Espinar J
Unidad de Sueño, Hospital Universitario San Carlos, Madrid, España.
Rev Neurol. 1998 Mar;26(151):469-72.
Disorders of arousal and parasomnias of sleep-wake transition are revisited. Disorders of arousal are: Sleepwalking (SW), confusional arousals (CA) and sleep terrors (ST). SW, CA and ST are different clinical manifestations of the same disorder being ST the most severe and SW the mildest manifestation. Disorders of arousal are typical parasomnias of NREM sleep, mainly slow wave sleep. Pathophysiological mechanism of these disorders is the state's dissociation of wakefulness and sleep. The conjunction of the constitutional factors (genetic, age, sleep privation, drugs, psychological, etc.), and precipitant factors (light, sound, temperature, touch, apnea, gastroesophageal reflux, seizure, fever, psychological, etc.) permit three possible arousal behavioral response: A full awakening, a shift stage of sleep or a partial arousal. Clinical significance of arousal parasomnias depend on the age. In children are caused by developmental and genetic factors and usually are autolimited. In adults usually are caused by psychopathology. In the elderly are often caused by organic brain syndromes. Parasomnias of sleep-wake transition are: Rhythmic movements of sleep, sleeptalking, starts and the nocturnal cramp. Most of them are mild disorders, almost physiological phenomena that usually don't need any treatment.
觉醒障碍与睡眠-觉醒转换期异态睡眠再探讨。觉醒障碍包括：梦游（SW）、错乱觉醒（CA）和夜惊（ST）。SW、CA和ST是同一障碍的不同临床表现，其中ST最为严重，SW最为轻微。觉醒障碍是NREM睡眠（主要是慢波睡眠）典型的异态睡眠。这些障碍的病理生理机制是觉醒与睡眠状态的分离。体质因素（遗传、年龄、睡眠剥夺、药物、心理等）和诱发因素（光线、声音、温度、触摸、呼吸暂停、胃食管反流、癫痫、发热、心理等）共同作用，可能引发三种觉醒行为反应：完全觉醒、睡眠阶段转换或部分觉醒。觉醒异态睡眠的临床意义取决于年龄。在儿童中，由发育和遗传因素引起，通常为自限性。在成人中，通常由精神病理学引起。在老年人中，常由器质性脑综合征引起。睡眠-觉醒转换期异态睡眠包括：睡眠中的节律性运动、说梦话、惊跳和夜间抽筋。其中大多数是轻度障碍，几乎属于生理现象，通常无需任何治疗。
