Luczenie – Rokowania, prognozy i postęp choroby

Luczenie
Rokowania, prognozy i postęp choroby

Lunatykowanie (somnambulizm) jest zaburzeniem snu o zróżnicowanym rokowaniu, silnie zależnym od wieku pacjenta, współistniejących chorób oraz zastosowanego leczenia. Epidemiologicznie, częstość występowania w ciągu ostatnich 12 miesięcy wynosi 5,0% (95% CI: 3,8-6,5) u dzieci oraz 1,5% (95% CI: 1,0-2,3) u dorosłych, a częstość całkowita w populacji to 6,9% (95% CI: 4,6-10,3). Zaburzenie zwykle ustępuje samoistnie z wiekiem, zaledwie około 1% dzieci kontynuuje epizody w dorosłości. Rokowanie pogarszają czynniki takie jak wysoki poziom lęku, impulsywność, współistniejące zaburzenia snu oraz stres środowiskowy. Lunatykowanie może prowadzić do obniżonej jakości życia, nadmiernej senności dziennej, objawów lękowych i depresyjnych oraz zwiększonego ryzyka urazów, w tym rzadkich, ale poważnych zachowań agresywnych i seksualnych (seksomnia).

Rokowanie lunatykowania (Łuczenie) – ocena przewidywanych wyników

Rokowanie w zależności od wieku pacjenta
Czynniki wpływające na przebieg choroby
Konsekwencje długoterminowe
Wpływ interwencji terapeutycznych na rokowanie
Wskazania do leczenia a rokowanie
Wnioski dotyczące rokowania
Kolejne rozdziały

Rokowanie lunatykowania (Łuczenie) – ocena przewidywanych wyników

Lunatykowanie (łuczenie) stanowi zaburzenie snu, którego rokowanie może być zróżnicowane w zależności od wieku pacjenta, współistniejących chorób i zastosowanego leczenia. Właściwe zrozumienie możliwego przebiegu choroby pozwala lekarzom na odpowiednie planowanie postępowania terapeutycznego i prewencyjnego.¹²

Rokowanie w zależności od wieku pacjenta

Występowanie lunatykowania wykazuje wyraźną zależność od wieku, co bezpośrednio wpływa na rokowanie długoterminowe. Według danych epidemiologicznych, częstość występowania lunatykowania jest znacząco wyższa w populacji pediatrycznej niż wśród dorosłych:³⁴

Aktualna częstość występowania w ciągu ostatnich 12 miesięcy wynosi 5,0% (95% CI: 3,8-6,5) u dzieci
U dorosłych częstość wynosi zaledwie 1,5% (95% CI: 1,0-2,3)
Szacowana częstość występowania lunatykowania w ciągu całego życia kształtuje się na poziomie 6,9% (95% CI: 4,6-10,3)

⁵

Co istotne z punktu widzenia prognostycznego, lunatykowanie zazwyczaj ustępuje samoistnie wraz z wiekiem. Jedynie około 1% osób, które doświadczały epizodów lunatykowania w dzieciństwie, kontynuuje te zachowania w wieku dorosłym. Nawet jeśli zaburzenie utrzymuje się w dorosłości, częstotliwość epizodów zwykle maleje z wiekiem.⁶

Czynniki wpływające na przebieg choroby

Rokowanie w lunatykowaniu jest uzależnione od kilku kluczowych czynników, które mogą wpływać na częstotliwość, nasilenie i konsekwencje epizodów:⁷⁸

Predyspozycje psychologiczne – pacjenci z lunatykowaniem często wykazują zwiększone poszukiwanie nowości (novelty seeking) i impulsywność, co może wiązać się z większą aktywnością układu nagrody i wpływać na utrzymywanie się objawów
Poziom lęku – osoby lunatykujące częściej doświadczają lęku antycypacyjnego (HA1) i martwią się o przyszłe wydarzenia, co może zaostrzać objawy
Czynniki środowiskowe – w tym stres społeczny i odrzucenie, które mogą nasilać epizody
Współistniejące zaburzenia snu – obecność innych zaburzeń snu może pogarszać rokowanie

⁹¹⁰¹¹

Badania wskazują na istnienie ciągłości między aktywnością mózgu i zachowaniem w stanie czuwania a aktywnością podczas snu, co może wyjaśniać utrzymywanie się epizodów lunatykowania u osób z określonymi cechami osobowości związanymi z układem nagrody.¹²

Konsekwencje długoterminowe

Mimo że lunatykowanie jest często postrzegane jako względnie łagodne zaburzenie, może prowadzić do istotnych konsekwencji długoterminowych:¹³

