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Case Reports
. 2009 Dec;32(12):1621-7.
doi: 10.1093/sleep/32.12.1621.

Dreamlike mentations during sleepwalking and sleep terrors in adults

Delphine Oudiette  1 , Smaranda Leu, Michel Pottier, Marie-Annick Buzare, Agnès Brion, Isabelle Arnulf
Affiliations
Case Reports

Dreamlike mentations during sleepwalking and sleep terrors in adults

Delphine Oudiette et al. Sleep. 2009 Dec.

Abstract

Background: Sleep terrors and sleepwalking are described as arousals from slow wave sleep with no or poor mental recollection.

Objective: To characterize the mental content retrospectively associated with sleep terrors or sleepwalking.

Setting: University Hospital.

Design: Controlled prospective cohort.

Participants: Forty-three patients referred for severe sleepwalking/sleep terrors (age: 26 +/- 7 y, 46% men, 5 with sleep terrors only, 8 with sleepwalking only, and 30 with both), matched with 25 healthy control subjects.

Intervention: Thirty-eight of the 43 patients (88%) underwent an interview about the frequency, time, behaviors, and mental content associated with the episodes of sleepwalking and sleep terrors, whenever they occurred over a lifetime. The mental contents were classified for complexity (Orlinski score), and for characters, emotions, fortune/misfortune, and social interactions (Hall and Van de Castle categories). Patients and control subjects underwent an overnight video-polysomnogram.

Results: Seventy-one percent of the patients reported at least 1 dreamlike mentation associated with the sleepwalking/sleep terrors episode. The dreamlike mentation action corresponded with the observed behavior. A total of 106 dreamlike mentations were collected (mean: 3 +/- 3.4 dreamlike mentations/patient, range 0-17). Most (95%) dreamlike mentations consisted of a single visual scene. These dreamlike mentations were frequently unpleasant, with aggression in 24% (the dreamer being always the victim), misfortune in 54%, and apprehension in 84%. The patients with dream mentations reported more severe daytime sleepiness.

Conclusion: Short, unpleasant dreamlike mentations may occur during sleepwalking/sleep terrors episodes, suggesting that a complex mental activity takes place during slow wave sleep. Sleepwalking may thus represent acting out of the corresponding dreamlike mentation.

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Figures

Figure 1
Figure 1
Hypnogram of Patient 21 (case report) with 10 sudden awakenings from slow wave sleep (shown by arrows) with corresponding behavior of surprise, sitting, and talking evoking a “status parasomnicus.”
See this image and copyright information in PMC

Comment in

  • Sleepwalking déjà vu.
    Pressman MR. Pressman MR. Sleep. 2009 Dec;32(12):1542-3. doi: 10.1093/sleep/32.12.1542. Sleep. 2009. PMID: 20041586 Free PMC article. No abstract available.

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