Night Terrors Research Articles

Spectral Dynamics Prior to Motor Events Differ Between NREM Sleep Parasomnias and Healthy Sleepers.

The umbrella term "Disorders of Arousal" (DoA), encompassing sleepwalking, confusional arousals, and sleep terrors, refers to parasomnias manifesting during non-rapid eye movement (NREM) sleep, commonly thought to arise from an aberrant arousal process. While previous studies have detailed EEG changes linked to DoA episodes, it remains uncertain how these alterations differ from a physiological arousal process. This study directly compared brain activity between DoA episodes and arousals associated with physiological movements (motor arousal) in individuals with DoA and healthy sleepers. Fifty-three adult patients with DoA (25 males, 32.2±15.5years) and 33 control subjects (14 males, 31.4±11.4years) underwent one or more home-EEG recordings. A semiparametric regression model was employed to elucidate the complex relationship between EEG activity across channels, within and across different groups, including motor arousals in DoA (n=169), parasomnia episodes in DoA (n=361), and motor arousals in healthy sleepers (n=137). Parasomnia episodes and motor arousals in both groups were preceded by a diffuse increase in slow-wave activity (SWA) and beta power, and a widespread decrease in sigma power. However, motor arousals in DoA displayed lower beta and central sigma than in healthy sleepers. Within DoA patients, episodes were preceded by lower beta, frontal sigma, and higher SWA than motor arousals. Our findings suggest that the arousal process is altered in DOA patients, and that specific EEG patterns are required for DOA episodes to emerge. These insights will help guide future research into the underlying circuits and objective markers of DOA.

Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors

Aim: In this study, it was aimed to investigate the clinical characteristics of children diagnosed with sleep terrors, including sleep environment and sleep habits, clinical features and comorbid psychiatric disorders. Method: Between 2020 and 2024, 51 children who were diagnosed with sleep terror according to DSM-5 diagnostic criteria in 3 different Child and Adolescent Psychiatry clinics were included in the study. The sociodemographic and clinical characteristics of the cases were examined retrospectively through the files. Results: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years. It was determined that 15 (29.4%) of the cases slept in a noisy environment and 41 (80.4%) of the cases had their sleep interrupted except for sleep terror attacks. At least one psychiatric disorder was detected in 17 (33.3%) patients, and the most common (9.8%) comorbid psychiatric disorder was attention deficit hyperactivity disorder. It was found that complete retrograde amnesia was significantly higher in preschoolers, and motor activity during the attack, physical injury and/or material damage, and full awakening during the attack were significantly higher in school-age children. It was determined that 64.7% of the parents intervened incorrectly during the episode, and in 29.4% of the cases, the wrong medication was applied in the treatment history. Conclusion: In sleep terrors, identification of triggering factors and comorbid psychiatric disorders during the diagnostic evaluation process, psychoeducation of parents in treatment, and selection of appropriate medication for medication are very important.

Research on the “1+1+1” Physical Intelligence Curriculum System under the Background of Healthy Children Action Plan

“14th Five-Year Plan” period is the first five years to the second century goal, but also the key period for the development of children’s health cause. “Healthy China 2030” plan outline “clearly put forward the implementation of healthy children plan [1]. Although the national level attaches great importance to children’s health, there are still many factors that affect children’s healthy growth in daily life, such as various diseases in children’s physical health, developmental delays in various physiological functions, insufficient exercise ability, obesity, etc., as well as mental health problems such as stuttering, night terrors, fear, anxiety, rage, lying, autism and hyperactivity. To solve these problems, not only the attention and deployment of the country and the government, but also the understanding and cooperation at the social level and the family level, in order to better promote the healthy growth of children under the joint efforts of everyone. The “1+1+1” “Body intelligence” curriculum system research includes a healthy child’s physical development system, a healthy child’s psychological (mental) development system, and a healthy child’s ability development system. Aiming at the problems of physical and mental development and ability development in the healthy growth of children, service programs are scientifically and rationally formulated, and implemented from the social level and family level to effectively improve children’s health level [2].

