Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults

Anna Castelnovo,1– 3 Giuseppe Loddo,4 Federica Provini,5,6 Silvia Miano,1 Mauro Manconi1,2,7 1Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; 2Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland;...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Castelnovo A, Loddo G, Provini F, Miano S, Manconi M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	somnambulism confusional arousal parasomnia dream consciousness mental content amnesia Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/d195b8d14ca74f80a4b8ad99546c7956
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d195b8d14ca74f80a4b8ad99546c7956
record_format	dspace
spelling	oai:doaj.org-article:d195b8d14ca74f80a4b8ad99546c79562021-12-02T17:07:12ZMental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults1179-1608https://doaj.org/article/d195b8d14ca74f80a4b8ad99546c79562021-06-01T00:00:00Zhttps://www.dovepress.com/mental-activity-during-episodes-of-sleepwalking-night-terrors-or-confu-peer-reviewed-fulltext-article-NSShttps://doaj.org/toc/1179-1608Anna Castelnovo,1– 3 Giuseppe Loddo,4 Federica Provini,5,6 Silvia Miano,1 Mauro Manconi1,2,7 1Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; 2Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; 3University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; 4Department of Primary Care, Azienda USL di Bologna, Bologna, Italia; 5IRCSS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia; 6Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italia; 7Department of Neurology, University Hospital, Inselspital, Bern, SwitzerlandCorrespondence: Anna Castelnovo Ospedale Civico Via Tesserete 46, Lugano, 6900, SwitzerlandEmail anna.castelnovo@eoc.chObjective/Background: Night terrors, sleepwalking and confusional arousals are behavioral manifestations of incomplete awakenings from sleep. According to international diagnostic criteria, these behaviors occur in the absence of any mental experience, or in the presence of very limited cognition or dream imagery (eg, a single visual scene). The aim of this study was to systematically and retrospectively investigate the mental content associated with sleep terrors and/or sleepwalking in both children and adults.Patients and Methods: Forty-five consecutive patients referred for a diagnosis of disorders of arousal (DOA) of all subtypes (sleepwalking/sleep terrors/confusional arousals) (25 adults: 30 ± 6 y, 15 females; 20 children: 10 ± 3 y, 6 females) underwent a detailed semi-structured interview about the mental content associated with their nocturnal episodes. The interview was comprehensive of specific questions about their subjective recall rate, several content details (characters, emotions, actions and setting/context), and hallucinatory or dissociative experiences during clinical episodes. Patients’ reports were classified for complexity (Orlinsky scale) and content (Hall and Van de Castle categories).Results: More than two-third of the children (n = 14) could not recall any mental activity associated with their episodes, whereas more than two-third (n = 16) of the adults recalled at least one mental experience. Half of the adult patients (n = 8) estimated that a specific mental content was subjectively present around 50% or more of the times. Seven adults and one child described clear and vivid hallucinatory experiences of “dreamed” objects or characters projected onto their real home environment, in the absence of any reality testing. Five adults and two children described one or more dissociative experiences. The content of the collected reports was dominated by dynamic actions acted out from a self-perspective, often with apprehension and in response to misfortune and danger, in a home-setting environment.Conclusion: These results suggest that current diagnostic criteria are tailored around the typical presentation of DOA in children, and do not always fit to adult patients with DOA. Furthermore, they support the concept that consciousness may reemerge in DOA patients during clinical episodes, in a peculiar dissociated, psychotic-like form.Keywords: somnambulism, confusional arousal, parasomnia, dream, consciousness, mental content, amnesiaCastelnovo ALoddo GProvini FMiano SManconi MDove Medical Pressarticlesomnambulismconfusional arousalparasomniadreamconsciousnessmental contentamnesiaPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 13, Pp 829-840 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	somnambulism confusional arousal parasomnia dream consciousness mental content amnesia Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	somnambulism confusional arousal parasomnia dream consciousness mental content amnesia Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Castelnovo A Loddo G Provini F Miano S Manconi M Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults
description	Anna Castelnovo,1– 3 Giuseppe Loddo,4 Federica Provini,5,6 Silvia Miano,1 Mauro Manconi1,2,7 1Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; 2Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; 3University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; 4Department of Primary Care, Azienda USL di Bologna, Bologna, Italia; 5IRCSS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia; 6Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italia; 7Department of Neurology, University Hospital, Inselspital, Bern, SwitzerlandCorrespondence: Anna Castelnovo Ospedale Civico Via Tesserete 46, Lugano, 6900, SwitzerlandEmail anna.castelnovo@eoc.chObjective/Background: Night terrors, sleepwalking and confusional arousals are behavioral manifestations of incomplete awakenings from sleep. According to international diagnostic criteria, these behaviors occur in the absence of any mental experience, or in the presence of very limited cognition or dream imagery (eg, a single visual scene). The aim of this study was to systematically and retrospectively investigate the mental content associated with sleep terrors and/or sleepwalking in both children and adults.Patients and Methods: Forty-five consecutive patients referred for a diagnosis of disorders of arousal (DOA) of all subtypes (sleepwalking/sleep terrors/confusional arousals) (25 adults: 30 ± 6 y, 15 females; 20 children: 10 ± 3 y, 6 females) underwent a detailed semi-structured interview about the mental content associated with their nocturnal episodes. The interview was comprehensive of specific questions about their subjective recall rate, several content details (characters, emotions, actions and setting/context), and hallucinatory or dissociative experiences during clinical episodes. Patients’ reports were classified for complexity (Orlinsky scale) and content (Hall and Van de Castle categories).Results: More than two-third of the children (n = 14) could not recall any mental activity associated with their episodes, whereas more than two-third (n = 16) of the adults recalled at least one mental experience. Half of the adult patients (n = 8) estimated that a specific mental content was subjectively present around 50% or more of the times. Seven adults and one child described clear and vivid hallucinatory experiences of “dreamed” objects or characters projected onto their real home environment, in the absence of any reality testing. Five adults and two children described one or more dissociative experiences. The content of the collected reports was dominated by dynamic actions acted out from a self-perspective, often with apprehension and in response to misfortune and danger, in a home-setting environment.Conclusion: These results suggest that current diagnostic criteria are tailored around the typical presentation of DOA in children, and do not always fit to adult patients with DOA. Furthermore, they support the concept that consciousness may reemerge in DOA patients during clinical episodes, in a peculiar dissociated, psychotic-like form.Keywords: somnambulism, confusional arousal, parasomnia, dream, consciousness, mental content, amnesia
format	article
author	Castelnovo A Loddo G Provini F Miano S Manconi M
author_facet	Castelnovo A Loddo G Provini F Miano S Manconi M
author_sort	Castelnovo A
title	Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults
title_short	Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults
title_full	Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults
title_fullStr	Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults
title_full_unstemmed	Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults
title_sort	mental activity during episodes of sleepwalking, night terrors or confusional arousals: differences between children and adults
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/d195b8d14ca74f80a4b8ad99546c7956
work_keys_str_mv	AT castelnovoa mentalactivityduringepisodesofsleepwalkingnightterrorsorconfusionalarousalsdifferencesbetweenchildrenandadults AT loddog mentalactivityduringepisodesofsleepwalkingnightterrorsorconfusionalarousalsdifferencesbetweenchildrenandadults AT provinif mentalactivityduringepisodesofsleepwalkingnightterrorsorconfusionalarousalsdifferencesbetweenchildrenandadults AT mianos mentalactivityduringepisodesofsleepwalkingnightterrorsorconfusionalarousalsdifferencesbetweenchildrenandadults AT manconim mentalactivityduringepisodesofsleepwalkingnightterrorsorconfusionalarousalsdifferencesbetweenchildrenandadults
_version_	1718381585777033216

Mental Activity During Episodes of Sleepwalking, Night Terrors or Confusional Arousals: Differences Between Children and Adults

Ejemplares similares