Department of Neurology, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland.
J Neurol. 2011 Jul;258(7):1261-7. doi: 10.1007/s00415-011-5922-3. Epub 2011 Feb 4.
Sleepwalking (SW) corresponds to a complex sleep-associated behavior that includes locomotion, mental confusion, and amnesia. SW is present in about 10% of children and 2-3% of adults. In a retrospective series of 165 patients with Parkinson's disease (PD), we found adult-onset ("de novo") SW "de novo" in six (4%) of them. The aim of this study was to assess prospectively and systematically the frequency and characteristics of SW in PD patients. A questionnaire including items on sleep quality, sleep disorders, and specifically also SW and REM sleep behavior disorder (RBD), PD characteristics and severity, was sent to the members of the national PD patients organization in Switzerland. In the study, 36/417 patients (9%) reported SW, of which 22 (5%) had adult-onset SW. Patients with SW had significantly longer disease duration (p = 0.035), they reported more often hallucinations (p = 0.004) and nightmares (p = 0.003), and they had higher scores, suggestive for RBD in a validated questionnaire (p = 0.001). Patients with SW were also sleepier (trend to a higher Epworth Sleepiness Scale score, p = 0.055). Our data suggest that SW in PD patients is (1) more common than in the general population, and (2) is associated with RBD, nightmares, and hallucinations. Further studies including polysomnographic recordings are needed to confirm the results of this questionnaire-based analysis, to understand the relationship between SW and other nighttime wandering behaviors in PD, and to clarify the underlying mechanisms.
梦游（SW）对应一种复杂的睡眠相关行为，包括运动、精神混乱和健忘。SW 在大约 10%的儿童和 2-3%的成年人中出现。在对 165 名帕金森病（PD）患者的回顾性系列研究中，我们发现其中有 6 名（4%）为成人起病（“新发”）SW。本研究的目的是前瞻性和系统地评估 PD 患者中 SW 的频率和特征。我们向瑞士全国 PD 患者组织的成员发送了一份包括睡眠质量、睡眠障碍以及特别是 SW 和 REM 睡眠行为障碍（RBD）项目的问卷。在这项研究中，36/417 名患者（9%）报告有 SW，其中 22 名（5%）有成人起病的 SW。有 SW 的患者疾病持续时间明显更长（p=0.035），他们更常报告幻觉（p=0.004）和噩梦（p=0.003），并且他们在一个经过验证的问卷中得分更高，提示存在 RBD（p=0.001）。有 SW 的患者也更困倦（倾向于更高的 Epworth 嗜睡量表评分，p=0.055）。我们的数据表明，PD 患者的 SW （1）比一般人群更常见，（2）与 RBD、噩梦和幻觉有关。需要进一步的研究，包括多导睡眠图记录，以确认这项基于问卷的分析结果，了解 PD 患者中 SW 与其他夜间漫游行为之间的关系，并阐明其潜在机制。