Understanding and Treating Nightmares: A Comprehensive Review of Psychosocial Strategies for Adults and Children.

Nightmares are distressing dreams that evoke strong negative emotions, such as fear or anxiety, often leading to waking from sleep and subsequent sleep disruption. They are prevalent across various age groups, with significant psychological and physiological health implications. This review explores the nature of nightmares, distinguishing them from other sleep disturbances like night terrors and sleep paralysis. It examines the prevalence of nightmares in children and adults, highlighting their impact on mental health and daily functioning. The review also emphasizes the importance of addressing nightmares through effective treatment strategies. While pharmacological options are available, psychosocial interventions offer promising non-pharmacological solutions. Cognitive behavioral therapy (CBT), imagery rehearsal therapy (IRT), and mindfulness-based therapies are discussed as key approaches for managing nightmares. These strategies focus on altering maladaptive thought patterns and emotional responses, reducing nightmares' frequency and intensity, and improving overall sleep quality. Psychosocial interventions provide a comprehensive approach to treating nightmares by addressing the underlying cognitive and emotional factors, benefitting individuals across different age groups. This review aims to highlight the efficacy of these strategies and their role in enhancing the quality of life for those affected by persistent nightmares.

Clinical safety of daridorexant in insomnia treatment: Analysis of FDA adverse event reports

ObjectiveDaridorexant, a novel dual orexin receptor antagonist, was approved by the FDA in 2022 for the treatment of insomnia in adults. The aim of this study is to delve into the adverse events (AEs) of daridorexant by analyzing data from the FAERS database, to assess its safety and effectiveness in clinical applications. MethodsThis study selected data from the FAERS database from the first quarter of 2022 to the third quarter of 2023. Various data analysis methods were used, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM), to assess AEs related to daridorexant. ResultsThe study analyzed a total of 2,624,030 AE reports, of which 1318 were related to daridorexant. It identified 59 preferred terms (PTs) involving 23 system organ classes (SOCs). Signal mining identified new potential AEs related to daridorexant, including sleep-related psychiatric symptoms (nightmare, abnormal dreams, sleep terror, etc.), emotional and perceptual abnormalities (hallucination, depression, agitation), physiological and behavioral responses (palpitations, dry mouth, energy increased, etc.), suicide risk (suicidal ideation, intentional overdose), and other special concern AEs (tachyphrenia, sleep-related eating disorder, hypersensitivity). ConclusionAlthough some new potential AEs have been identified, these findings need further verification in broader datasets and long-term studies due to limitations in data sources and analysis methods. Future research should comprehensively assess the safety and effectiveness of daridorexant, providing more accurate guidance for medical professionals in the treatment of insomnia.

Evaluating the Impacts of Parasomnias on Sleep and Exploring Their Therapeutic Interventions

Sleep disorders are topics of important discussion as they apply to a function crucial for the growth and development of individuals. Sleep plays a pivotal role in one's long-term health but various disorders may limit or prevent high-quality sleep for children and adults. One of these common disorder groups is parasomnias. As there is still much to learn in medicine when it comes to parasomnias and their treatments, it is of utmost importance to understand the processes behind the occurrence of parasomnias and their associated conditions. This review breaks down the most common parasomnias, categorizing them based on the onset of disease during rapid eye movement (REM) or non-rapid eye movement (NREM) sleep stages. This includes somnambulism (sleepwalking), confusional arousals, night terrors, REM behavior disorder (RBD), nightmare disorder, and others. It highlights the characteristics of diagnosis for these individual disorders and attempts to evaluate them through an etiological, epidemiological, and pathophysiological lens. This review also presents the current pharmacological and non-pharmacological interventions for these disorders.

The effect of predictive nursing on the mental state, compliance and sleep quality of senile cervicitis: An observational study.

