Sleep Talking Research Articles

Snoring in Portuguese primary school children.

To determine the prevalence of snoring and its potential associations with sleep problems, such as daytime symptoms, medical conditions, school performance, and behavioral disturbances in Portuguese children attending primary school. A previously validated questionnaire was sent to the parents of 1381 children attending primary schools in a parish of Coimbra, Portugal. To assess behavioral disturbances, the Portuguese version of Rutter's Children's Behavior Questionnaire for completion by teachers was used. Of the 988 questionnaires returned (71.5%), complete information concerning snoring was obtained for 976 children (496 girls and 480 boys; mean age: 8.1 +/- 1.5 years). Loud snoring during sleep was reported as frequent or constantly present (LSn) in 84 children (8.6%), as occasionally present in 299 children (30.6%), and as never present (NSn) by 593 children (60.8%). The LSn and NSn groups did not differ with respect to age, gender, sleep duration, time to fall asleep, frequency of night wakings, bedwetting, daytime tiredness, and school achievement. However, LSn was significantly associated with increased bedtime problems (fears and struggles), increased need for comforting activities to fall asleep, behaviors suggestive of parasomnias (sleep talking, teeth grinding, and night terrors), increased daytime sleepiness and irritability, and behavioral disturbances. Children in the LSn group were also more likely to report recurrent medical problems particularly those involving infections of the respiratory tract. Snoring is a common symptom in Portuguese children that is associated with behavioral daytime and sleep time disturbances. Children with loud snoring may benefit from early evaluation and intervention.

Statistical genetic analysis of some problem behaviors during sleep in childhood--estimation of genetic and environmental factors influencing multiple health phenomena simultaneously

This study was conducted to clarify the genetic and environmental factors for some problem behaviors during sleep in childhood, namely sleep talking, half-sleeping, night terrors and nocturnal enuresis. The subjects were 881 pairs of twins, consisting of 609 monozygotic (279 male-male, 330 female-female) and 272 dizygotic (86 male-male, 84 female-female, 102 opposite-sexed). They were all applicants to the junior high school affiliated with Tokyo University from 1981 to 1998. The twins' mothers had previously completed a medical questionnaire and had been interviewed by three to five interviewers. With regard to the above mentioned four traits, they selected one answer from the choices 'often', 'sometimes' 'never' and 'unknown' for each twin. The interviewer checked the answers and, where necessary, explained the meaning of any terms such as "night terrors". Genetic analysis was performed as follows. First the answers were summarized in the form of a 2 x 2 contingency table; 'often' and 'sometimes' were included in one category. Then, tetrachoric correlations of the contingency table were calculated according to zygosity using the program package PRELIS2. Furthermore, covariance structure analysis was performed for several genetic models using the program package LISREL8. The results were as follows. Univariate genetic analysis showed that all four traits were under genetic control. Sleep talking, half-sleeping and night terrors were under strong or moderate genetic control. As to nocturnal enuresis, the genetic effect was moderate and shared environmental factors played an important role. Sex difference was observed in the case of half-sleeping and enuresis. Moreover these traits tended to occur together, and sleep talking, half-sleeping and night terrors shared common genetic and environmental factors in addition to specific genetic and environmental factors.

Night terrors, sleepwalking, and confusional arousals in the general population: their frequency and relationship to other sleep and mental disorders.

Arousal parasomnias (night terrors, sleepwalking, and confusional arousals) have seldom been investigated in the adult general population. Clinical studies of parasomnias, however, show that these disorders may be indicators of underlying mental disorders and may have serious consequences. A representative sample of the United Kingdom population (N = 4972) was interviewed by telephone with the Sleep-EVAL system. Night terrors were reported by 2.2% (95% CI = 1.8% to 2.6%) of the sample, sleepwalking by 2.0% (1.6% to 2.4%), and confusional arousals by 4.2% (3.6% to 4.8%). The rate of these 3 parasomnias decreased significantly with age, but no gender difference was observed. Multivariate models identified the following independent factors as associated with confusional arousals (odds ratio [OR]): age of 15-24 years (OR = 4.1), shift work (OR = 2.1), hypnagogic hallucinations (OR = 3.3), deep sleep (OR = 1.6), daytime sleepiness (OR = 1.9), sleep talking (OR = 1.7), daily smoking (OR = 1.7), adjustment disorder (OR = 3.1), and bipolar disorder (OR = 13.0). Factors associated with night terrors were subjective sense of choking or blocked breathing at night (OR = 5.1), obstructive sleep apnea syndrome (OR = 4.1), alcohol consumption at bedtime (OR = 3.9), violent or injury-causing behaviors during sleep (OR = 3.2), hypnagogic hallucinations (OR = 2.2), and nightmares at least 1 night per month (OR = 4.0). Factors associated with sleepwalking were age of 15-24 years (OR = 5.2), subjective sense of choking or blocked breathing at night (OR = 5.1), sleep talking (OR = 5.0), and a road accident in the past year (OR = 3.9) after controlling for possible effects of sleep deprivation, life stress, and mental and sleep disorders. Arousal parasomnias, especially night terrors and confusional arousals, are often the expression of a mental disorder. Other life or medical conditions, such as shift work or excessive need of sleep for confusional arousals and stressful events for sleepwalking, may also trigger parasomnias. Prevalence rates are based on self-reported data and, consequently, are likely underestimated.

