of sleepwalking in adults needs to be highlighted and emphasized."
This study appears in the March issue of the journal SLEEP.
Stanford University School of Medicine researchers found a link between nocturnal wanderings and certain psychiatric disorders, such as depression and anxiety.
The study also showed that people with depression were 3.5 times more likely to sleepwalk than those without, and people with alcohol abuse/dependence or obsessive-compulsive disorder were also significantly more likely to have sleepwalking episodes.
Other findings in the study included;
The duration of sleepwalking was mostly chronic; with just over 80 percent of those who have sleepwalked reporting they've done so for more than five years.
Sleepwalking was not associated with gender and seemed to decrease with age.
Nearly one-third of individuals with nocturnal wandering had a family history of the disorder.
People using over-the-counter sleeping pills had a higher likelihood of reporting sleepwalking episodes at least two times per month. (Indeed, a sleeping pill was the trigger for Homer Simpson's middle-of-the-night shenanigans.)
Information on sleepwalking can be found at the National Sleep Foundation.
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