To explore the effect of predictive nursing on the mental state, compliance and sleep quality of elderly patients with cervicitis. The clinical data of 96 elderly patients with cervicitis who were admitted to our hospital from June 2019 to June 2021 were selected as the research objects. According to the different treatments, they were divided into a control group and an observation group with 48 cases each. Among them, the control group was given routine care, and the observation group was given predictive care on the basis of the control group. The effects of the quality of life, mental state, compliance and sleep quality of the 2 groups of patients before and after nursing were compared. Comparing the nursing compliance of the 2 groups of elderly patients with cervicitis, statistics showed that the difference was statistically significant (P < .05). After nursing, the sleep quality, increased arousal, unstable sleep, and night terrors of the 2 groups of elderly patients with cervicitis were significantly improved, and the negative emotion score of the observation group was significantly lower than that of the control group. Statistics show that this difference is statistically significant (P < .05). The comparison of the quality of life scores of the 2 groups of patients before nursing was not statistically significant (P > .05). After nursing, the mental vitality score, social interaction score, emotional restriction score, and mental status of the observation group were significantly higher than those of the control group. Statistics showed that the difference was statistically significant (P < .05). After nursing, the psychological pressure of the 2 groups of elderly patients with cervicitis was significantly improved, and the observation group fear, anxiety, desire for knowledge, fear of discrimination, despair, and low self-esteem were significantly lower than those of the control group. The difference was statistically significant (P < .05). Predictive nursing can effectively improve the quality of life and sleep of elderly patients with cervicitis, reduce psychological pressure, improve compliance and sleep quality, and benefit the prognosis and clinical treatment of patients. It has a certain reference value for the nursing of elderly patients with cervicitis.

Exploring adverse events of Vilazodone: evidence from the FAERS database

ObjectiveThis study aims to conduct an exhaustive evaluation of Vilazodone's safety in clinical application and to unearth the potential adverse event (AE) risks associated with its utilization based on FDA Adverse Event Reporting System (FAERS) database.MethodsThis research employed data spanning from the first quarter of 2011 to the third quarter of 2023 from the FAERS database. Various signal detection methodologies, including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM), were utilized to ascertain the correlation between Vilazodone and specific AEs.ResultsThe study compiled a total of 17,439,268 reports of drug AEs, out of which 5,375 were related to Vilazodone. Through signal mining, 125 Preferred Terms (PTs) encompassing 27 System Organ Classes (SOCs) were identified. The findings indicated a higher prevalence among females and patients within the 45 to 65 age bracket. The principal categories of AEs included Psychiatric disorders, Nervous system disorders, and Gastrointestinal disorders, with prevalent incidents of Diarrhoea, Nausea, and Insomnia. Moreover, the study identified robust signals of novel potential AEs, notably in areas such as sleep disturbances (Sleep paralysis, Hypnagogic hallucination, Rapid eye movements sleep abnormal, Sleep terror, Terminal insomnia, Tachyphrenia), sexual dysfunctions (Female orgasmic disorder, Orgasm abnormal, Disturbance in sexual arousal, Spontaneous penile erection, Anorgasmia, Sexual dysfunction, Ejaculation delayed), and other symptoms and injuries (Electric shock sensation, Violence-related symptom, Gun shot wound).ConclusionAlthough Vilazodone presents a positive prospect in the management of MDD, the discovery of AEs linked to its use, particularly the newly identified potential risks such as sleep and sexual dysfunctions, necessitates heightened vigilance among clinicians.

Fever-induced acute sleep terrors in children and adolescents following SARS-CoV-2 infection.

