Violent and Complex Behaviors and Non-Restorative Sleep Are the Main Features of Disorders of Arousal in Adulthood: Real Picture or a More Severe Phenotype?

被引:5
作者
Mainieri, Greta [1 ]
Loddo, Giuseppe [2 ]
Baldelli, Luca [1 ]
Montini, Angelica [1 ]
Mondini, Susanna [3 ]
Provini, Federica [1 ,3 ]
机构
[1] Univ Bologna, Dept Biomed & NeuroMotor Sci, I-40139 Bologna, Italy
[2] Azienda AUSL Bologna, Dept Primary Care, I-40100 Bologna, Italy
[3] IRCCS Ist Sci Neurolog Bologna, I-40139 Bologna, Italy
关键词
parasomnia; disorder of arousal; slow wave sleep; NREM sleep; sleepwalking; confusional arousal; sleep terror; sleep-related violence; FRONTAL-LOBE EPILEPSY; SLOW-WAVE ACTIVITY; CONFUSIONAL AROUSALS; ONSET SLEEPWALKING; NIGHT-TERRORS; PARASOMNIAS; SOMNAMBULISM; EPISODES; ALCOHOL; WAKEFULNESS;
D O I
10.3390/jcm12010372
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Disorders of arousal (DoA) are NREM parasomnias characterized by motor and emotional behaviors emerging from incomplete arousals from deep sleep. DoA are largely present in pediatric populations, a period during which they are labeled as self-limited manifestations. However, an extensive literature has shown that DoA can persist in adulthood, with different characteristics from childhood DoA. Adult DoA patients usually report excessive daily sleepiness, sleep-related violence during DoA episodes or potentially harmful behaviors, which are rare in childhood. The semeiological features of DoA episodes in adulthood may complicate differential diagnoses with other motor manifestations during sleep, in particular sleep-related hypermotor epilepsy. However, it cannot be excluded that adults with DoA attending sleep centers constitute a more severe phenotype, thus not being representative of adult DoA in the general population. Video-polysomnographic studies of DoA document a spectrum of motor patterns of different complexities, the simplest of which may often go unnoticed. Despite the different complexities of the episodes, neurophysiologic studies showed the co-existence of deep sleep and wakefulness during DoA episodes or even before their onset. These aspects make DoA an ideal model to investigate the mechanisms regulating local sleep, sleep arousal and cognitive functions including spatial and temporal orientation, attention or memory.
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页数:12
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