Functional impairment in adult sleepwalkers: a case-control study

Abstract

Study objectives: To investigate the restorative quality of sleep and daytime functioning in sleepwalking adult patients in comparison with controls.

Design: Prospective case-control study.

Setting: Data were collected at the Sleep Disorders Center, Hôpital-Gui-de Chauliac, Montpellier, France between June 2007 and January 2011.

Participants: There were 140 adult sleepwalkers (100 (median age 30 y, 55% male) in whom primary SW was diagnosed) who underwent 1 night of video polysomnography. All patients participated in a standardized clinical interview and completed a battery of questionnaires to assess clinical characteristics of parasomnia, daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and health-related quality of life. Results were compared with those of 100 sex- and age-matched normal controls.

Interventions: N/A.

Measurements and results: Of the sleepwalkers, 22.3% presented with daily episodes and 43.5% presented with weekly episodes. Median age at sleepwalking onset was 9 y. Familial history of sleepwalking was reported in 56.6% of sleepwalkers and violent sleep related behaviors in 57.9%, including injuries requiring medical care for at least one episode in 17%. Significant associations were found between sleepwalking and daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and altered quality of life. Early-onset sleepwalkers had higher frequency of violent behaviors and injuries. Sleepwalkers with violent behaviors had higher frequency of sleep terrors and triggering factors, with greater alteration in health-related quality of life.

Conclusion: Adult sleepwalking is a potentially serious condition that may induce violent behaviors, self-injury or injury to bed partners, sleep disruption, excessive daytime sleepiness, fatigue, and psychological distress, all of which affect health-related quality of life.

Citation: Lopez R; Jaussent I; Scholz S; Bayard S; Montplaisir J; Dauvilliers Y. Functional impairment in adult sleepwalkers: a case-control study. SLEEP 2013;36(3):345-351.

Keywords: Depression; fatigue; parasomnia; sleepwalking.

Figure 1

Age at first episode in adult patients with sleepwalking.

Figure 2

Spidergrams showing the median values for SF-36 domain scores and OR (95% confidence interval) in sleepwalkers (n = 100) versus control patients (n = 100), for a five-point decrease. Scores range from 0 to 100, where 0 represents the worst possible health and 100 is perfect health. Mean scores for the individual SF-36 domains (PF, Physical Functioning; SF, Social Functioning; RP, Physical Role; BP, Bodily Pain; GH, General Health; MH, Mental Health; RE, Emotional Role; VT, Vitality) were significantly lower in SW patients compared with controls. OR, odds ratio.