Abstract
Episodes of somnambulism have been described as far back as the ancient Greeks. Lacking our current knowledge of sleep and sleep disorders, these episodes no doubt included conditions other than the nonrapid eye movement (NREM) arousal parasomnias—sleepwalking (somnambulism), sleep terrors, and confusional arousals. Epilepsy, rapid eye movement (REM) behavior disorder, dissociative disorder, and other causes of nocturnal wandering were no doubt the source of many behaviors labeled as somnambulism. Until the 1930s, somnambulism was often attributed to religious or supernatural causes. Until the 1960s, somnambulism was attributed to acting out of dreams. Psychodynamic theory in the first half of the twentieth century attributed it to unresolved psychic trauma. Several nineteenth-century writers, while attributing somnambulism to dreaming, made accurate clinical descriptions and even ventured physiological explanations similar to modern theories. The first scientific research was conducted in 1884. In 1963, the first sleep-laboratory-based studies of somnambulism were conducted and to the researchers’ surprise they found that the complex behaviors in sleep were not associated with the recently described REM sleep or with REM-sleep-related dreaming. Rather, it occurred following a partial arousal from deep sleep. This eventually led in 1968 to a description of somnambulism and related disorders as “disorders of arousal.” This continues to form the basis of our understanding of NREM arousal parasomnias until this day. Hundreds of research studies have since followed. NREM arousal disorders can now be provoked in the sleep laboratory by sleep deprivation and acoustic stimuli for research purposes. Standards for differential diagnosis have been published. The underlying theory of NREM arousal disorders now involves evidence showing a dissociation of different brain areas during sleep and the fact that some parts of the brain may be technically awake while others are asleep.
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American Academy of Sleep Medicine. ICSD-2—International Classification of Sleep Disorders, 2nd ed. Diagnostic and Coding Manual. Westchester: American Academy of Sleep Medicine; 2005.
Aserinsky E, Kleitman N. Regularly occurring periods of eye motility, and concomittant phenomena, during sleep. Science 1953;118:273–4.
Gastaut H, Broughton R. Paroxysmal psychological events and certain phases of sleep. Percept Mot Skills. 1963;17:362. (Epub 1963/10/01).
Prichard JC. Somnambulism and animal magnetism. In Forbes JT, Tweedie A, Conolly J, editors. The Cyclopaedia of practical medicine. London: Whittaker, Treacher and Company; 1835. p. 21–39.
Colquhoun JC. Introduction. Edinburgh: Adam and Charles Black; 1845.
Tuke D. Sleep-walking and hypnotism. Philadelphia: P. Blakiston; 1884.
Broughton R, Billings R, Cartwright R, Doucette D, Edmeads J, Edwardh M, et al. Homicidal somnambulism: a case report. Sleep 1994;17(3):253–64.
Pressman MR. Disorders of arousal from sleep and violent behavior: the role of physical contact and proximity. Sleep 2007;30(8):1039–47.
Schenck CH, Bundlie SR, Ettinger MG, Mahowald MW. Chronic behavioral disorders of human REM sleep: a new category of parasomnia. Sleep 1986;9(2):293–308.
Pady DS. The medico-psychological interests of King James I. Clio Medica. 1984;19(1–2):22–31.
Walker N. Crime and insanity in England. Edinburgh: Edinburgh University Press; 1968. p. 302.
Petrain D. An English translation of John William Polidori’s (1815) medical dissertation on Oneirodynia (Somnambulism). Eur Rom Rev 2010;21:775–88.
Broughton RJ. NREM arousal parasomnias. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 3rd ed. Philadelphia: W. B. Saunders Company; 2000. p. 1336.
Pressman MR. Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med Rev. 2007;11(1):5–30.
Ray I. A treatise on the medical jurisprudence of insanity. Boston: Charles C. Little and James Brown; 1838.
Wharton F. A monograph on mental unsoundness. Philadelphia: Kay and Brother; 1855. p. 228.
Hammond W. Sleep and its derangements. Philadelphia: Lippincott; 1869.
Yellowless, D. Homicide by somnabulist. J Ment Scie 1878;24:451–8.
Hurwitz TD, Mahowald MW, Schenck CH, Schluter JL, Bundlie SR. A retrospective outcome study and review of hypnosis as treatment of adults with sleepwalking and sleep terror. J Nerv Ment Dis. 1991;179(4):228–33.
Sours JAF, Frunkin P, Indermill RR. Somnambulism: its clinical significance and dynamic meaning in late adolescence and adulthood. Arch Gen Psychiatry. 1963;9:400–13.