Obniżona jakość życia związana ze zdrowiem – udokumentowano, że pacjenci z lunatykowaniem doświadczają gorszej jakości życia w porównaniu z grupami kontrolnymi
Nadmierna senność dzienna i zmęczenie – przewlekłe zaburzenia prowadzą do zaburzeń funkcjonowania w ciągu dnia
Objawy lękowe i depresyjne – występują częściej u osób z lunatykowaniem
Zwiększone ryzyko urazów – pacjenci narażeni są na urazy wynikające z przypadkowych upadków, skoków przez okno czy innych niebezpiecznych działań podczas epizodów
Rzadkie, ale potencjalnie poważne zachowania – w tym nieodpowiednie zachowania seksualne (seksomnię) czy agresję

¹⁴¹⁵

Lunatykowanie u dorosłych powinno być traktowane jako potencjalnie poważny stan, którego konsekwencje nie powinny być ignorowane. Zaburzenie to pozostaje często nierozpoznane, mimo że może być wyraźnie związane z konsekwencjami dziennymi i zaburzeniami nastroju prowadzącymi do znacznego wpływu na jakość życia.¹⁶

Wpływ interwencji terapeutycznych na rokowanie

Interwencje terapeutyczne mogą znacząco poprawić rokowanie w lunatykowaniu. Wybór metody leczenia powinien być dostosowany do indywidualnych potrzeb pacjenta:¹⁷¹⁸

Psychoterapia ukierunkowana na zaburzenia snu – może pomóc pacjentom rozwinąć strategie radzenia sobie z indywidualnymi konfliktami psychologicznymi, zmniejszając częstotliwość i intensywność epizodów oraz poprawiając architekturę snu
Planowane budzenie – technika o niskim ryzyku skutków ubocznych, która może zmniejszać częstotliwość epizodów
Hipnoza – wykazuje potencjał terapeutyczny przy minimalnym ryzyku działań niepożądanych
Interwencje farmakologiczne – stosowane w wybranych przypadkach, choć brak jest badań klinicznych potwierdzających ich skuteczność

¹⁹²⁰

Istotnym elementem poprawiającym rokowanie jest również tworzenie bezpiecznego środowiska snu oraz unikanie przez osoby zagrożone zachowaniami agresywnymi podczas lunatykowania alkoholu i narkotyków, które są znanymi czynnikami nasilającymi impulsywność.²¹²²

Wskazania do leczenia a rokowanie

Nie wszyscy pacjenci z lunatykowaniem wymagają leczenia, co ma istotne znaczenie dla rokowania. Interwencje terapeutyczne są wskazane w następujących sytuacjach:²³²⁴

Epizody lunatykowania stwarzają ryzyko urazu
Zaburzenie zakłóca funkcjonowanie członków rodziny
Prowadzi do zakłopotania lub zaburzeń snu u osoby lunatykującej
Współistnieją inne zaburzenia snu powodujące senność dzienną
Występują problemy behawioralne i emocjonalne
Pacjent ogranicza swoje aktywności (np. unikanie wyjazdów szkolnych, podróży) z powodu lunatykowania

²⁵²⁶²⁷

Leczenie koncentruje się przede wszystkim na zapewnieniu bezpieczeństwa oraz eliminacji czynników wywołujących lunatykowanie, co znacząco poprawia rokowanie długoterminowe.²⁸

Zalecenia praktyczne wpływające na rokowanie

W celu poprawy rokowania i zmniejszenia ryzyka powikłań związanych z lunatykowaniem, zaleca się:²⁹³⁰

Stworzenie bezpiecznego środowiska snu (zabezpieczenie okien, usunięcie przeszkód, blokady drzwi)
Regularną konsultację ze specjalistą zaburzeń snu, szczególnie gdy lunatykowanie utrzymuje się w dorosłości
Identyfikację i leczenie współistniejących zaburzeń snu, które mogą nasilać objawy
Wdrożenie regularnej higieny snu i unikanie czynników zaostrzających (deprywacja snu, stres)
Abstynencję od alkoholu i substancji psychoaktywnych, szczególnie u osób z ryzykiem zachowań agresywnych podczas epizodów

³¹³²

Pomimo braku randomizowanych badań klinicznych oceniających skuteczność różnych metod leczenia lunatykowania, stosowanie interwencji o niskim ryzyku działań niepożądanych jest zalecane w przypadkach powodujących osobisty dyskomfort lub przemoc wobec innych.³³

