Disorders of Arousal - the Parasomnias of NREM-Sleep: A Case-Based Mini-Review
Elza А. Balian1,2 *, Lilit G. Atabekyan2, Narine M. Nadryan1,2, Haykuhi A. Hovakimyan1,2, Samson G. Khachatryan1,2
1 Department of Neurology and Neurosurgery, Avdalbekyan National Institute of Health, Yerevan, Armenia
2 Sleep, epilepsy and movement disorders center, Somnus Neurology Clinic, Yerevan, Armenia
ABSTRACT
Disorders of arousal (DoA) are non-rapid eye movement (NREM) sleep parasomnias, including sleepwalking, confusional arousals, and sleep terrors. Although more common in childhood, they may persist or re-emerge in adolescence and adulthood, sometimes with complex or aggressive behaviors that raise safety and diagnostic concerns. This mini-review presents a clinical case of a 17-year-old boy with longstanding nocturnal episodes, initially mild but later increasing in frequency and intensity. Video-polysomnography confirmed multiple behavioral events arising from his deep sleep stage, with features consistent with confusional arousal and somnambulistic types of NREM parasomnia. The diagnostic criteria, subtypes of DoA, risk factors, differential diagnosis and management of NREM parasomnias are briefly reviewed.
Keywords: parasomnia; NREM sleep; confusional arousal; somnambulism; sleepwalking; nocturnal epilepsy