Sleepwalking in psychiatric patients: comparison of childhood and adult onset.
OBJECTIVE
In contrast to the 'benign and self-limiting nature' of childhood sleepwalking, some population and case studies have suggested that adult sleepwalking is more likely to be associated with psychopathology and psychotropic medications. There is a paucity, however, of systematic study in adult psychiatric populations, and the aim of the present study was therefore to compare the impact of psychopathology and medication usage on sleepwalking with reference to age of onset.


METHODS
Clinical characteristics, sleep symptoms, psychiatric diagnosis and psychotropic usage in 66 childhood- and adult-onset sleepwalkers as identified from a psychiatric clinic, were studied.


RESULTS
There was a higher proportion of adult-onset sleepwalking in the psychiatric population. In comparison with childhood-onset sleepwalkers, adult-onset sleepwalkers had higher peak frequency of attacks and a high comorbidity with sleep-related eating features. Factors including frequent insomnia (odds ratio (OR) = 5.39, 95% confidence interval (CI) = 1.58-18.40, p = 0.007) and lifetime usage of regular zolpidem (OR = 5.58, 95%CI = 1.65-18.84, p < 0.006) were associated with a higher risk of adult-onset sleepwalking.


CONCLUSIONS
Adult-onset sleepwalking in a psychiatric sample has unique clinical characteristics and specific risk factors. These patients were more likely to present with sleep-related eating features, comorbid insomnia, had and lifetime usage of non-benzodiazepine hypnotics, especially zolpidem. A heightened awareness of the presence of sleepwalking and their associated risk factors among the adult psychiatric population is needed.
Department of Psychiatry, Shatin Hospital, Chinese University of Hong Kong, Shatin, Hong Kong. ykwing@cuhk.edu.hk
Siu-Ping
SP
Lam
Samson Yat-Yuk
SY
Fong
Mandy Wai-Man
MW
Yu
Shirley Xin
SX
Li
Yun-Kwok
YK
Wing
D000328:Adult; D017668:Age of Onset; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000009:adverse effects*; D013009:Somnambulism / Q000150:complications* / Q000453:epidemiology*
D011619:Psychotropic Drugs