Wnioski dotyczące rokowania

Rokowanie w lunatykowaniu jest generalnie korzystne, szczególnie u dzieci, u których zaburzenie zwykle ustępuje samoistnie wraz z dojrzewaniem. U pacjentów, u których lunatykowanie utrzymuje się w dorosłości, właściwe postępowanie diagnostyczne i terapeutyczne może znacząco zmniejszyć częstotliwość i nasilenie epizodów oraz związane z nimi ryzyko.³⁴³⁵

Czynniki prognostyczne wskazujące na potencjalnie gorsze rokowanie obejmują:³⁶³⁷

Utrzymywanie się lunatykowania w dorosłości
Wysokie nasilenie lęku i depresji
Współistniejące inne zaburzenia snu
Obecność cech osobowości związanych z poszukiwaniem nowości i impulsywnością
Brak odpowiedniego leczenia współistniejących problemów psychologicznych

³⁸³⁹

Należy podkreślić, że lunatykowanie u dorosłych, często uznawane za łagodny stan, może być potencjalnie poważnym zaburzeniem wpływającym na jakość życia związaną ze zdrowiem. Właściwe rozpoznanie i leczenie może zapewnić istotną poprawę funkcjonowania pacjentów i zmniejszyć związane z tym zaburzeniem obciążenie.⁴⁰⁴¹

