title: Sleepiness in sleepwalking and sleep terrors: a higher sleep pressure?
abstract: To identify the determinants of excessive daytime sleepiness in adults with sleepwalking or sleep terrors (SW/ST).
  
  
  
  We collected the charts of all consecutive adult patients admitted from 2012 to 2014 for SW/ST. They had completed the Paris Arousal Disorders Severity Scale and the Epworth Sleepiness Scale, and had undergone one (n = 34) or two consecutive (n = 124) nocturnal videopolysomnographies. The demographic, clinical, and sleep determinants of excessive daytime sleepiness (defined as an Epworth Sleepiness Scale score of greater than 10) were analyzed.
  
  
  
  Almost half (46.8%) of the 158 adult patients with SW/ST reported excessive daytime sleepiness. They had shorter sleep onset latencies (in night 1 and night 2), shorter REM sleep latencies, longer total sleep time, and higher REM sleep percentages in night 2, but no greater clinical severity of the parasomnia than patients without sleepiness. The level of sleepiness correlated with the same measures (sleep onset latency on both nights, REM sleep onset latency, and total sleep time in night 2), plus the latency to N3. In the regression model, higher sleepiness was determined by shorter sleep onset latency on night 1, lower number of awakenings in N3 on night 1, and higher total sleep time on night 2.
  
  
  
  Daytime sleepiness in patients with SW/ST is not the consequence of disturbed sleep but is associated with a specific polygraphic phenotype (rapid sleep onset, long sleep time, lower numbers of awakenings on N3) that is suggestive of a higher sleep pressure that may contribute to incomplete arousal from N3.
authors.affiliation: Sleep Disorders Unit of the Pitié-Salpêtrière University Hospital, APHP, Paris, France.
authors.forename: Marisol
authors.initials: M
authors.lastname: Carrillo-Solano
authors.affiliation: Sleep Disorders Unit of the Pitié-Salpêtrière University Hospital, APHP, Paris, France; Biostatistics Department of the Pitié-Salpêtrière University Hospital, APHP, Paris, France.
authors.forename: Smaranda
authors.initials: S
authors.lastname: Leu-Semenescu
authors.affiliation: Sorbonne University, UPMC Univ Paris 06, IHU Neuroscience, Paris, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Golmard
authors.affiliation: Sleep Disorders Unit of the Pitié-Salpêtrière University Hospital, APHP, Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Groos
authors.affiliation: Sleep Disorders Unit of the Pitié-Salpêtrière University Hospital, APHP, Paris, France; Biostatistics Department of the Pitié-Salpêtrière University Hospital, APHP, Paris, France; Brain Research Institute (CRICM), INSERM UMR-S975, CNRS UMR7225, Paris, France. Electronic address: isabelle.arnulf@psl.aphp.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Arnulf
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006970:Disorders of Excessive Somnolence / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D020184:Night Terrors / Q000209:etiology*; D017286:Polysomnography / Q000379:methods; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology*; D012895:Sleep, REM; D013009:Somnambulism / Q000209:etiology*; D014741:Video Recording; D055815:Young Adult
keywords: Parasomnia; Sleep pressure; Sleep terrors; Sleepiness; Sleepwalking