Diagnosis and Management of NREM Sleep Parasomnias in Children and Adults

doi:10.3390/diagnostics13071261

Review

. 2023 Mar 27;13(7):1261.

doi: 10.3390/diagnostics13071261.

Diagnosis and Management of NREM Sleep Parasomnias in Children and Adults

Greta Mainieri¹, Giuseppe Loddo², Federica Provini^{1

3}, Lino Nobili^{4

5}, Mauro Manconi^{6

7

8}, Anna Castelnovo^{6

7

9}

Affiliations

¹ Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40139 Bologna, Italy.
² Department of Primary Care, Azienda AUSL di Bologna, 40100 Bologna, Italy.
³ IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy.
⁴ Unit of Child Neuropsychiatry, IRCCS Istituto G. Gaslini, 16147 Genoa, Italy.
⁵ Department of Neuroscience-Rehabilitation-Ophthalmology-Genetics-Maternal and Child Health, DINOGMI, Università degli Studi di Genova, 16132 Genoa, Italy.
⁶ Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, 6900 Lugano, Switzerland.
⁷ Faculty of Biomedical Sciences, Università Della Svizzera Italiana, 6900 Lugano, Switzerland.
⁸ Department of Neurology, University Hospital, Inselspital, 3010 Bern, Switzerland.
⁹ University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland.

PMID: 37046480
PMCID: PMC10093221
DOI: 10.3390/diagnostics13071261

Review

Diagnosis and Management of NREM Sleep Parasomnias in Children and Adults

Greta Mainieri et al. Diagnostics (Basel). 2023.

. 2023 Mar 27;13(7):1261.

doi: 10.3390/diagnostics13071261.

Authors

Greta Mainieri¹, Giuseppe Loddo², Federica Provini^{1

3}, Lino Nobili^{4

5}, Mauro Manconi^{6

7

8}, Anna Castelnovo^{6

7

9}

Affiliations

¹ Department of Biomedical and NeuroMotor Sciences, University of Bologna, 40139 Bologna, Italy.
² Department of Primary Care, Azienda AUSL di Bologna, 40100 Bologna, Italy.
³ IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy.
⁴ Unit of Child Neuropsychiatry, IRCCS Istituto G. Gaslini, 16147 Genoa, Italy.
⁵ Department of Neuroscience-Rehabilitation-Ophthalmology-Genetics-Maternal and Child Health, DINOGMI, Università degli Studi di Genova, 16132 Genoa, Italy.
⁶ Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, 6900 Lugano, Switzerland.
⁷ Faculty of Biomedical Sciences, Università Della Svizzera Italiana, 6900 Lugano, Switzerland.
⁸ Department of Neurology, University Hospital, Inselspital, 3010 Bern, Switzerland.
⁹ University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland.

PMID: 37046480
PMCID: PMC10093221
DOI: 10.3390/diagnostics13071261

Abstract

Non-rapid eye movement (NREM) sleep parasomnias are recurrent abnormal behaviors emerging as incomplete arousals out of NREM sleep. Mounting evidence on NREM sleep parasomnias calls for an update of clinical and therapeutical strategies. In the current review, we summarize the state of the art and provide the necessary background to stimulate a critical revision of diagnostic criteria of disorders of arousal (DoA), the most common NREM sleep parasomnia. In particular, we highlight the poor sensitivity of the diagnostic items related to amnesia and absence of conscious experiences during DoA episodes, encourage the role of video-polysomnography and home-video recordings in the diagnostic and treatment work-up, and suggest three levels of diagnostic certainty based on clinical and objective findings. Furthermore, we highlight current gaps of knowledge that prevent the definition of standard guidelines and future research avenues.

Keywords: NREM sleep parasomnias; confusional arousal; disorders of arousal; sexsomnia; sleep terror; sleep-related eating disorder; sleepwalking.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Proposed levels of certainty in DoA diagnosis.

