Sleep Deprivation — a Potent Tool in Uncovering Parasomnias?
Diagnosis of parasomnias in the sleep laboratory is difficult since the nocturnal behavior reported by the patients often does not show in the laboratory. To test the efficacy of sleep deprivation as a tool to provoke somnambulism we investigated 10 patients (three women and seven men, mean age 27 ± 3.4) with somnambulism and/or night terrors. Their standard polysomnographies and nocturnal behavior was compared to that of sex and age matched controls and to polysomnography and behavior after sleep deprivation.
Patients with parasomnias and controls did not show significant differences in sleep parameters with exception of a nonsignificantly longer arousal duration in controls. In the MRI patients with parasomnias did not reveal abnormality of the brain that might release nocturnal behavior.
We found that sleep deprivation enhances complex behavior but not somnambulistic episodes by increasing number of stage shifts and movement time. The majority of somnambulistic behavior is triggered by stage shifts and not by arousal in the sense of the ASDS arousal definition. It is stereotype with few variations in nonviolent action. Its complexity seems to depend on the duration of arousals.
Sleep deprivation can be recommended as an efficacious method to increase complex behavior from sleep. Concerning the underlying pathology it seems to be important to register the quality of arousals triggering the behavior in future investigations instead of focussing number of arousals and stage shifts only.
KeywordsSleep Deprivation Movement Time Sleep Stage Slow Wave Sleep Arousal Index
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