Adult-onset NREM parasomnia with hypnopompic hallucinatory pain: a case report.
Sleep February 1, 2013 Laura Mantoan, Sofia H Eriksson, Angus P Nisbet et al.
A 43-year-old woman experienced nocturnal episodes of pain and screaming that began at age 30, with no childhood or family history of parasomnia. Events occurred in the first half of the night within two hours of sleep onset, gradually increased in frequency, and were partially forgotten. Clinical and polysomnographic evaluation diagnosed adult-onset sleep terrors, excluding seizures and periodic limb movements as triggers. Mild sleep-disordered breathing was noted but of debatable significance. Brain and spine imaging ruled out lesions or neuropathies. Treatments with clonazepam, paroxetine, or gabapentin were poorly tolerated and ineffective, while trazodone worsened episodes. This is the first report of hypnopompic psychic pain linked to a NREM parasomnia, possibly representing a sensory hallucination analogous to visual hypnopompic hallucinations.