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

Materiały źródłowe

#1 Sleepwalking (Somnambulism): Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/14292-sleepwalking
Sleepwalking increases your risk of injury. You may slip and fall or do other things that you shouldn’t do unless you’re fully awake and attentive. Though it’s uncommon, some people who sleepwalk may do things to others that aren’t appropriate or safe. Examples include inappropriate sexual behaviors (also known as sexsomnia). Others may experience confusion and become agitated if woken up. For these reasons, it’s important to try to prevent sleepwalking episodes and take safety precautions. […] Sleepwalking is usually something children grow out of once they reach puberty. Only about 1% of people who walked in their sleep as children are still sleepwalking as adults. If you don’t grow out of it, the episodes usually become less frequent as you get older. […] Sleepwalking usually isn’t serious. But people who sleepwalk are at high risk for injury from things like falling down stairs, jumping out of windows, sleep driving, eating and cooking in sleep. There are even recorded instances where people became violent while sleepwalking. Fortunately, violent behavior is very rare.
#2 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
Sleepwalking is a relatively common and innocuous arousal disorder during nonrapid eye movement sleep. […] Most patients who sleepwalk do not require treatment, but comorbid sleep disorders that result in daytime tiredness, and behaviour and emotional problems require assessment and interventions. […] A recent meta-analysis showed the estimated lifetime prevalence of sleepwalking is 6.9% (95% confidence interval [CI]: 4.6, 10.3). […] The current prevalence rate of sleepwalking, within the past 12 months, was significantly higher in children 5.0% (95% CI: 3.8, 6.5) than in adults 1.5% (95% CI: 1.0, 2.3). […] It is essential, therefore, that presentations of sleepwalking with daytime tiredness and/or behavioural and emotional problems, particularly in children, include an assessment of other sleep disorders.
#3 Psychological Treatment for Sleepwalking: two case reports
https://pmc.ncbi.nlm.nih.gov/articles/PMC3072019/
Sleepwalking prevalence rates are higher in childhood than in adulthood. […] The aim of this report was to demonstrate psychological integrity and functioning as a correlate of a sleepwalking predisposition and to describe a sleep disorder-focused psychotherapy as an option for treating sleepwalking in adults that shows effects on sleep-related behaviors, psychological symptoms, and objective sleep data. […] These case reports show that psychological factors may trigger sleepwalking episodes and that psychotherapy helped each patient develop strategies to deal with their individual psychological conflicts, relieving them from sleepwalking-related symptoms as well as reducing frequency and intensity beyond improved sleep architecture. […] In conclusion, the aim of this report was not only to demonstrate that appropriate psychological treatment may improve sleep, relieve symptoms, and diminish episode severity but also to show that psychological factors may precipitate, exacerbate, or even perpetuate sleepwalking.
#4 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
Sleepwalking is a relatively common and innocuous arousal disorder during nonrapid eye movement sleep. […] Most patients who sleepwalk do not require treatment, but comorbid sleep disorders that result in daytime tiredness, and behaviour and emotional problems require assessment and interventions. […] A recent meta-analysis showed the estimated lifetime prevalence of sleepwalking is 6.9% (95% confidence interval [CI]: 4.6, 10.3). […] The current prevalence rate of sleepwalking, within the past 12 months, was significantly higher in children 5.0% (95% CI: 3.8, 6.5) than in adults 1.5% (95% CI: 1.0, 2.3). […] It is essential, therefore, that presentations of sleepwalking with daytime tiredness and/or behavioural and emotional problems, particularly in children, include an assessment of other sleep disorders.
#5 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
Sleepwalking is a relatively common and innocuous arousal disorder during nonrapid eye movement sleep. […] Most patients who sleepwalk do not require treatment, but comorbid sleep disorders that result in daytime tiredness, and behaviour and emotional problems require assessment and interventions. […] A recent meta-analysis showed the estimated lifetime prevalence of sleepwalking is 6.9% (95% confidence interval [CI]: 4.6, 10.3). […] The current prevalence rate of sleepwalking, within the past 12 months, was significantly higher in children 5.0% (95% CI: 3.8, 6.5) than in adults 1.5% (95% CI: 1.0, 2.3). […] It is essential, therefore, that presentations of sleepwalking with daytime tiredness and/or behavioural and emotional problems, particularly in children, include an assessment of other sleep disorders.
#6 Sleepwalking (Somnambulism): Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/14292-sleepwalking
Sleepwalking increases your risk of injury. You may slip and fall or do other things that you shouldn’t do unless you’re fully awake and attentive. Though it’s uncommon, some people who sleepwalk may do things to others that aren’t appropriate or safe. Examples include inappropriate sexual behaviors (also known as sexsomnia). Others may experience confusion and become agitated if woken up. For these reasons, it’s important to try to prevent sleepwalking episodes and take safety precautions. […] Sleepwalking is usually something children grow out of once they reach puberty. Only about 1% of people who walked in their sleep as children are still sleepwalking as adults. If you don’t grow out of it, the episodes usually become less frequent as you get older. […] Sleepwalking usually isn’t serious. But people who sleepwalk are at high risk for injury from things like falling down stairs, jumping out of windows, sleep driving, eating and cooking in sleep. There are even recorded instances where people became violent while sleepwalking. Fortunately, violent behavior is very rare.
#7 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares
https://pmc.ncbi.nlm.nih.gov/articles/PMC4546110/