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References

1. American Academy of Sleep Medicine . International Classification of Sleep Disorders. 3rd ed. American Academy of Sleep Medicine; Darien, IL, USA: 2014.
1. Castelnovo A., Lopez R., Proserpio P., Nobili L., Dauvilliers Y. NREM sleep parasomnias as disorders of sleep-state dissociation. Nat. Rev. Neurol. 2018;14:470–481. doi: 10.1038/s41582-018-0030-y. - DOI - PubMed
1. Zadra A., Desautels A., Petit D., Montplaisir J. Somnambulism: Clinical aspects and pathophysiological hypotheses. Lancet Neurol. 2013;12:285–294. doi: 10.1016/S1474-4422(12)70322-8. - DOI - PubMed
1. Idir Y., Oudiette D., Arnulf I. Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: The old and the new. J. Sleep Res. 2022;31:e13596. doi: 10.1111/jsr.13596. - DOI - PubMed
1. Kalantari N., McDuff P., Pilon M., Desautels A., Montplaisir J.-Y., Zadra A. Self-reported developmental changes in the frequency and characteristics of somnambulistic and sleep terror episodes in chronic sleepwalkers. Sleep Med. 2022;89:147–155. doi: 10.1016/j.sleep.2021.12.008. - DOI - PubMed

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[1] American Academy of Sleep Medicine . International Classification of Sleep Disorders. 3rd ed. American Academy of Sleep Medicine; Darien, IL, USA: 2014.

[2] American Academy of Sleep Medicine . International Classification of Sleep Disorders. 3rd ed. American Academy of Sleep Medicine; Darien, IL, USA: 2014.

[3] Castelnovo A., Lopez R., Proserpio P., Nobili L., Dauvilliers Y. NREM sleep parasomnias as disorders of sleep-state dissociation. Nat. Rev. Neurol. 2018;14:470–481. doi: 10.1038/s41582-018-0030-y. - DOI - PubMed

[4] Castelnovo A., Lopez R., Proserpio P., Nobili L., Dauvilliers Y. NREM sleep parasomnias as disorders of sleep-state dissociation. Nat. Rev. Neurol. 2018;14:470–481. doi: 10.1038/s41582-018-0030-y. - DOI - PubMed

[5] Zadra A., Desautels A., Petit D., Montplaisir J. Somnambulism: Clinical aspects and pathophysiological hypotheses. Lancet Neurol. 2013;12:285–294. doi: 10.1016/S1474-4422(12)70322-8. - DOI - PubMed

[6] Zadra A., Desautels A., Petit D., Montplaisir J. Somnambulism: Clinical aspects and pathophysiological hypotheses. Lancet Neurol. 2013;12:285–294. doi: 10.1016/S1474-4422(12)70322-8. - DOI - PubMed

[7] Idir Y., Oudiette D., Arnulf I. Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: The old and the new. J. Sleep Res. 2022;31:e13596. doi: 10.1111/jsr.13596. - DOI - PubMed

[8] Idir Y., Oudiette D., Arnulf I. Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: The old and the new. J. Sleep Res. 2022;31:e13596. doi: 10.1111/jsr.13596. - DOI - PubMed

[9] Kalantari N., McDuff P., Pilon M., Desautels A., Montplaisir J.-Y., Zadra A. Self-reported developmental changes in the frequency and characteristics of somnambulistic and sleep terror episodes in chronic sleepwalkers. Sleep Med. 2022;89:147–155. doi: 10.1016/j.sleep.2021.12.008. - DOI - PubMed

[10] Kalantari N., McDuff P., Pilon M., Desautels A., Montplaisir J.-Y., Zadra A. Self-reported developmental changes in the frequency and characteristics of somnambulistic and sleep terror episodes in chronic sleepwalkers. Sleep Med. 2022;89:147–155. doi: 10.1016/j.sleep.2021.12.008. - DOI - PubMed

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Diagnosis and Management of NREM Sleep Parasomnias in Children and Adults

Affiliations

Diagnosis and Management of NREM Sleep Parasomnias in Children and Adults

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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Abstract

Conflict of interest statement

Figures

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References

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