Background: Sleepwalking (SW) is found to affect children predominantly, but it can persist or appear de novo even among adults. In this study, we assessed the demographic, clinical and polysomnographic profile, trigger factors and associated comorbidities of adult-onset (AO-SW) and childhood-onset (CO-SW) adult sleepwalkers. Methods: In adult sleepwalkers, a structured clinical interview, a battery of questionnaires, video-polysomnography (v-PSG) and standard electroencephalography (EEG) were performed. Results: Among 63 sleepwalkers, 45% had ≥1 episodes/month, 54% had partial recall of the episodes and 36% reported trigger factors for SW. Almost all subjects reported co-occurring parasomnias. In v-PSG, 4% exhibited episodes of SW, 17% confusional arousals, 21% had an increased apnea-hypopnea-index and 6% exhibited features of an overlap parasomnia disorder. In our cohort, 73% reported CO-SW and 27% AO-SW. In subjects with AO-SW, positive family history for parasomnias was found in 33% (vs. 49% in CO-SW), neurological comorbidities in 44% (vs. 14%), psychiatric comorbidities in 25% (vs. 33%), EEG abnormalities in 50% (vs. 29%). Violence during SW episodes was more frequent in males and in subjects with CO-SW (45% for self-injury and 44% for violent behaviour vs. 33 and 29% respectively in the AO-SW group). Conclusions: Adult SW represents a complex and potentially dangerous condition. The characteristics of AO-SW often differ from those of CO-SW.

Broughton RJ: Sleep disorders: disorders of arousal? Enuresis, somnambulism, and nightmares occur in confusional states of arousal, not in “dreaming sleep”. Science 1968; 159: 1070–1078.
Kales A, Jacobson A, Paulson MJ, Kales JD, Walter RD: Somnambulism: psychophysiological correlates. I. All-night EEG studies. Arch Gen Psychiatry 1966; 14: 586–594.
Hublin C, Kaprio J: Genetic aspects and genetic epidemiology of parasomnias. Sleep Med Rev 2003; 7: 413–421.
Kales A, Soldatos CR, Caldwell AB, et al: Somnambulism. Clinical characteristics and personality patterns. Arch Gen Psychiatry 1980; 37: 1406–1410.
Hublin C, Kaprio J, Partinen M, Heikkilä K, Koskenvuo M: Prevalence and genetics of sleepwalking: a population-based twin study. Neurology 1997; 48: 177–181.
Ohayon MM, Mahowald MW, Dauvilliers Y, Krystal AD, Leger D: Prevalence and comorbidity of nocturnal wandering in the U.S. adult general population. Neurology 2012; 78: 1583–1589.
Lopez R, Jaussent I, Scholz S, Bayard S, Montplaisir J, Dauvilliers Y: Functional impairment in adult sleepwalkers: a case-control study. Sleep 2013; 36: 345–351.
Labelle MA, Desautels A, Montplaisir J, Zadra A: Psychopathologic correlates of adult sleepwalking. Sleep Med 2013; 14: 1348–1355.
Bušková J, Piško J, Pastorek L, Šonka K: The course and character of sleepwalking in adulthood: a clinical and polysomnographic study. Behav Sleep Med 2015; 13: 169–177.
Lam SP, Fong SY, Yu MW, Li SX, Wing YK: Sleepwalking in psychiatric patients: comparison of childhood and adult onset. Aust N Z J Psychiatry 2009; 43: 426–430.
Di Fabio N, Poryazova R, Oberholzer M, Baumann CR, Bassetti CL: Sleepwalking, REM sleep behaviour disorder and overlap parasomnia in patients with Parkinson’s disease. Eur Neurol 2013; 70: 297–303.
AASM Manual for the Scoring of Sleep and Associated Events: Rules TaTS, ed 1. Westchester/IL, American Academy of Sleep Medicine, 2007.
Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14: 540–545.
Bloch KE, Schoch OD, Zhang JN, Russi EW: German version of the Epworth Sleepiness Scale. Respiration 1999; 66: 440–447.
Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV: Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004; 27: 1255–1273.
Frauscher B, Iranzo A, Gaig C, et al: Normative EMG values during REM sleep for the diagnosis of REM sleep behavior disorder. Sleep 2012; 35: 835–847.
Siclari F, Khatami R, Urbaniok F, et al: Violence in sleep. Brain2010; 133: 3494–3509.
Schenck CH, Boyd JL, Mahowald MW: A parasomnia overlap disorder involving sleepwalking, sleep terrors, and REM sleep behavior disorder in 33 polysomnographically confirmed cases. Sleep 1997; 20: 972–981.
Guilleminault C, Kirisoglu C, Bao G, Arias V, Chan A, Li KK: Adult chronic sleepwalking and its treatment based on polysomnography. Brain 2005; 128: 1062–1069.
Ohayon MM, Guilleminault C, Priest RG: Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders. J Clin Psychiatry 1999; 60: 268–276; quiz 277.
Espa F, Dauvilliers Y, Ondze B, Billiard M, Besset A: Arousal reactions in sleepwalking and night terrors in adults: the role of respiratory events. Sleep 2002; 25: 871–875.
Kang SH, Yoon IY, Lee SD, Han JW, Kim TH, Kim KW: REM sleep behavior disorder in the Korean elderly population: prevalence and clinical characteristics. Sleep 2013; 36: 1147–1152.
Lin FC, Lai CL, Huang P, Liu CK, Hsu CY: The rapid-eye-movement sleep behavior disorder in Chinese-Taiwanese patients. Psychiatry Clin Neurosci 2009; 63: 557–562.
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