We previously suggested that abnormal sleep behaviors, i.e., as found in parasomnias, may often be the expression of increased activity of the reward system during sleep. […] These results suggest that patients with parasomnia might share common waking personality traits associated to reward-related brain functions. […] Here we directly tested whether reward-related personality traits, such as novelty seeking, are differentially associated with primary sleepwalking and idiopathic nightmares and with specific characteristics of NREM and REM sleep. […] Thus, elevated daytime novelty seeking and impulsivity suggests increased ML-DA activity, which may extend into sleep where it would contribute to overt behaviors in sleepwalkers and increased motivational biases in nightmares. […] The convergence of the phenomenological characteristics of both sleepwalking and nightmares episodes (emotionality and motivated behaviors) with daytime reward-related personality traits (e.g., increased novelty seeking) further indicates a continuity between brain activity/behavior during wake and sleep states.
#8 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares
https://pmc.ncbi.nlm.nih.gov/articles/PMC4546110/
In addition to reward-related traits, patients with parasomnias had higher scores on the anticipatory worry (HA1) subscale, a measure specific for pessimism and worrying about what might go wrong in future, and on the social attachment (RD3) subscale. […] While the level of anxiety in the sleepwalkers of our study did not meet the criteria for generalized anxiety disorder, as expected given the infrequency of severe psychopathology in other studies, both trait anxiety (STAI-T) and anticipatory worrying (HA1 subscale of TCI) measures suggest that sleepwalkers experience more frequent anxiety and worry than controls. […] Thus, both parasomnia subgroups share some general anticipatory fear, which is intermittently exacerbated by social rejection.
#9 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares
https://pmc.ncbi.nlm.nih.gov/articles/PMC4546110/
In addition to reward-related traits, patients with parasomnias had higher scores on the anticipatory worry (HA1) subscale, a measure specific for pessimism and worrying about what might go wrong in future, and on the social attachment (RD3) subscale. […] While the level of anxiety in the sleepwalkers of our study did not meet the criteria for generalized anxiety disorder, as expected given the infrequency of severe psychopathology in other studies, both trait anxiety (STAI-T) and anticipatory worrying (HA1 subscale of TCI) measures suggest that sleepwalkers experience more frequent anxiety and worry than controls. […] Thus, both parasomnia subgroups share some general anticipatory fear, which is intermittently exacerbated by social rejection.
#10 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134504
We previously suggested that abnormal sleep behaviors, i.e., as found in parasomnias, may often be the expression of increased activity of the reward system during sleep. […] These results suggest that patients with parasomnia might share common waking personality traits associated to reward-related brain functions. They also provide further support to the notion that reward-seeking networks are active during human sleep. […] Here we directly tested whether reward-related personality traits, such as novelty seeking, are differentially associated with primary sleepwalking and idiopathic nightmares and with specific characteristics of NREM and REM sleep. […] Thus, elevated daytime novelty seeking and impulsivity suggests increased ML-DA activity, which may extend into sleep where it would contribute to overt behaviors in sleepwalkers and increased motivational biases in nightmares.
#11 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134504
The convergence of the phenomenological characteristics of both sleepwalking and nightmares episodes (emotionality and motivated behaviors) with daytime reward-related personality traits (e.g., increased novelty seeking) further indicates a continuity between brain activity/behavior during wake and sleep states.
#12 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0134504
The convergence of the phenomenological characteristics of both sleepwalking and nightmares episodes (emotionality and motivated behaviors) with daytime reward-related personality traits (e.g., increased novelty seeking) further indicates a continuity between brain activity/behavior during wake and sleep states.
#13 Sleepwalking Causes & the Dangers of Sleepwalking in Adults
https://aasm.org/adult-sleepwalking-is-serious-condition-that-impacts-health-related-quality-of-life/
Adult sleepwalking is serious condition that impacts health-related quality of life. A new study found that adult sleepwalking is a potentially serious condition that may induce violent behaviors and affect health-related quality of life. We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group. What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences and dangers of sleepwalking episodes should not be ignored. Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life. The burden of sleepwalking in adults needs to be highlighted and emphasized.
#14 Sleepwalking (Somnambulism): Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/14292-sleepwalking
Sleepwalking increases your risk of injury. You may slip and fall or do other things that you shouldn’t do unless you’re fully awake and attentive. Though it’s uncommon, some people who sleepwalk may do things to others that aren’t appropriate or safe. Examples include inappropriate sexual behaviors (also known as sexsomnia). Others may experience confusion and become agitated if woken up. For these reasons, it’s important to try to prevent sleepwalking episodes and take safety precautions. […] Sleepwalking is usually something children grow out of once they reach puberty. Only about 1% of people who walked in their sleep as children are still sleepwalking as adults. If you don’t grow out of it, the episodes usually become less frequent as you get older. […] Sleepwalking usually isn’t serious. But people who sleepwalk are at high risk for injury from things like falling down stairs, jumping out of windows, sleep driving, eating and cooking in sleep. There are even recorded instances where people became violent while sleepwalking. Fortunately, violent behavior is very rare.
#15 Sleepwalking Causes & the Dangers of Sleepwalking in Adults
