Parasomnias manifest different phenotypes in age- and sex-groups. An internet-based video research

Abstract

Abstract Hypothesis There are typical patterns - phenotypes - of sleep behaviors characterizing age-, and sex-groups of parasomnia patients. Materials and methods We analyzed sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating” “sleep sex”, “sleep talking”, “aggression in sleep” and somnambulism in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified those persons shown on the videos into estimated sex- and age (children, adults, elderly) - groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus sex- and age- groups by STATA package providing 95% confidence interval and the probability of statistical significance.Results Twohundred-twentyfour videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Adults sleep talked full sentences more often than children and elderly people (P<0.001). Elderly males had 40-fold odds compared to adults and children, to perform aggressive movements, and 70-fold odds of complex movements in the bed, compared to adults.Conclusion Elderly people rarely sleepwalk in our research. Elderly males perform intense and violent movements in bed, unlike other groups. The existence of parasomnia phenotypes allows prevention of injury types and raises theoretical questions on the mechanism including social and brain-network features of parasomnias.