Psychopathologic correlates of adult sleepwalking.

OBJECTIVES Sleepwalking (SW) often has been associated with psychopathology, but the nature and magnitude of this relation remains unclear. The aim of our study was to investigate the presence of psychopathology in a large cohort of sleepwalkers and to determine if levels of psychopathology showed differential relations to specific characteristics of the disorder, including clinical history. METHODS One-hundred and five sleepwalkers (39 men, 66 women; mean age, 32.4±9.5years) referred to our sleep disorders clinic for chronic SW underwent a comprehensive clinical investigation that included an overnight polysomnography (PSG) assessment in 90% of cases. All participants also completed a series of questionnaires, including the Beck Depression Inventory, Second Revision (BDI-II), the Beck Anxiety Inventory (BAI), and the Symptom Checklist 90-Revised (SCL-90-R). RESULTS The proportion of sleepwalkers who scored above the minimal clinical threshold on the BDI-II, BAI, and SCL-90-R was 27%, 40%, and 28%, respectively. Only 15% of sleepwalkers showed moderate to severe symptoms on the BDI-II and 19% on the BAI. Taken as a whole, these profiles are similar to those observed in the general adult population. The presence of psychopathology in sleepwalkers was associated with a negative family history for SW, a higher frequency of nightmares, and with potentially injurious behaviors enacted during somnambulistic episodes. CONCLUSIONS A majority of adult sleepwalkers consulting for the disorder do not report clinically significant levels of depression or anxiety. Overall, sleepwalkers with and without psychopathology appear more similar than dissimilar.

[1]  D. Oudiette,et al.  Sleep-related eating disorder versus sleepwalking: a controlled study. , 2012, Sleep medicine.

[2]  M. Pressman Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. , 2007, Sleep medicine reviews.

[3]  H. Moldofsky,et al.  Sleep and pain. , 2001, Sleep medicine reviews.

[4]  H. Moldofsky,et al.  Sleep-related violence. , 1995, Sleep.

[5]  G. Klackenberg SOMNAMBULISM IN CHILDHOOD‐PREVALENCE, COURSE AND BEHAVIORAL CORRELATIONS , 1982, Acta paediatrica Scandinavica.

[6]  J. Montplaisir,et al.  Does sleepwalking impair daytime vigilance? , 2011, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[7]  A. Kales,et al.  Somnambulism: psychophysiological correlates. II. Psychiatric interviews, psychological testing, and discussion. , 1966, Archives of general psychiatry.

[8]  Y. Wing,et al.  Sleepwalking in Psychiatric Patients: Comparison of Childhood and Adult Onset , 2009, The Australian and New Zealand journal of psychiatry.

[9]  J. Montplaisir,et al.  Dynamics of slow-wave activity during the NREM sleep of sleepwalkers and control subjects. , 2000, Sleep.

[10]  J. Montplaisir,et al.  Polysomnographic diagnosis of sleepwalking: Effects of sleep deprivation , 2008, Annals of neurology.

[11]  J. Kaprio,et al.  Prevalence and Genetics of Sleepwalking , 1997, Neurology.

[12]  R G Priest,et al.  Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders. , 1999, The Journal of clinical psychiatry.

[13]  M. Llorente,et al.  Night terrors in adults: phenomenology and relationship to psychopathology. , 1992, The Journal of clinical psychiatry.

[14]  A. Pradalier,et al.  Somnambulism, Migraine and Propranolol , 1987, Headache.

[15]  A. Besset,et al.  Sleep architecture, slow wave activity, and sleep spindles in adult patients with sleepwalking and sleep terrors , 2000, Clinical Neurophysiology.

[16]  R. Daroff,et al.  The International Classification of Sleep Disorders , 1991, Neurology.

[17]  Randolph C. Arnau,et al.  Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients. , 2001, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[18]  J. Montplaisir,et al.  Precipitating factors of somnambulism , 2008, Neurology.

[19]  A. Beck,et al.  Beck Depression Inventory–II , 2011 .

[20]  P. Areán,et al.  Psychometric evaluation of the Beck Anxiety Inventory with older medical patients. , 1997 .

[21]  M. Crutchfield,et al.  Sleepwalking, night terrors, and consciousness. , 1990, BMJ.

[22]  D. Charney,et al.  Somnambulism: Clinical Characteristics and Personality Patterns , 1980 .

[23]  L. Derogatis,et al.  The SCL-90 and the MMPI: A Step in the Validation of a New Self-Report Scale , 1976, British Journal of Psychiatry.

[24]  Paul L. Hewitt,et al.  The Beck Anxiety Inventory: a psychometric analysis , 1993 .

[25]  C. Howard,et al.  Violence in sleep: medico-legal issues and two case reports , 1987, Psychological Medicine.

[26]  R. Bell,et al.  The Beck Anxiety Inventory in a non-clinical sample. , 1995, Behaviour research and therapy.

[27]  M. Mahowald,et al.  Prevalence and comorbidity of nocturnal wandering in the US adult general population , 2012, Neurology.