This study aims toprovide physicians withinsights into the clinical manifestations and outcomes of children and young adolescents experiencing sleep terrors following SARS-CoV-2 infection. We enrolled patients who developed new onset sleep terrors after SARS-CoV-2infection fromDecember2022to April 2023 in the Xijing hospital, Xi'an, China. We enrolled six patients who experienced sleep terrors following SARS-CoV-2 infection. Out of these patients, five were children and only one was an adolescent, with a mean age of 9 years. Neuroimagingresults were negative for all cases. Sleep terrors occurred during both the active course of COVID-19 illness and the recovery period in all patients. Symptoms included crying or screaming in terror, hyperactivity, inappropriate behavior and periods of mental confusion during sleep. These episodes typicallyoccurred 40 min to 1 h after falling asleep. EEG monitoring confirmed two patients' episodes occurred during non-rapid eye movement (NREM) stage 3 sleep. The duration of sleep terrors ranged from 3mines to30 mines, with each patient experiencing 3-4 to 30-40 instances. Initially, the frequency of episodes was highest at 3-4 times per night, gradually decreasing to once a night, then once a week, until complete disappearance. No medical intervention was required. Clinical follow-up ranged from 6 to 12 months, with spontaneous remission occurring within 1 week to 2 months for different patients. SARS-CoV-2 infectionmay precipitate acute sleep terrors in children and adolescents. The course of these sleep terrors is generally benign, with all patients achieving spontaneous complete remission over time.

Construction and Initial Examination of Inter-Rater Reliability of a Structured Clinical Interview for DSM-5-TR Sleep Disorders (SCISD) – Kid

ABSTRACT Study Objectives To construct and evaluate the inter-rater reliability of the Structured Clinical Interview for DSM-5-TR Sleep Disorders – Kid (SCISD-Kid). Method The SCISD-Kid was modeled on the adult SCISD-R and accounted for pediatric developmental and sociocultural factors. Fifty sleep-disturbed children (M age = 11.9, SD = 2.9) and 50 caregivers responded to the final SCISD-Kid. Video recordings were double-scored to evaluate inter-rater reliability. Results The final SCISD-Kid contained approximately 90 questions. Eight of the nine covered disorders had prevalence rates sufficient for analyses for both samples (i.e., k > 2). Inter-rater reliability was examined using Cohen kappa coefficients (κ); reliability estimates ranged from excellent to good. For youth, restless legs syndrome yielded the lowest reliability (.48), while nightmare disorder, narcolepsy, and NREM sleep arousal disorder – sleepwalking type showed the highest reliability (1.00). Across caregivers, NREM sleep arousal disorder – sleep terror type (.49) and hypersomnolence (.54) had the lowest reliability. In contrast, circadian rhythm – delayed sleep phase type, nightmare disorder, and NREM sleep arousal disorder – sleepwalking type showed the highest reliability (1.00). Conclusions The SCISD-Kid is a promising tool for screening sleep disorders. It showed good to excellent reliability across both samples. Next steps for validation will be discussed.

Posttraumatic Stress Disorder: The Lighthouse at the End of the World and the Boy who Searched for the Light

Defining the word "trauma" is a delicate and difficult challenge, but I think it is very important to include the word trauma in our vocabulary. Generally, when we think of the word trauma, most of us associate it with a catastrophic event. However, it can apper into our lives and disrupt the proper functioning of our mind, body and soul generated by even "smaller" events. The difference is made by everyone's degree of resistance to stress.&#x0D; &#x0D; It is also very important to use the word trauma in a way that is as conscious as possible, but also correct.&#x0D; The studies tell us very clearly, starting from Sigmund Freud’s Era, that you cannot overcome, you cannot improve, you cannot heal something that you cannot express in words. Trauma is the effect or the produced by an event or an experience in our inner universe. It is a form of disconnection from one's own person, from one's own story and most often from one's own body.&#x0D; While the causes and symptoms of trauma are various, there are some basic signs. People who have been through traumatic events will often appear shaken and disoriented and may often seem withdrawn or absent even when speaking.&#x0D; Another clear sign of trauma is the anxiety (night terrors, nervousness, irritability, poor concentration and mood swings).&#x0D; Trauma often manifests itself both emotionally and physically.&#x0D; The emotion motion is one of the most common ways trauma manifests itself. Some common emotional symptoms of trauma include denial, anger, sadness, and emotional outbursts , anxiety or panic attacks.&#x0D; Some common physical signs are: paleness, lethargy, exhaustion, poor concentration, and rapid heartbeats.&#x0D; The effects of trauma can occur either in a short period of time after the event has taken place or in weeks or even years. The earlier the trauma is addressed, the more successful the person will be in the recovery process.&#x0D; We all go through scary situations at some point, but we all react differently. If a person cannot get over the traumatic event and his feelings about the experience remain present or worsen as time goes on, he might suffer from Post Traumatic Stress Disorder.&#x0D; Sometimes when we go through an extremely terrifying or chronically stressful experience, the brain overestimates the danger and our stress systems malfunction.&#x0D; When this happens, different areas of the brain begin to make mistakes as they interpret the world around them and tell the rest of the body how to respond.&#x0D; PTSD is associated with problems in the brain structures and neurotransmitters (the brain's chemical messengers) that are responsible with the way we respond to fear and stress.&#x0D; The word trauma can really scare us, but there is also healing.&#x0D; But healing is not guaranteed, according to Gabor Matte,but it is available and it depends only on our freedom to choose what we do next.&#x0D; What does trauma recovery mean?&#x0D; It's about reclaiming our healthy parts, reclaiming the external reality as a benchmark and reclaiming our ability to acknowledge the pain from the past, allowing it the right to exist in present context.&#x0D;