https://aasm.org/adult-sleepwalking-is-serious-condition-that-impacts-health-related-quality-of-life/
Adult sleepwalking is serious condition that impacts health-related quality of life. A new study found that adult sleepwalking is a potentially serious condition that may induce violent behaviors and affect health-related quality of life. We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group. What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences and dangers of sleepwalking episodes should not be ignored. Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life. The burden of sleepwalking in adults needs to be highlighted and emphasized.
#16 Sleepwalking Causes & the Dangers of Sleepwalking in Adults
https://aasm.org/adult-sleepwalking-is-serious-condition-that-impacts-health-related-quality-of-life/
Adult sleepwalking is serious condition that impacts health-related quality of life. A new study found that adult sleepwalking is a potentially serious condition that may induce violent behaviors and affect health-related quality of life. We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group. What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences and dangers of sleepwalking episodes should not be ignored. Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life. The burden of sleepwalking in adults needs to be highlighted and emphasized.
#17 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#18 Psychological Treatment for Sleepwalking: two case reports
https://pmc.ncbi.nlm.nih.gov/articles/PMC3072019/
Sleepwalking prevalence rates are higher in childhood than in adulthood. […] The aim of this report was to demonstrate psychological integrity and functioning as a correlate of a sleepwalking predisposition and to describe a sleep disorder-focused psychotherapy as an option for treating sleepwalking in adults that shows effects on sleep-related behaviors, psychological symptoms, and objective sleep data. […] These case reports show that psychological factors may trigger sleepwalking episodes and that psychotherapy helped each patient develop strategies to deal with their individual psychological conflicts, relieving them from sleepwalking-related symptoms as well as reducing frequency and intensity beyond improved sleep architecture. […] In conclusion, the aim of this report was not only to demonstrate that appropriate psychological treatment may improve sleep, relieve symptoms, and diminish episode severity but also to show that psychological factors may precipitate, exacerbate, or even perpetuate sleepwalking.
#19 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
There have been no clinical trials to assess the efficacy of any treatments for sleepwalking, despite more than 100 years of case reports of psychological, pharmacological and other interventions. […] If sleepwalking is causing distress to the sleepwalker or their family members, or the sleepwalker is limiting their activities (eg not going on school camps or travelling), psychological interventions scheduled waking or hypnosis hold the greatest potential with the least likelihood of adverse effects. […] However, it is also important that people at risk of violence during sleepwalking abstain from alcohol and drugs, which are known to exacerbate impulsivity. […] In the absence of clinical trials, tentative, low-risk treatments are suggested for sleepwalking that results in personal distress or violence towards others.
#20 Psychological Treatment for Sleepwalking: two case reports
https://pmc.ncbi.nlm.nih.gov/articles/PMC3072019/
Sleepwalking prevalence rates are higher in childhood than in adulthood. […] The aim of this report was to demonstrate psychological integrity and functioning as a correlate of a sleepwalking predisposition and to describe a sleep disorder-focused psychotherapy as an option for treating sleepwalking in adults that shows effects on sleep-related behaviors, psychological symptoms, and objective sleep data. […] These case reports show that psychological factors may trigger sleepwalking episodes and that psychotherapy helped each patient develop strategies to deal with their individual psychological conflicts, relieving them from sleepwalking-related symptoms as well as reducing frequency and intensity beyond improved sleep architecture. […] In conclusion, the aim of this report was not only to demonstrate that appropriate psychological treatment may improve sleep, relieve symptoms, and diminish episode severity but also to show that psychological factors may precipitate, exacerbate, or even perpetuate sleepwalking.
#21 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
There have been no clinical trials to assess the efficacy of any treatments for sleepwalking, despite more than 100 years of case reports of psychological, pharmacological and other interventions. […] If sleepwalking is causing distress to the sleepwalker or their family members, or the sleepwalker is limiting their activities (eg not going on school camps or travelling), psychological interventions scheduled waking or hypnosis hold the greatest potential with the least likelihood of adverse effects. […] However, it is also important that people at risk of violence during sleepwalking abstain from alcohol and drugs, which are known to exacerbate impulsivity. […] In the absence of clinical trials, tentative, low-risk treatments are suggested for sleepwalking that results in personal distress or violence towards others.
#22 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#23 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#24 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
Sleepwalking is a relatively common and innocuous arousal disorder during nonrapid eye movement sleep. […] Most patients who sleepwalk do not require treatment, but comorbid sleep disorders that result in daytime tiredness, and behaviour and emotional problems require assessment and interventions. […] A recent meta-analysis showed the estimated lifetime prevalence of sleepwalking is 6.9% (95% confidence interval [CI]: 4.6, 10.3). […] The current prevalence rate of sleepwalking, within the past 12 months, was significantly higher in children 5.0% (95% CI: 3.8, 6.5) than in adults 1.5% (95% CI: 1.0, 2.3). […] It is essential, therefore, that presentations of sleepwalking with daytime tiredness and/or behavioural and emotional problems, particularly in children, include an assessment of other sleep disorders.