[28]  T. Nielsen,et al.  Disturbed dreaming, posttraumatic stress disorder, and affect distress: a review and neurocognitive model. , 2007, Psychological bulletin.

[29]  R. Broughton,et al.  Sleep Disorders: Disorders of Arousal? , 1968, Science.

[30]  P. Sedgwick,et al.  Is there a dissociative process in sleepwalking and night terrors? , 2001, Postgraduate medical journal.

[31]  C. Guilleminault,et al.  Sleepwalking, a disorder of NREM sleep instability. , 2006, Sleep medicine.

[32]  D. Chambless,et al.  Reliability and validity of the beck anxiety inventory , 1992 .

[33]  D C Donderi,et al.  Nightmares and bad dreams: their prevalence and relationship to well-being. , 2000, Journal of abnormal psychology.

[34]  E. Bixler,et al.  Hereditary Factors in Sleepwalking and Night Terrors , 1980, British Journal of Psychiatry.

[35]  David J. A. Dozois,et al.  A psychometric evaluation of the Beck Depression inventory-II , 1998 .

[36]  D. Oudiette,et al.  Dreamlike mentations during sleepwalking and sleep terrors in adults. , 2009, Sleep.

[37]  G. Besson,et al.  Migraine and somnambulism , 2005, Neurology.

[38]  M W Mahowald,et al.  A polysomnographic and clinical report on sleep-related injury in 100 adult patients. , 1989, The American journal of psychiatry.

[39]  A. Beck,et al.  An inventory for measuring clinical anxiety: psychometric properties. , 1988, Journal of consulting and clinical psychology.

[40]  R. Cartwright Re: Pressman, M. Response to Rosalind Cartwright's letter to the editor. Sleep Medicine Reviews 2007; 11(4): 329-333. , 2008, Sleep medicine reviews.

[41]  C. Bassetti,et al.  Violence in sleep , 2009 .

[42]  A. de Weerd,et al.  Sleep disorders and depressive feelings: a global survey with the Beck depression scale. , 2003, Sleep medicine.

[43]  J. Sours,et al.  SOMNAMBULISM: ITS CLINICAL SIGNIFICANCE AND DYNAMIC MEANING IN LATE ADOLESCENCE AND ADULTHOOD. , 1963, Archives of general psychiatry.

[44]  S. Duntley,et al.  Novel genetic findings in an extended family pedigree with sleepwalking , 2011, Neurology.

[45]  A. Beck,et al.  Differentiating Elderly Medical and Psychiatric Outpatients With the Beck Anxiety Inventory , 1994 .

[46]  G. Uguccioni,et al.  Fight or flight? Dream content during sleepwalking/sleep terrors vs. rapid eye movement sleep behavior disorder. , 2013, Sleep medicine.

[47]  T. Stern,et al.  Life-threatening injuries resulting from sleepwalking and night terrors. , 1986, Psychosomatics.

[48]  S. Scholz,et al.  Functional impairment in adult sleepwalkers: a case-control study. , 2013, Sleep.

[49]  A. Desautels,et al.  Somnambulism: clinical aspects and pathophysiological hypotheses , 2013, The Lancet Neurology.

[50]  R A Steer,et al.  Further Evidence for the Construct Validity of the Beck Depression Inventory-II with Psychiatric Outpatients , 1997, Psychological reports.

[51]  F. Pillmann Complex Dream-Enacting Behavior in Sleepwalking , 2009, Psychosomatic medicine.

[52]  Lr Derogatis,et al.  SCL-90-R, Administration, Scoring, and Procedures Manual-II for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series , 1983 .

[53]  C. Guilleminault,et al.  Adult chronic sleepwalking and its treatment based on polysomnography. , 2005, Brain : a journal of neurology.

[54]  张哉根,et al.  Leu-M , 1991 .

[55]  A. Osman,et al.  The beck anxiety inventory: Psychometric properties in a community population , 1993 .

[56]  M. Kivimäki,et al.  The Beck Depression Inventory and General Health Questionnaire as measures of depression in the general population: A validation study using the Composite International Diagnostic Interview as the gold standard , 2012, Psychiatry Research.

[57]  R. Chervin,et al.  Sleepwalking and sleep terrors in prepubertal children: what triggers them? , 2003, Pediatrics.

[58]  L. McWilliams,et al.  Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample , 2003, Pain.

[59]  Kristen C Stone,et al.  Psychometric Evaluation of the Beck Anxiety Inventory: A Sample With Sleep-Disordered Breathing , 2008, Behavioral sleep medicine.

[60]  J. Montplaisir,et al.  Development of Parasomnias From Childhood to Early Adolescence , 2000, Pediatrics.

[61]  M. Pressman Prevalence and Comorbidity of Nocturnal Wandering in the Us Adult General Population , 2013, Neurology.

[62]  J. Carrier,et al.  Effects of Caffeine are more Marked on Daytime Recovery Sleep than on Nocturnal Sleep , 2007, Neuropsychopharmacology.