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成人中儿童期和成人期发作性睡行症的人口统计学、临床及多导睡眠图特征

Demographic, Clinical and Polysomnographic Characteristics of Childhood- and Adult-Onset Sleepwalking in Adults.

作者信息

Bargiotas Panagiotis, Arnet Iris, Frei Michael, Baumann Christian R, Schindler Kaspar, Bassetti Claudio L

机构信息

Sleep-Wake-Epilepsy Center (SWEZ), Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland.

Department of Neurology, University Hospital Zurich, Zurich, Switzerland.

出版信息

Eur Neurol. 2017;78(5-6):307-311. doi: 10.1159/000481685. Epub 2017 Oct 26.

Abstract

BACKGROUND

Sleepwalking (SW) is found to affect children predominantly, but it can persist or appear de novo even among adults. In this study, we assessed the demographic, clinical and polysomnographic profile, trigger factors and associated comorbidities of adult-onset (AO-SW) and childhood-onset (CO-SW) adult sleepwalkers.

METHODS

In adult sleepwalkers, a structured clinical interview, a battery of questionnaires, video-polysomnography (v-PSG) and standard electroencephalography (EEG) were performed.

RESULTS

Among 63 sleepwalkers, 45% had ≥1 episodes/month, 54% had partial recall of the episodes and 36% reported trigger factors for SW. Almost all subjects reported co-occurring parasomnias. In v-PSG, 4% exhibited episodes of SW, 17% confusional arousals, 21% had an increased apnea-hypopnea-index and 6% exhibited features of an overlap parasomnia disorder. In our cohort, 73% reported CO-SW and 27% AO-SW. In subjects with AO-SW, positive family history for parasomnias was found in 33% (vs. 49% in CO-SW), neurological comorbidities in 44% (vs. 14%), psychiatric comorbidities in 25% (vs. 33%), EEG abnormalities in 50% (vs. 29%). Violence during SW episodes was more frequent in males and in subjects with CO-SW (45% for self-injury and 44% for violent behaviour vs. 33 and 29% respectively in the AO-SW group).

CONCLUSIONS

Adult SW represents a complex and potentially dangerous condition. The characteristics of AO-SW often differ from those of CO-SW.

摘要

背景

梦游(SW)主要见于儿童,但在成人中也可能持续存在或新发。在本研究中,我们评估了成人起病型(AO-SW)和儿童起病型(CO-SW)成人梦游者的人口统计学、临床和多导睡眠图特征、触发因素及相关共病情况。

方法

对成人梦游者进行结构化临床访谈、一系列问卷调查、视频多导睡眠图(v-PSG)和标准脑电图(EEG)检查。

结果

在63名梦游者中,45%每月发作≥1次,54%对发作有部分记忆,36%报告有梦游的触发因素。几乎所有受试者都报告有并存的异态睡眠。在v-PSG检查中,4%出现梦游发作,17%出现混乱觉醒,21%呼吸暂停低通气指数升高,6%表现出重叠性异态睡眠障碍特征。在我们的队列中,73%报告为CO-SW,27%为AO-SW。在AO-SW受试者中,33%有异态睡眠的阳性家族史(CO-SW为49%),44%有神经科共病(CO-SW为14%),25%有精神科共病(CO-SW为33%),50%脑电图异常(CO-SW为29%)。梦游发作时的暴力行为在男性和CO-SW受试者中更常见(自我伤害为45%,暴力行为为44%,而AO-SW组分别为33%和29%)。

结论

成人梦游是一种复杂且潜在危险的情况。AO-SW的特征通常与CO-SW不同。

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