Neurology：大约三成美国人曾梦游

5月15日，最新一期《神经病学》（Neurology）杂志发表了美国加利福尼亚州斯坦福睡眠流行病研究中心主任莫里斯·瓦永的一项研究发现，平均每三名美国人中就有一人曾经离床梦游。研究认为，精神状态的极度低沉以及其他睡眠紊乱状况都可能增加梦游可能性。

研究使用的一项调查数据显示，在美国15个州的1.6万名受访对象中，29%的人承认曾经梦游至少一次，将近3%的人承认梦游频率在每年一次至每月一次之间，1%的人平均每月梦游两次或两次以上。

过去有关梦游症的研究大多在实验室或临床完成。瓦永说，这项研究的目的是调查在现实日常生活中梦游发生的实际状况，以及梦游与生活习惯、精神压力的关联。

研究发现，最易发生梦游的人群通常伴随酗酒、服用安眠药、失眠、睡眠呼吸停止、精神低沉中的一种或多种。

另外，研究发现，在出现过梦游状况的人群中，大约三分之一的人承认他们有梦游家族史。

没有参与这项研究的神经病学研究者蒂莫西·扬对三成人有过梦游经历的结论并不感到惊讶。他说，许多人在幼年时代都有过梦游经历，梦游频率一般会随着年龄增长而降低。蒂莫西·扬先前的一项研究显示，大约三分之一的儿童会出现梦游。

蒂莫西·扬说，说梦话等常见睡眠行为事实上也是一种梦游。但一般认为，睡眠期间离床行动或走出寓所才是病症。

doi:10.1212/WNL.0b013e3182563be5
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Prevalence and comorbidity of nocturnal wandering in the US adult general population

M.M. Ohayon, MD, DSc, PhD, M.W. Mahowald, MD, Y. Dauvilliers, MD, PhD, A.D. Krystal, MD, MS and D. Léger, MD, PhD

Objective: To assess the prevalence and comorbid conditions of nocturnal wandering with abnormal state of consciousness (NW) in the American general population.

Methods: Cross-sectional study conducted with a representative sample of 19,136 noninstitutionalized individuals of the US general population ≥18 years old. The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental, and organic disorders (DSM-IV-TR; International Classification of Sleep Disorders, version 2; International Classification of Diseases–10).

Results: Lifetime prevalence of NW was 29.2% (95% confidence interval [CI] 28.5%–29.9%). In the previous year, NW was reported by 3.6% (3.3%–3.9%) of the sample: 1% had 2 or more episodes per month and 2.6% had between 1 and 12 episodes in the previous year. Family history of NW was reported by 30.5% of NW participants. Individuals with obstructive sleep apnea syndrome (odds ratio [OR] 3.9), circadian rhythm sleep disorder (OR 3.4), insomnia disorder (OR 2.1), alcohol abuse/dependence (OR 3.5), major depressive disorder (MDD) (OR 3.5), obsessive-compulsive disorder (OCD) (OR 3.9), or using over-the-counter sleeping pills (OR 2.5) or selective serotonin reuptake inhibitor (SSRI) antidepressants (OR 3.0) were at higher risk of frequent NW episodes (≥2 times/month).

Conclusions: With a rate of 29.2%, lifetime prevalence of NW is high. SSRIs were associated with an increased risk of NW. However, these medications appear to precipitate events in individuals with a prior history of NW. Furthermore, MDD and OCD were associated with significantly greater risk of NW, and this was not due to the use of psychotropic medication. These psychiatric associations imply an increased risk due to sleep disturbance.

GLOSSARY

CI= confidence interval; DSM-IV-TR= Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision; ICSD-II= International Classification of Sleep Disorders, version 2; MDD= major depressive disorder; NREM= non–REM; NSAID= nonsteroidal anti-inflammatory drug; NW= nocturnal wandering; OCD= obsessive-compulsive disorder; OR= odds ratio; SSRI= selective serotonin reuptake inhibitor.