Sleep Disorders' Prevalence and Impact on Academic Performance among Undergraduate Nursing Students in a Selected University, United Arab Emirates.

Throughout their academic pursuits, students may encounter various sleep-related issues, including insomnia, sleep apnea, hypersomnia, or sleep terror disorder. These disorders can profoundly impact their well-being, emotional state, and academic achievements. This study, of significant relevance to the field of nursing and sleep disorders, aimed to investigate the prevalence of sleep disorders and their impact on academic performance among undergraduate nursing students in the United Arab Emirates. A cross-sectional research method was implemented among 177 undergraduate nursing students. Two tools were used: Too I consisted of two parts: sociodemographic and academic performance classifications, whereas Tool II comprised the SLEEP-50 questionnaire. Our findings revealed that 30.6% of nursing students had one or more sleep disorders. Insomnia was the most prevalent among the nursing students (37.5%), followed by circadian rhythm (33.3%), narcolepsy (26.6%), sleep apnea and restless leg syndrome (25%), nightmares (22.2%), and sleepwalking (11.11%). There was a significant relation between restless leg syndrome and academic performance, while in linear regression analysis, it was found that the variable that most affects sleep is gender. The implications of this study's findings are clear-nursing schools must intensify their efforts to raise awareness about the detrimental effects of sleep problems on academic performance. Furthermore, subsequent research is crucial to evaluate the execution of interventions aimed at preventing such disorders.

Challenging Case: A Multidisciplinary Approach to Demystifying Chronic Sleep Impairment in an Infant with a Complex Medical and Behavioral Profile.

Challenging Case: A Multidisciplinary Approach to Demystifying Chronic Sleep Impairment in an Infant with a Complex Medical and Behavioral Profile.

Sleep Health among Children Adopted from Foster Care: The Moderating Effect of Parent–Child Sleep Interactions

ABSTRACT Objectives Sleep disruption is prevalent among children placed in foster care, elevating risk for a range of deleterious outcomes. Theoretically, achieving permanency via adoption may have a positive influence on children’s sleep via the presence of various factors, but little is known about the sleep health of children adopted from foster care, including predictors and moderators of sleep health. Method The current study included 226 parents who adopted a child from foster care in the U.S. (aged 4–11 years) within the past two years and a propensity score matched sample of 379 caregivers of children currently in foster care. Both samples completed online questionnaires about their child’s sleep, physical, and mental health. Results Comparatively, children in foster care experienced more nightmares, night terrors, moving to someone else’s’ bed during the night, and worse overall sleep quality, whereas adopted children were reported to experience significantly more nighttime awakenings. In the adopted sample, a greater number of prior foster placements unexpectedly predicted lower total sleep disturbance scores, but this relationship was moderated by parent–child interactions around sleep. In general, greater parental involvement in children’s sleep was associated with lower levels of child sleep disturbance. Conclusions Findings suggest that while specific sleep problems might remit after children in foster care achieve permanence, nighttime sleep fragmentation often persists. Parent–child interactions surrounding sleep may be pivotal in improving sleep health in this population.

