Sleep and wakefulness in somnambulism: a spectral analysis study.
OBJECTIVE
The sleep structure and the dynamics of EEG slow-wave activity (SWA) were investigated in 12 young adults and age- and gender-matched controls.


METHODS
Polysomnography was performed in subjects with well-documented chronic sleepwalking and in matched controls. Blinded visual scoring was performed using the international criteria from the Rechtschaffen and Kales atlas [A manual of standardized technology, techniques and scoring systems for sleep stages of human subjects. Los Angeles: UCLA Brain Information Service, Brain Research Institute, 1968.] and by determining the presence of microarousals as defined in the American Sleep Disorders Association (ASDA) atlas [Sleep 15 (1992) 173.]. An evaluation of SWA overnight was performed on total nocturnal sleep to determine if a difference existed between groups of subjects, since sleepwalking usually originates with slow-wave sleep. Investigation of the delta power in successive nonoverlapping 4-second windows in the 32 seconds just prior to EMG activity associated with a confusional arousal was also conducted. One central EEG lead was used for all analyses.


RESULTS
Somnambulistic individuals experienced more disturbed sleep than controls during the first NREM-REM sleep cycle. They had a higher number of ASDA arousals and presented lower peak of SWA during the first cycle that led to a lower SWA decline overnight. When the investigation focused on the short segment immediately preceding a confusional arousal, they presented an important increase in the relative power of low delta (0.75-2 Hz) just prior to the confusional arousal.


CONCLUSIONS
Sleepwalkers undergo disturbed nocturnal sleep at the beginning of the night. The increased power of low delta just prior to the confusional arousal experienced may not be related to Stages 3-4 NREM sleep. We hypothesize that it may be translated as a cortical reaction to brain activation.
Guilleminault
C
C
Stanford Sleep Disorders Clinic and Research Center, Stanford University, Suite 3301, 401 Quarry Road, Stanford, CA 94605, USA. cguil@leland.stanford.edu
Poyares
D
D
Aftab
F A
FA
Palombini
L
L
Abat
F
F
D000328:Adult; D001143:Arousal / Q000502:physiology; D001921:Brain / Q000503:physiopathology; D004569:Electroencephalography; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012895:Sleep, REM / Q000502:physiology; D013009:Somnambulism / Q000453:epidemiology* / Q000503:physiopathology; D014851:Wakefulness / Q000502:physiology*