Dement WC, Kleitman N. The relation of eye movements during sleep to dream activity: an objective method for the study of dreaming. J Exp Psychol. 1957;53(5):339–46.
Gastaut H, Batini C, Broughton R, Fressy J, Tassinari CA. Etude électroencéphalographique des manifestations paroxystiques non-épileptiques au cours du sommeil nocturne. Rev Neurol. 1964;110:309–10.
Gastaut H, Batini C, Broughton R, Fressy J, Tassinari CA. Etude électroencéphalographique des phénomènes non-épileptiques au cours du sommeil. In: Fischgold H, editor. Le sommeil de nuit normal et pathologique: Etudes électroencéphalographiques. Paris: Masson; 1965, p. 215.
Broughton R, Gastaut H. Recent sleep research on enuresis nocturna, sleep walking, sleep terrors and confusional arousals: a review of dissociative awakening disorders in slow wave sleep. In: Levin P, Koella W, editors. Sleep 1974. Karger: Basel; 1975. p. 82–91.
Jacobson A, Kales A, Lehmann D, Zweizig J. Somnambulism: all-night electroencephalographic studies. Science. 1965:975–7.
Kales A, Jacobson A, Paulson MJ, Kales JD, Walter RD. Somnambulism: psychophysiological correlates. I. All-night EEG studies. Arch Gen Psychiatry. 1966;14:586–94.
Fischer C, Kahn E, Edwards A, David DM. A psychophysiological study of nightmares and night terrors. The suppression of stage 4 night terrors with diazepam. Arch Gen Psychiatry. 1973;28:252–9.
Gastaut H, Broughton R. A clinical and polygraphic study of episodic phenomena during sleep. In Wortis J, editor. Recent advances in biological psychiatry (Vol 7). New York: Plenum; 1965. p. 197–221.
Broughton RJ. Sleep disorders: disorders of arousal? Enuresis, somnambulism, and nightmares occur in confusional states of arousal, not in “dreaming sleep”. Science. 1968;159:1070–8.
Gastaut H, Dongier M, Batini C, Rhodes J. Etude électroencéphalographique des terreurs nocturnes et diurnes chez un névrosé. Rev Neurol. 1962;107:277–99.
Broughton R. Aggression during sleepwalking: a case report. Sleep Res. 1978;7:215.
Broughton R, Warnes H. Violence in sleep: eleven cases. Sleep Res. 1989;18:205.
Broughton R, Shimizu T. Sleep-related violence: a medical and forensic challenge. Sleep. 1995;18:727–30.
Broughton R. Pathophysiology of enuresis nocturna, sleep terrors and sleep walking: current status and the Marseilles contribution. In: Broughton R, editor, Henti Gastaut and the Marseilles contribution to the Neurosciences. Amsterdam: Elsevier; 1982. p. 401.
Tassinari CA, Mancia D, Della Bernardina B, Gastaut H. Pavor nocturnus of non-epileptic nature in epileptic children. Electroenceph Clin Neurophysiol. 1972;33:603–7.
Jouvet M. Research on the neural structures and responsible mechanisms in different phases of physiological sleep. Arch Ital Biol. 1962;100:125–206.
Hodes RD, Dement WC, editors. Abolition of electrically induced reflexes during rapid eye movement (REM) periods of sleep in normal subjects (preliminary report). Brooklyn: Association for the psychophysiology of sleep (APSS). 1963.
Berger R. Tonus of extrinsic laryngeal muscles during sleep and dreaming. Science. 1961;134:840.
Jacobson A, Kales A, Lehmann D, Hoedemaker FS. Muscle tonus in human subjects during sleep and dreaming. Exp Neurol. 1964;10:418–24.
Rechtschaffen A, Kales A, editors. A manual of standardized terminology, techniques, and scoring system for sleep stages of human subjects. Los Angeles. Brain Information Service/Brain Research Institute. 1968.
Dement W, Kleitman N. Cyclic variations in EEG during sleep and their relationship to eye movements, body motility and dreaming. Electroencephalogr Clin Neurophysiol. 1957;9:673–90.
Williams RL, Karacan I, Hursch C. EEG of human sleep: clinical applications. New York: Wiley; 1974.
Pressman MR, Hypersynchronous delta sleep EEG activity and sudden arousals from slow-wave sleep in adults without a history of parasomnias: clinical and forensic implications. Sleep. 2004;27:706–10.
Joncas S, Zadra A, Montplasir J. Sleep deprivation increases the frequency and complexity of behavioral manifestations in adult sleep walkers. Sleep. 2000;23(Suppl. 2):A14.