Toward the study of the relationship between psychological defenses and psychosocial stress factors in modern foreign science

The phenomenon of psychological defenses is considered from the standpoint of various approaches (cognitive, psychodynamic, behavioral, etc.), to understanding this phenomenon. The novelty in the research of foreign authors of the first quarter of the 21st century is traced. Empirical studies of psychological defenses within the framework of the theory of “stress vaccination”, “minority stress” in connection with “distorted perception”, social control and psychological well-being are presented. The impact of social factors (stress, depression, etc.) on the development of immature psychological defenses in a person, which reduce the level of psychological well-being, the ability to cope with mental conditions and disorders, and the level of self-esteem, is relevant. In cases of gender discrimination, alienation (avoidance) is more often chosen, while stigmatization on some other grounds leads to self-condemnation, self-doubt, and depression. Separate studies are devoted to the negative consequences of the use of immature and neurotic psychological defenses, as a result of which positive results are devalued, and the task is perceived subjectively as more difficult, while the use of mature protective mechanisms increases the mental stability of the individual. A number of modern foreign studies are devoted to understanding psychological defenses as factors of recovery or degradation, for example, the interpretation of the mechanisms underlying depression as protective (“smoke detector”), and sleepwalking and night terrors as a causes of “failure” of more mature and adaptive psychological defenses. The latest research on the trigger of time and place in its relationship with the cognitive processes of a person experiencing a psychotic episode can provide a more favorable outcome on the path of recovery. The purpose of this work was to study the current directions of research on the problem of psychological protection in foreign publications of the late 20th — first quarter of the 21st century. The research methods were the analysis and structured presentation of literary sources of foreign authors on the problem of the phenomenon of psychological defenses in modern foreign science.

5-MeO-DMT for post-traumatic stress disorder: a real-world longitudinal case study

Psychedelic therapy is, arguably, the next frontier in psychiatry. It offers a radical alternative to longstanding, mainstays of treatment, while exciting a paradigm shift in translational science and drug discovery. There is particular interest in 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT)—a serotonergic psychedelic—as a novel, fast-acting therapeutic. Yet, few studies have directly examined 5-MeO-DMT for trauma- or stress-related psychopathology, including post-traumatic stress disorder (PTSD). Herein, we present the first longitudinal case study on 5-MeO-DMT for chronic refractory PTSD, in a 23-year-old female. A single dose of vaporized bufotoxin of the Sonoran Desert Toad (Incilius alvarius), containing an estimated 10−15 mg of 5-MeO-DMT, led to clinically significant improvements in PTSD, with next-day effects. This was accompanied by marked reductions in hopelessness and related suicide risk. Improvements, across all constructs, were sustained at 1-, 3-, 6-, and 12-months follow-up, as monitored by a supporting clinician. The subject further endorsed a complete mystical experience, hypothesized to underly 5-MeO-DMT’s therapeutic activity. No drug-related, serious adverse events occurred. Together, results showed that 5-MeO-DMT was generally tolerable, safe to administer, and effective for PTSD; however, this was not without risk. The subject reported acute nausea, overwhelming subjective effects, and late onset of night terrors. Further research is warranted to replicate and extend these findings, which are inherently limited, non-generalizable, and rely on methods not clinically accepted.

Effects of medical and nursing group rounds combined with emotional nursing on quality of life and emotion in patients with malignant lymphoma.