#25 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#26 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
Sleepwalking is a relatively common and innocuous arousal disorder during nonrapid eye movement sleep. […] Most patients who sleepwalk do not require treatment, but comorbid sleep disorders that result in daytime tiredness, and behaviour and emotional problems require assessment and interventions. […] A recent meta-analysis showed the estimated lifetime prevalence of sleepwalking is 6.9% (95% confidence interval [CI]: 4.6, 10.3). […] The current prevalence rate of sleepwalking, within the past 12 months, was significantly higher in children 5.0% (95% CI: 3.8, 6.5) than in adults 1.5% (95% CI: 1.0, 2.3). […] It is essential, therefore, that presentations of sleepwalking with daytime tiredness and/or behavioural and emotional problems, particularly in children, include an assessment of other sleep disorders.
#27 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
There have been no clinical trials to assess the efficacy of any treatments for sleepwalking, despite more than 100 years of case reports of psychological, pharmacological and other interventions. […] If sleepwalking is causing distress to the sleepwalker or their family members, or the sleepwalker is limiting their activities (eg not going on school camps or travelling), psychological interventions scheduled waking or hypnosis hold the greatest potential with the least likelihood of adverse effects. […] However, it is also important that people at risk of violence during sleepwalking abstain from alcohol and drugs, which are known to exacerbate impulsivity. […] In the absence of clinical trials, tentative, low-risk treatments are suggested for sleepwalking that results in personal distress or violence towards others.
#28 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#29 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#30 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
There have been no clinical trials to assess the efficacy of any treatments for sleepwalking, despite more than 100 years of case reports of psychological, pharmacological and other interventions. […] If sleepwalking is causing distress to the sleepwalker or their family members, or the sleepwalker is limiting their activities (eg not going on school camps or travelling), psychological interventions scheduled waking or hypnosis hold the greatest potential with the least likelihood of adverse effects. […] However, it is also important that people at risk of violence during sleepwalking abstain from alcohol and drugs, which are known to exacerbate impulsivity. […] In the absence of clinical trials, tentative, low-risk treatments are suggested for sleepwalking that results in personal distress or violence towards others.
#31 Sleepwalking – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511
To diagnose sleepwalking, your healthcare professional reviews your medical history and symptoms. […] If sleepwalking could lead to injury, disrupts family members, or results in embarrassment or sleep disruption for the people who sleepwalk, treatment may be needed. Treatment generally focuses on promoting safety and stopping what’s causing the sleepwalking. […] If sleepwalking is a problem for you or your child, try to: Make the environment safe. […] If you sleepwalk and have concerns about safety or underlying conditions, see your healthcare professional. […] Your healthcare professional may refer you to a sleep specialist. […] Is this likely a short- or long-term condition?
#32 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
There have been no clinical trials to assess the efficacy of any treatments for sleepwalking, despite more than 100 years of case reports of psychological, pharmacological and other interventions. […] If sleepwalking is causing distress to the sleepwalker or their family members, or the sleepwalker is limiting their activities (eg not going on school camps or travelling), psychological interventions scheduled waking or hypnosis hold the greatest potential with the least likelihood of adverse effects. […] However, it is also important that people at risk of violence during sleepwalking abstain from alcohol and drugs, which are known to exacerbate impulsivity. […] In the absence of clinical trials, tentative, low-risk treatments are suggested for sleepwalking that results in personal distress or violence towards others.
#33 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
There have been no clinical trials to assess the efficacy of any treatments for sleepwalking, despite more than 100 years of case reports of psychological, pharmacological and other interventions. […] If sleepwalking is causing distress to the sleepwalker or their family members, or the sleepwalker is limiting their activities (eg not going on school camps or travelling), psychological interventions scheduled waking or hypnosis hold the greatest potential with the least likelihood of adverse effects. […] However, it is also important that people at risk of violence during sleepwalking abstain from alcohol and drugs, which are known to exacerbate impulsivity. […] In the absence of clinical trials, tentative, low-risk treatments are suggested for sleepwalking that results in personal distress or violence towards others.
#34 Sleepwalking (Somnambulism): Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/14292-sleepwalking
Sleepwalking increases your risk of injury. You may slip and fall or do other things that you shouldn’t do unless you’re fully awake and attentive. Though it’s uncommon, some people who sleepwalk may do things to others that aren’t appropriate or safe. Examples include inappropriate sexual behaviors (also known as sexsomnia). Others may experience confusion and become agitated if woken up. For these reasons, it’s important to try to prevent sleepwalking episodes and take safety precautions. […] Sleepwalking is usually something children grow out of once they reach puberty. Only about 1% of people who walked in their sleep as children are still sleepwalking as adults. If you don’t grow out of it, the episodes usually become less frequent as you get older. […] Sleepwalking usually isn’t serious. But people who sleepwalk are at high risk for injury from things like falling down stairs, jumping out of windows, sleep driving, eating and cooking in sleep. There are even recorded instances where people became violent while sleepwalking. Fortunately, violent behavior is very rare.