Joncas S, Zadra A, Paquet J, Montplaisir J. The value of sleep deprivation as a diagnostic tool in adult sleepwalkers. Neurology. 2002;58:936–40.
Lecendreux M, Bassetti C, Dauvilliers Y, Mayer G, Neidhart E, Tafti M. HLA and genetic susceptibility to sleepwalking. Mol Psychiatry. 2003;8:114–7.
Licis AK, Desruisseau DM, Yamada KA, Duntley SP, Gurnett CA. Novel genetic findings in extended family pedigree with sleep-walking. Neurology. 2011;76:49–52.
Schenck CH, Mahowald MW. Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med. 1996;100:333–7.
Harris M, Grundstein RR. Treatments for somnambulism in adults: assessing the evidence. Sleep Med Rev. 2009;13:295–7.
Broughton R, Mullington J. Polysomnography: principles and applications in sleep and arousal disorders. In: Niedermeyer E, Lopes da Silva E, editors. Electroencephalography: basic principles. Clinical applications and related fields. Baltimore: Williams and Wilkens; 2004. p. 899.
Boucher B, Broughton R. Sleep architecture differences between sleep terror and sleepwalker patients and matched controls. J Sleep Res. 2000;9(Suppl 1):23.
Broughton RJ. Phasic and dynamic aspects of sleep: a symposium review and synthesis. In: Terzano MG, Halasz P, Declerck AC, editors. Phasic and dynamic aspects of sleep. New York: Raven; 1991. p. 185.
Guilleminault C, Palombini L, Pelayo R, Chervin RD. Sleepwalking and sleep terrors in prepubertal children: what triggers them? Pediatrics. 2003;111:17–25.
Guilleminault C, Kirisoglu C, Bao G, Arias V, Chen A, Li KK. Adult chronic sleepwalking and its treatment based on polysomnography. Brain. 2005;12:1062–9.
Guilleminault C, Kirisoglu C, da Rosa AC, Lopez C, Chen A. Sleepwalking, a disorder of NREM sleep instability. Sleep Med. 2006;7:163–70.
Fisher C, Byrne J, Edwards A, Kahn E. REM and NREM nightmares. Int Psychiat Clin. 1970;7:183–7.
Shapiro CM, Trajanovic NN, Fedoroff JP. Sexsomnia- a new parasomnia? Can J Psychiatry-Rev Can Psychiatrie. 2003;48:311–7.
Guilleminault C, Moscovitch A, Yuen K, Poyares D. Atypical sexual behavior during sleep. Psychosom Med. 2002;64:328–36.
Arnulf I, Neutel D, Herlin B, Golmard JL, Leu-Semenescu S, de Cock VC, Vidailhet M. Sleepiness in idiopathic REM sleep behavior disorder and Parkinson disease. Sleep. 2015. Pii:sp-00663-14 (Epub ahead of print).
Lugaresi E, Cirignotta F. Hypnogenic paroxysmal dystonia: epileptic seizures or new syndrome? Sleep. 1981;4:129–38.
Lugaresi E, Cirignotta F, Montagna P. Nocturnal paroxysmal dystonia. J Neurol Neurosurg Psychiatry. 1986;49:375–80.
Provini F, Piazzi G, Lugaresi E. From nocturnal paroxysmal dystonia to frontal lobe epilepsy. J Clin Neurophysiol. 2000;111:52–8.
Halasz P, Kelemen A, Szucs A. Physiopathogenetic interrelationship between nocturnal frontal lobe epilepsy and NREM arousal parasomnia. Epilepsy Res Treat. 2012;12:312–93.
Passouant P, Latour H, Cadilhac J. L’épilepsie morphéique. Ann Med Psychol. 1961;109:529–41.
Cadilhac J, Vlahovitch B, Delange-Walter C. Considérations sur les modifications des décharges épileptiques au cours de la période des mouvements oculaires. In: Fischgold H, editor. Le sommeil de nuit normal et pathologique. Paris: Masson; 1965.
Gastaut H, Broughton R. Epileptic seizures: clinical and electrographic features, diagnosis and treatment. Sringfield: Charles C Thomas; 1972, 286 pp.
Bassetti C, Vela S, Donati I, Weber H. SPECT during sleepwalking. Lancet. 2000;356:484–5.
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Pressman, M., Broughton, R. (2015). NREM Arousal Parasomnias. In: Chokroverty, S., Billiard, M. (eds) Sleep Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2089-1_44
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