Analysis of polysomnographic events surrounding 252 slow-wave sleep arousals in thirty-eight adults with injurious sleepwalking and sleep terrors

Carlos H. Schenck, Juan A. Pareja, Andrea L. Patterson, Mark W. Mahowald

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106 Scopus citations

Abstract

A systematic study of electrophysiologic events [eight-channel EEG, electrocardiogram, electromyogram (EMGs)] surrounding 252 arousals from slow- wave sleep (SWS) in adults with sleepwalking (SW) and sleep terrors (ST) is reported. Hospital-based, overnight polysomnographic monitoring was conducted in 38 adults presenting to a sleep disorders center with injurious SW, ST (21 males, 17 females; mean age 29 years, range 17-69 years). Before nonbehavioral or behavioral arousals from SWS, neither EEG 'delta wave buildup,' nor heart rate (HR) acceleration, nor tonic/phasic EMG activation was identified. The post-arousal EEG demonstrated three patterns: (a) diffuse, rhythmic, delta activity with a typical frequency of 2.2 Hz, a typical amplitude of 85 μV, and a typical duration of 20 s; (b) diffuse delta and theta activity intermixed with alpha and beta activity; and (c) prominent alpha and beta activity. Multichannel, high-voltage, delta activity was observed in <2% of all prearousal periods. HR acceleration emerged abruptly with SWS arousals, with significant changes in mean pre- versus postarousal HR (p < .001). Macrostructural sleep parameters ('sleep architecture') were intact. Therefore, our findings in adults with SW, ST strongly support the classification of SW/ST as disorders of (abrupt) arousal.

Original languageEnglish (US)
Pages (from-to)159-166
Number of pages8
JournalJournal of Clinical Neurophysiology
Volume15
Issue number2
DOIs
StatePublished - Aug 26 1998

Keywords

  • Arousal/disorders of arousal
  • Electrocardiogram
  • Electroencephalogram
  • Parasomnia
  • Sleep (night) terrors/sleepwalking
  • Slow-wave sleep/delta sleep

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