#35 Assessment and treatment of sleepwalking in clinical practice
https://www.racgp.org.au/afp/2017/august/assessment-and-treatment-of-sleepwalking-in-clinic
Sleepwalking is a relatively common and innocuous arousal disorder during nonrapid eye movement sleep. […] Most patients who sleepwalk do not require treatment, but comorbid sleep disorders that result in daytime tiredness, and behaviour and emotional problems require assessment and interventions. […] A recent meta-analysis showed the estimated lifetime prevalence of sleepwalking is 6.9% (95% confidence interval [CI]: 4.6, 10.3). […] The current prevalence rate of sleepwalking, within the past 12 months, was significantly higher in children 5.0% (95% CI: 3.8, 6.5) than in adults 1.5% (95% CI: 1.0, 2.3). […] It is essential, therefore, that presentations of sleepwalking with daytime tiredness and/or behavioural and emotional problems, particularly in children, include an assessment of other sleep disorders.
#36 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares
https://pmc.ncbi.nlm.nih.gov/articles/PMC4546110/
In addition to reward-related traits, patients with parasomnias had higher scores on the anticipatory worry (HA1) subscale, a measure specific for pessimism and worrying about what might go wrong in future, and on the social attachment (RD3) subscale. […] While the level of anxiety in the sleepwalkers of our study did not meet the criteria for generalized anxiety disorder, as expected given the infrequency of severe psychopathology in other studies, both trait anxiety (STAI-T) and anticipatory worrying (HA1 subscale of TCI) measures suggest that sleepwalkers experience more frequent anxiety and worry than controls. […] Thus, both parasomnia subgroups share some general anticipatory fear, which is intermittently exacerbated by social rejection.
#37 Sleepwalking Causes & the Dangers of Sleepwalking in Adults
https://aasm.org/adult-sleepwalking-is-serious-condition-that-impacts-health-related-quality-of-life/
Adult sleepwalking is serious condition that impacts health-related quality of life. A new study found that adult sleepwalking is a potentially serious condition that may induce violent behaviors and affect health-related quality of life. We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group. What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences and dangers of sleepwalking episodes should not be ignored. Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life. The burden of sleepwalking in adults needs to be highlighted and emphasized.
#38 Increased Reward-Related Behaviors during Sleep and Wakefulness in Sleepwalking and Idiopathic Nightmares
https://pmc.ncbi.nlm.nih.gov/articles/PMC4546110/
In addition to reward-related traits, patients with parasomnias had higher scores on the anticipatory worry (HA1) subscale, a measure specific for pessimism and worrying about what might go wrong in future, and on the social attachment (RD3) subscale. […] While the level of anxiety in the sleepwalkers of our study did not meet the criteria for generalized anxiety disorder, as expected given the infrequency of severe psychopathology in other studies, both trait anxiety (STAI-T) and anticipatory worrying (HA1 subscale of TCI) measures suggest that sleepwalkers experience more frequent anxiety and worry than controls. […] Thus, both parasomnia subgroups share some general anticipatory fear, which is intermittently exacerbated by social rejection.
#39 Sleepwalking Causes & the Dangers of Sleepwalking in Adults
https://aasm.org/adult-sleepwalking-is-serious-condition-that-impacts-health-related-quality-of-life/
Adult sleepwalking is serious condition that impacts health-related quality of life. A new study found that adult sleepwalking is a potentially serious condition that may induce violent behaviors and affect health-related quality of life. We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group. What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences and dangers of sleepwalking episodes should not be ignored. Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life. The burden of sleepwalking in adults needs to be highlighted and emphasized.
#40 Sleepwalking Causes & the Dangers of Sleepwalking in Adults
https://aasm.org/adult-sleepwalking-is-serious-condition-that-impacts-health-related-quality-of-life/
Adult sleepwalking is serious condition that impacts health-related quality of life. A new study found that adult sleepwalking is a potentially serious condition that may induce violent behaviors and affect health-related quality of life. We found a higher frequency of daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms and altered quality of life in patients with sleepwalking compared to the control group. What would usually be considered a benign condition, adult sleepwalking is a potentially serious condition and the consequences and dangers of sleepwalking episodes should not be ignored. Sleepwalking is an underdiagnosed condition that may be clearly associated with daytime consequences and mood disturbances leading to a major impact on quality of life. The burden of sleepwalking in adults needs to be highlighted and emphasized.
#41 Psychological Treatment for Sleepwalking: two case reports
https://pmc.ncbi.nlm.nih.gov/articles/PMC3072019/
Sleepwalking prevalence rates are higher in childhood than in adulthood. […] The aim of this report was to demonstrate psychological integrity and functioning as a correlate of a sleepwalking predisposition and to describe a sleep disorder-focused psychotherapy as an option for treating sleepwalking in adults that shows effects on sleep-related behaviors, psychological symptoms, and objective sleep data. […] These case reports show that psychological factors may trigger sleepwalking episodes and that psychotherapy helped each patient develop strategies to deal with their individual psychological conflicts, relieving them from sleepwalking-related symptoms as well as reducing frequency and intensity beyond improved sleep architecture. […] In conclusion, the aim of this report was not only to demonstrate that appropriate psychological treatment may improve sleep, relieve symptoms, and diminish episode severity but also to show that psychological factors may precipitate, exacerbate, or even perpetuate sleepwalking.