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In the midst of a night terror, the affected person may wander in a distressed state while still asleep, and examples of sufferers attempting to run or aggressively defend themselves during these incidents have been reported in medical literature. [15] In some cases, sleepwalking in adults may be a symptom of a psychological disorder.
The onset of symptoms is usually within 2 and 3 hours of sleep onset (at the time of transition from slow-wave sleep to a lighter sleep stage) and those events can last from 10 to 30 minutes. Patients generally wake up without any recollection of the event. It is necessary to distinguish confusional arousals in adults from children. [3]
Night terror, also called sleep terror, is a sleep disorder causing feelings of panic or dread and typically occurring during the first hours of stage 3–4 non-rapid eye movement (NREM) sleep [1] and lasting for 1 to 10 minutes. [2]
Sleep onset is the transition from wakefulness into sleep. Sleep onset usually transits into non-rapid eye movement sleep (NREM sleep) but under certain circumstances (e.g. narcolepsy ) it is possible to transit from wakefulness directly into rapid eye movement sleep (REM sleep).
RBD is a sleep disorder characterized by the loss of normal skeletal muscle atonia during REM sleep and is associated with prominent motor activity and vivid dreaming. [6] [2] These dreams often involve screaming, shouting, laughing, crying, arm flailing, kicking, punching, choking, and jumping out of bed.
Sleep specialists measure the patient's sleep onset and offset, dim light melatonin onset, and evaluate Horne-Ostberg morningness-eveningness questionnaire results. Sleep specialists may also conduct a polysomnography test to rule out other sleep disorders like narcolepsy. Age and family history of the patient is also taken into consideration. [2]
Sleep-talking can also be caused by depression, sleep deprivation, day-time drowsiness, alcohol, and fever. It often occurs in association with other sleep disorders such as confusional arousals, sleep apnea, and REM sleep behavior disorder. In rare cases, adult-onset sleep-talking is linked with a psychiatric disorder or nocturnal seizure. [2]
Sleep apnea is the second most frequent cause of secondary hypersomnia, affecting up to 4% of middle-aged adults, mostly men. Upper airway resistance syndrome (UARS) is a clinical variant of sleep apnea that can also cause hypersomnia. [8] Just as other sleep disorders (like narcolepsy) can coexist with sleep apnea, the same is true for UARS.