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OKAY BACK FROM THE SLEEP LAB 🧪

Terzaghi And Colleagues Reported One Confusional Arousal In 2009

Confusional Arousals Belong To The Same Family As Sleepwalking

The Authors Recorded It With Electrodes Implanted In The Brain

Their Patient Was A 20 Year Old Man

His Condition Was Refractory Focal Epilepsy

A History Of Arousal Parasomnias Began For Him At Age 2

Implantation Aimed To Define His Epileptogenic Area For Surgery

Fourteen Electrodes Were Placed Across Several Brain Regions

Some Reached Motor Areas And The Cingulate Gyrus

Others Reached The Parietal Lobules

An Episode Of NREM Parasomnia Was Captured On The Recording

That Episode Lasted 32 Seconds

Next Morning He Had No Recall Of The Event

Motor And Cingulate Cortices Showed A Local Arousal

Frontoparietal Associative Cortices Showed Increased Delta Activity

Both Findings Came Before Onset And Lasted Throughout

The Visible Episode Started 5 Seconds After The Recording Changed

Authors Conclude It Was Not A Global Phenomenon

They Describe Different Local States Existing At The Same Time

This Was One Patient With Epilepsy

One Case Cannot Show What Happens In Every Sleepwalker

A 2012 Review Describes The Idea Behind This Finding

Sleepwalking And Related Disorders Result From Incomplete Dissociation

The Dissociation Is Of Wakefulness From NREM Sleep

NREM Means Nonrapid Eye Movement Sleep

Conditions Causing Repeated Arousals Can Lead To NREM Parasomnias

The Review Says They Impair Normal Arousal Mechanisms

Conditions That Promote Sleep Inertia Can Do The Same

The 2012 Review Links Amnesia To Low Activity In Memory Regions

One Inappropriate Act It Lists Is Placing Car Keys In The Refrigerator

A Later Update Covers NREM Parasomnias In Adults

Reviewers Trace These Disorders Primarily To N3 Sleep

Confusional Arousals And Sleepwalking Are Termed Disorders Of Arousal

These Share Features Of Autonomic And Motor Activation

The Update Also Describes A Person Asleep With Open Eyes

That Person Is Moving Around And Experiencing Autonomic Arousal

After More Than 60 Years Of Study The Mechanism Is Not Fully Known

Other Studies Found Signs Of N3 Sleep And Arousal Before An Episode

Together The Studies Suggest Sleep And Wakefulness May Coexist

The Update Names Sleep Deprivation As A Priming Factor For Episodes

Montreal Researchers Tested Sleep Loss As A Trigger

Zadra Pilon And Montplaisir Evaluated 40 Suspected Sleepwalkers

Each Was Referred To A Sleep Research Centre In Montreal

Baseline Sleep Was Monitored During An Initial Assessment

Patients Were Later Kept Awake For The Entire Evening

Recovery Sleep Followed 25 Hours Awake

Researchers Videotaped Each Sleep Period

Behaviors Ranged From Playing With Sheets To Trying To Jump Bed Rails

Only Half Of Patients Showed Episodes During Baseline Sleep

Baseline Sleep Showed Some 32 Behavioral Episodes

After Sleep Deprivation 90 Percent Of Patients Had Episodes

Recovery Sleep Brought 92 Behavioral Episodes In Total

After Deprivation Sleepwalkers Leave Slow Wave Sleep Less Easily

That Includes Passing To Another Stage Or Waking Fully

Zadra Said Sleep Deprivation Can Precipitate Sleepwalking

That Finding Applies To Predisposed Individuals

It Does Not Show That Sleep Loss Triggers Episodes In Everyone

Zadra Advised Sleepwalkers To Keep A Regular Bedtime