Sleep-related eating disorder (SRED) is a parasomnia that arises primarily from NREM sleep with recurrent episodes of involuntary eating and drinking. This chapter discusses the case of a 32-year-old woman who presented with sleep-related eating episodes, who also had difficulty with sleep initiation insomnia, somnambulism, somniloquy and symptoms of restless legs syndrome (RLS) since she was 6 years old. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. Overnight diagnostic polysomnography (PSG) was performed. Based on the PSG results, a diagnosis of SRED was made. Complications include obesity, injuries, toxic ingestions and psychological distress with excessive weight gain. Treatment of the underlying sleep disorder, if present, is usually effective. Underlying mood disorder or alcohol or substance abuse should be addressed. Pharmacotherapy consists of administration of antidepressants (e.g. SSRIs), dopaminergic agonists or topiramate.

This chapter discusses the case of an 8-year-old female who was admitted to a pediatric neurology clinic for evaluation of chronic sleep-related behaviors that were unresponsive to anticonvulsant treatment. It presents the clinical history, examination, follow-up, treatment, diagnosis, and the results of the procedures performed on the patient. The combination of polysomnography (PSG) and clinical history led to a diagnosis of both somnambulism (sleepwalking) and seizure disorder. The possibility that her sleepwalking episodes were representative of partial complex seizures or prolonged postictal states cannot be ruled out given the relative limitations of the evaluation. The EEG concomitants of an active seizure have classically included generalized depression or slowing, rhythmic slow-wave or spike/polyspike and wave activity that can occur immediately prior to or during an event, and postictal slowing or depression frequently following a spell. Video recording and response to treatment aid in making a diagnosis of probability.

This chapter presents the case study of a male adult sleepwalker with recurrence of sleepwalking events previously suffered in childhood. It describes the clinical history, examination, and the results of the procedures performed and the results obtained. He had a history of sleep-walking in childhood but stopped exhibiting events after the age of 14 years. The patient underwent polysomnography (PSG) because the episodes were frequent, violent and potentially dangerous to his wife. He had had 40 hours sleep deprivation previously. A diagnosis of sleepwalking (somnambulism) was made. Sleep deprivation and irregular hours were the main triggers of recurrence of sleepwalking in this patient. The PSG was also important to exclude the presence of concurrent sleep disorders such as sleep apnea and periodic limb movement disorder (PLMD), as both conditions can precipitate sleepwalking events by producing sleep instability secondary to arousals.

This chapter focuses on sleepwalking, also known as somnambulism. The symptoms and manifestations that characterize sleepwalking show great variations both within and across predisposed patients. Sleepwalking is more common in childhood than in adulthood, as most children will experience, at least temporarily, one or more of the NREM sleep parasomnias during childhood or early adolescence. Sleep laboratory investigations have yielded considerable information on the polysomnographic characteristics of sleepwalkers. There is a strong genetic component to somnambulism. About 80% of somnambulistic patients have at least one family member affected by this parasomnia, and the prevalence of somnambulism is higher in children of parents with a history of sleepwalking. In addition to the atypical sleep parameters and genetic component reviewed, other factors have been proposed, including psychopathology and deregulation of serotonergic systems. Hypnosis (including self-hypnosis) has been found to be effective in both children and adults presenting with chronic sleepwalking.