Terry

Article Abstract Background: Although the relative incidence of violent behavior during sleep (VBS) is presumed to be low, no epidemiologic data exist to evaluate the prevalence of the phenomenon or to begin to understand its precursors or subtypes. This study examined the frequency of violent or injurious behavior during sleep and associated psychiatric risk factors. Method: A representative United Kingdom sample of 2078 men and 2894 women between the ages of 15 to 100 years (representing 79.6% of those contacted) participated in a telephone interview directed by the Sleep-EVAL expert system specially designed for conducting such diagnostic telephone surveys. Results: Two percent (N=106) of respondents reported currently experiencing VBS. The VBS group experienced more night terrors and daytime sleepiness than the non-VBS group. Sleep talking, bruxism, and hypnic jerks were more frequent within the VBS than the other group, as were hypnagogic hallucinations (especially the experience of being attacked), the incidence of smoking, and caffeine and bedtime alcohol intake. The VBS group also reported current features of anxiety and mood disorders significantly more frequently and reported being hospitalized more often during the previous 12 months than the non-VBS group. Subjects with mood or anxiety disorders that co-occurred with other nocturnal symptoms had a higher risk of reporting VBS than all other subjects. Conclusion: We have identified a number of sleep, mental disorder, and other general health factors that characterize those experiencing episodes of VBS. These findings suggest that specific factors, perhaps reflecting an interaction of lifestyle and hereditary contributions, may be responsible for the observed variability in this rare but potentially serious condition.

Snoring, apnoea and ENT symptoms in the paediatric community.

This study was designed to determine the prevalence of snoring and assess the extent of associated ENT symptoms in children up to 10 years of age. A questionnaire was presented to the parents of 245 children chosen at random from the General Practice list of the town of Frome, Somerset, UK. The prevalence of snoring was found to be 27%. This increased to 47% in the presence of an upper respiratory infection. Snoring was found to be significantly (P < 0.001) associated with a history of poor hearing, restless sleep, and having a cold. Less significant (P < 0.01) associations occurred with parental smoking, eczema, sleep talking, moving around the bed at night, sore throats, having a runny nose and mouth breathing. Snoring is a common symptom in children up to 10 years of age. Without evidence of other ENT disease the snoring child does not require referral to an ENT department for further investigation.

Sleep problems among infants and young children.

Parental concerns about their young children9s sleep are among the most frequent behavior problems discussed with pediatricians. In view of this high prevalence, it is important to review the origins of these problems and emerging information about how best to manage them. Definition Sleep disorders among children can be classified as dyssomnias, parasomnias, and disruptions secondary to other conditions. The dyssomnias are disturbances in the amount or timing of the sleep. They include intrinsic sleep disorders such as narcolepsy and sleep apnea, interactional sleep disorders such as excessive night waking, and sleep phase disorders, when the time the parents assign for sleep and the child9s period of needing it are not synchronous. Parasomnias, on the other hand, are abnormal behaviors that occur during sleep, such as night terrors, nightmares, sleep walking, and sleep talking. Sleep also can be disturbed as the result of various mental and physical conditions, including asthma, epilepsy, and anxiety disorders. The dyssomnias (sleep refusal and night waking) and parasomnias (night terrors and nightmares) of infancy and early childhood are the most common complaints of parents to pediatricians. Sometimes, however, parents may not seek help for these problems; at other times, they may be concerned by what actually is normal sleep behavior.

Sleep Problems Among Infants and Young Children

Parental concerns about their young children's sleep are among the most frequent behavior problems discussed with pediatricians. In view of this high prevalence, it is important to review the origins of these problems and emerging information about how best to manage them. Definition Sleep disorders among children can be classified as dyssomnias, parasomnias, and disruptions secondary to other conditions. The dyssomnias are disturbances in the amount or timing of the sleep. They include intrinsic sleep disorders such as narcolepsy and sleep apnea, interactional sleep disorders such as excessive night waking, and sleep phase disorders, when the time the parents assign for sleep and the child's period of needing it are not synchronous. Parasomnias, on the other hand, are abnormal behaviors that occur during sleep, such as night terrors, nightmares, sleep walking, and sleep talking. Sleep also can be disturbed as the result of various mental and physical conditions, including asthma, epilepsy, and anxiety disorders. The dyssomnias (sleep refusal and night waking) and parasomnias (night terrors and nightmares) of infancy and early childhood are the most common complaints of parents to pediatricians. Sometimes, however, parents may not seek help for these problems; at other times, they may be concerned by what actually is normal sleep behavior.

