Mainieri Greta, Loddo Giuseppe, Provini Federica
Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40139 Bologna, Italy.
Azienda AUSL di Bologna, 40124 Bologna, Italy.
Clocks Sleep. 2021 Jan 21;3(1):53-65. doi: 10.3390/clockssleep3010004.
Non-rapid eye movement (NREM) sleep parasomnias are characterized by motor and emotional behaviors emerging from incomplete arousals from NREM sleep and they are currently referred to as disorders of arousal (DoA). Three main clinical entities are recognized, namely confusional arousal, sleep terror and sleepwalking. DoA are largely present in pediatric populations, an age in which they are considered as transitory, unhabitual physiological events. The literature background in the last twenty years has extensively shown that DoA can persist in adulthood in predisposed individuals or even appear de novo in some cases. Even though some episodes may arise from stage 2 of sleep, most DoA occur during slow wave sleep (SWS), and particularly during the first two sleep cycles. The reasons for this timing are linked to the intrinsic structure of SWS and with the possible influence on this sleep phase of predisposing, priming and precipitating factors for DoA episodes. The objective of this paper is to review the intrinsic sleep-related features and chronobiological aspects affecting SWS, responsible for the occurrence of the majority of DoA episodes during the first part of the night.
非快速眼动（NREM）睡眠异态以NREM睡眠不完全觉醒时出现的运动和情绪行为为特征，目前被称为觉醒障碍（DoA）。公认有三种主要的临床类型，即混乱性觉醒、夜惊和梦游。DoA在儿童群体中很常见，在这个年龄段，它们被视为短暂的、非习惯性的生理事件。过去二十年的文献背景广泛表明，DoA在易感个体中可能会持续到成年，甚至在某些情况下会新发。尽管有些发作可能起源于睡眠第2阶段，但大多数DoA发生在慢波睡眠（SWS）期间，尤其是在前两个睡眠周期。这种时间安排的原因与SWS的内在结构以及DoA发作的易感、启动和促发因素对该睡眠阶段的可能影响有关。本文的目的是综述影响SWS的内在睡眠相关特征和生物钟学方面，这些因素导致大多数DoA发作发生在夜间的第一部分。
