Sodan Turan Hatice, Gündüz Nermin, Polat Aslıhan, Tural Ümit
Department of Psychiatry, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Noro Psikiyatr Ars. 2015 Jun;52(2):204-206. doi: 10.5152/npa.2015.7243. Epub 2015 Jun 1.
Parasomnias are a group of disorders characterized by abnormal behaviors, physical activities, and autonomic arousal symptoms while transition to sleep or continuation of sleep. Sleep terror (ST) is classified under parasomnias characterized by sudden fear attacks beginning with crying attacks or high-frequency screams and continuing with increased autonomic symptoms. ST occurs in the first few hours of sleep during the delta phase. Further, the lifetime prevalence of ST in adults is less than 1%. It is important to obtain; anamnesis from patients' bed partner for a clinical evaluation of ST. Methods, such as evaluating sleep diaries and video recordings, can help ST diagnosis. It is also important to evaluate patients' medical history, history of substance or alcohol abuse, psychological traumatic experiences, primary or secondary incomes, and detailed neurological aspects. Physician can select some serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCADs) as medical treatment if patients have a high frequency of attacks. Because of addiction and relapse of ST episodes, benzodiazepines are not preferred as the first-line treatment. In this study, we will discuss ST, which is rare in adulthood, and use of long-acting benzodiazepine based on two cases.
异态睡眠是一组以睡眠转换或持续睡眠期间出现异常行为、身体活动和自主神经唤醒症状为特征的疾病。睡眠惊恐(ST)属于异态睡眠,其特征是突然发作的恐惧,始于哭闹发作或高频尖叫,并伴有自主神经症状加重。ST发生在睡眠的最初几个小时,处于δ波睡眠阶段。此外,成年人中ST的终生患病率低于1%。从患者的同床伴侣处获取病史对于ST的临床评估很重要。评估睡眠日记和录像等方法有助于ST的诊断。评估患者的病史、药物或酒精滥用史、心理创伤经历、主要或次要收入以及详细的神经学方面也很重要。如果患者发作频率高,医生可以选择一些5-羟色胺再摄取抑制剂(SSRIs)或三环类抗抑郁药(TCADs)进行药物治疗。由于ST发作存在成瘾性和复发问题,苯二氮䓬类药物不作为一线治疗药物。在本研究中,我们将基于两例病例讨论成年期罕见的ST以及长效苯二氮䓬类药物的使用。