REM sleep without atonia at early stage of sporadic olivopontocerebellar atrophy

In order to investigate whether REM sleep without atonia (RWA) is detected even at early stage of sporadic olivopontocerebellar atrophy (OPCA), all-night polysomnography with video monitoring was performed on 5 patients presenting with no nocturnal behavioral complaints. RWA associated with sleep talk and/or minor movements in the head, neck, face and extremities was documented in all cases. Preserved proper NREM/REM cycle and relatively normal sleep architecture suggest the abnormality is confined to REM sleep. Dysfunction of the mechanisms underlying muscle atonia in REM sleep, especially functional or anatomical interruption of ponto-medullary pathways mediating REM sleep atonia, seems to cause RWA in these patients. RWA may be a clinically important finding as a sign of brainstem dysfunction at early stage of neurodegenerative diseases.

SIDS and tourette syndrome: Is there an etiologic relationship?

SIDS has been repeatedly linked to the presence of prolonged sleep apnea and defective arousal mechanisms. Multiple cases of SIDS may occur in some families, and siblings of SIDS infants are at a 3 to 10 times greater risk of SIDS than the general population. This suggests genetic factors can play a role. Sleep laboratory studies of adults with Tourette syndrome (TS) show that 23% have sleep apnea and 29% have abnormal arousals. Disorders of arousal such as enuresis, sleep walking, sleep talking, and night terrors are common in children with TS. We report seven TS families in which one or more close relatives died of SIDS, or had apparent life-threatening episode (ALTE) and required apnea monitoring. Serotonin is the major neurotransmitter involved in sleep regulation and abnormalities of serotonin have been implicated in both SIDS and TS. These and other observations suggest that the Tourette syndrome gene (Gts) may be the genetic factor contributing to an increased risk of SIDS.

Sleeptalking

Sleeptalking

PART II: Sleep Disorders in Children

In this part of the chapter we have used new terminology and developed a new system for classification of sleep disorders in children. We suggest that excessive daytime sleepiness should be investigated by clinicians before troubles at school necessitate referral. The narcolepsy-hypersomnia syndrome generally has not been recognized in the pediatric age group. Symptoms of excessive fear of falling asleep need to be viewed in this context. Sleep apnea-hypersomnia has received insufficient attention in the American literature. It is a syndrome that affects both adults and children with potentially disastrous cardiovascular and pulmonary complications. The relationship of the sleep apnea-hypersomnia syndrome to the sudden infant death syndrome remains speculative, although preliminary results from our longitudinal study have indicated a possible link. Both the narcolepsy-hypersomnia and the sleep apnea-hypersomnia syndromes are reviewed in detail. In contrast, we review briefly the NREM dyssomnias, including night terrors, sleepwalking, sleep talking and enuresis. All are well known to clinicians dealing with children, and we have related them to findings emanating from the sleep laboratory. We suggest that they are physiologically rather than psychogenically based and frequently represent immaturities of the central nervous system. Finally, the insomnias of childhood are presented. We emphasize that they are rare, and after ruling out organic conditions and drug-dependency syndromes, cultural styles or family stresses generally account for the majority of complaints.

The frequency of sleep talking in the laboratory among chronic sleep talkers and good dream recallers.

The frequency of sleep talking in the laboratory among chronic sleep talkers and good dream recallers.

Evoked sleep-talking.

Evidence for modifications of verbal behavior without awareness when awake, increased spontaneous sleep-speech by posthypnotic suggestion, and discriminative motor responses during sleep suggested the possibility of induced/conditioned sleep-talking. Three students with no history of sleep disturbance or talking were trained for a total of 8 nights with avoidance-escape conditioning to sleep talk. The administration of light and tone stimuli followed schedules based on sleep stage and time (continuous, variable and fixed interval), with Ss at first naive and later informed. Reinforcements of vocalization through reductions or elimination of stimuli were adjusted to maximize responding without awakening S. Responses varied from groans, sighs, and unintelligible mumbling to coherent speech with and without affective tone, related and unrelated to the experiment, and rich or stereotyped. Latency and frequency of sleep responses over successive nights may depend on the interaction of stimuli intensity levels with type of sleeper (light/deep). Avoidance vocalizations, behavioral and transient EEG awakening significantly decreased from Stage 1 through 4. Conditioning techniques may be feasible in the development of sleep-talking skills.

Patterns of sleep talking.

In recent years, the work of Aserinsky, Dement, Kleitman, and others^1-5has stimulated research on the relationship of electroencephalographic (EEG) and eye-movement patterns to dreaming. This type of research usually involves continuous monitoring of the EEG's of sleeping subjects. In those laboratories where the use of an intercom system has permitted simultaneous sound monitoring of subjects' sleeping rooms, investigators have had the opportunity to hear subjects talking in their sleep. This paper reports our observations of sleep talking and its relationship to EEG patterns, dreaming, and other variables. Since our findings will be discussed in the context of the recent EEG-dream research, a brief introduction to this area is indicated. In one of their reports, Dement and Kleitman defined 4 EEG stages of sleep: Stage 1—low voltage, random activity; Stage 2—spindling and K complexes against a low-voltage background; Stage 3—spindling and K complexes against a