National Sleep Foundation

Chapter 6: Parasomnias

Etiology and Risk Factors of NREM Sleep Arousal Disorders

Non-Rapid Eye Movement (NREM) Sleep Arousal Disorders can be precipitated by sleep deprivation (which causes increased and deeper Slow Wave Sleep), by certain medical and psychiatric illnesses (e.g., Post-Traumatic Stress Disorder); pain and/or emotional stress; shift work; and by specific medications (e.g., alcohol, sedative hypnotics, neuroleptics, stimulants)1.  For example, taking zolpidem or trazadone has been reported to cause Sleep-Related Eating Disorder (SRED) in some patients2 3 4.    

As noted, confusional arousals are more likely among children. There is a genetic component and a family history of NREM Sleep Arousal Disorders increases the individual’s risk5.  For example, sleep-walking is associated with having the DQB1 gene6,  and increased incidence of SRED has been documented in relatives of affected individuals7.

The cause of sleep sex (sexsomnia) is not known, although those who engage in sleep-walking and sleep-talking are more likely to experience it.

References

  1. Morgenthaler TI, Silber MH. Amnestic sleep related eating disorder associated with zolpidem. Sleep Med. 2002;3:323-328.
  2. Pagel JF (2008) The Treatment of Parasomnias, in Handbook of Sleep Disorders (Ed.) C. Kushida. Informa. London. 523-534.
  3. Hoque, R. Chesson, A., Zolpidem-induced sleepwalking, sleep related eating disorder and sleep-driving: fluorine-18-fluorodeoxyglucose positron emission tomography analysis, and a literature review of other unexpected clinical effects of zolpidem, Clin Sleep Med;5(5):471-6, 2009.
  4. Markov D, Jaffe F, Doghramji K, MD, “Update on Parasomnias: A Review for Psychiatric Practice,” Psychiatry (Edgmont). 2006 Jul; 3(7): 69–76. Published online 2006 Jul. PMCID: PMC2958868
  5. Markov D, Jaffe F, Doghramji K, MD, “Update on Parasomnias: A Review for Psychiatric Practice,” Psychiatry (Edgmont). 2006 Jul; 3(7): 69–76. Published online 2006 Jul. PMCID: PMC2958868
  6. De Ocampo J, Foldvary N, Dinner DS, Golish J. Sleep-related eating disorder in fraternal twins. Sleep Med. 2002;3:525-526.