To investigate the effects of medical and nursing visits in the same group combined with emotional care on the quality of life and emotions of patients with malignant lymphoma. One hundred sixty cases of malignant lymphoma patients admitted to our hospital from March 2020 to July 2022 were selected as retrospective study subjects and divided into 80 cases each in the control group and the observation group according to the different nursing methods. Among them, the control group implemented conventional emotional care, and the observation group implemented medical and nursing visits in the same group on the basis of the control group. The differences in quality of life, anxiety-related scores and sleep quality between the 2 groups of patients with malignant lymphoma before and after nursing were compared. After nursing, the mental vitality (P = .015), social interaction (P < .001), emotional restriction (P = .007), and mental status (P = .028) scores of patients in the observation group were higher than those in the control group. After nursing, the Self-Rating Anxiety Scale (P < .001) and Hamilton Anxiety Scale (P < .001) of malignant lymphoma patients in the observation group were significantly lower than those in the control group, and the sleep quality (P < .001), increased awakening (P < .001), sleep disturbance (P < .001), night terrors (P < .001) scores in the observation group were significantly lower than those in the control group. The combination of medical and nursing group checkups and emotional care can effectively improve the quality of life and sleep of patients with malignant lymphoma and reduce adverse emotions, which is beneficial to patient prognosis and clinical treatment. It has certain reference value for the care of patients with malignant lymphoma.

A Case Report on Alcohol Dependence Syndrome with Relation to Insomnia

Alcohol dependence is a pattern of substance use, leading to clinically significant impairment or distress; chronic alcohol abuse has been known to disrupt the normal sleep cycle and lead to sleep disorders, including sleep terror disorder. A male patient of age 42 years was a known alcoholic for 24 years, and the patient does not have any previous psychiatric history. Then, he stopped drinking for four days and developed insomnia. The patient gave an account of emotional outbreaks from 2 days; vital signs included blood pressure 140\90 , pulse rate 81 bpm, respiratory rate 20 , and oxygen saturation 97%@RA and the patient's GRBS level was 210 mg\, and the patient was immediately given with medication in. 4mg (IV), . (2 amp in 100 ml NS, BD), . Panto 40mg (IV), the same drug, was continued for three days, and there was no complaint of visual hallucinations. The patient felt symptomatically better and was discharged on the 4th day with no fresh complaints. The patient was advised to continue Tab. 2mg for three days. The preliminary case investigation evaluated the link between insomnia and alcohol dependence syndrome (ADS).

47.1 Diagnosis and Treatment of Sleep Terrors and Sleepwalking

47.1 Diagnosis and Treatment of Sleep Terrors and Sleepwalking

Non-REM Sleep Parasomnias.

Non-rapid eye movement (non-REM) parasomnias are common across the lifespan. This article describes the manifestations, diagnosis, and management of non-REM parasomnias in adults and discusses the social implications of these conditions. Non-REM parasomnias represent a hybrid state of wakefulness and sleep, often triggered by events that increase the frequency of arousals or make it more difficult to fully arouse from sleep. Sleep deprivation, certain medications, and untreated obstructive sleep apnea are known to provoke parasomnias, particularly in those who are genetically predisposed. Non-REM parasomnias include disorders of arousal (ie, sleepwalking, sleep terrors, and confusional arousals), sleep-related eating disorder, and exploding head syndrome. Clinical overlap exists between sleep-related eating disorder and disorders of arousal, suggesting that sleep-related eating disorder may be a fourth disorder of arousal or a manifestation of sleepwalking. Exploding head syndrome is a unique parasomnia of uncertain etiology. Non-REM parasomnias can range from minor nuisances to severe, life-altering events. While some patients with non-REM parasomnia experience significant consequences during sleep, wakefulness, or both, non-REM parasomnias do not pose a major risk to most patients. For all patients with non-REM parasomnias, safety should be explicitly discussed and addressed. Nonpharmacologic treatment should be prioritized, as increasing total sleep time, avoiding triggering substances, and treating comorbid sleep disorders is often sufficient for the management of non-REM parasomnias. If symptoms persist despite these interventions, treatment with clonazepam or other medications can be considered.