Not Only Sleepwalking But NREM Parasomnia Irrespective of the Type Is Associated with HLA DQB1*05:01.

Abstract

STUDY OBJECTIVES:

Despite the high prevalence and clinical relevance of NREM parasomnias, data on supportive genetic markers are scarce, and mainly refer to sleepwalking only.

METHODS:

We retrospectively analyzed clinical, polysomnographic, and HLA findings of 74 adults (37 men) with NREM parasomnia gathered from four neurological sleep centers. Parasomniac events were classified according to ICSD-2 criteria. HLA DQB1 genotyping was compared to regional-matched reference allele-frequencies.

RESULTS:

Fifty-six patients had more than 2 different parasomnia type: 11 sleepwalking, 4 sleep terrors, 3 confusional arousals only. Parasomniac events were documented during video-polysomnography (V-PSG) in 70% (49/70) of subjects (71.4% confusional arousals, 8.2% sleep terrors, 4.1% sleepwalking, 16.3% ≥ 2 NREM parasomnia types). Violent behavior during V-PSG occurred in 8.5% (6/71). NREM parasomnia onset was reported after the age of 30 years in 6.8% (5/74). The HLA DQB1*05:01 allele was present in 41% (29/71) compared to 24.2% in the regional-matched reference allele group (p < 0.05). This haplotype prevalence did not differ within the NREM parasomnia type. Epworth Sleepiness Score was 10 or higher in 28.6%.

CONCLUSIONS:

This is a large polysomnography-based case series of patients with NREM parasomnia. In patients with suspected sleepwalking or sleep terrors, polysomnography is highly useful in detecting arousals from NREM sleep as a marker of NREM parasomnia. We confirmed previous findings by demonstrating a high prevalence of the HLA DQB1*05:01 genotype for different types of NREM parasomnias. Our findings therefore support a common genetic background, and corroborate the importance of video-polysomnography in the work-up of parasomnia.

• Authors: Anna Heidbreder, Birgit Frauscher, Thomas Mitterling, Matthias Boentert, Anja Schirmacher, Paul Hörtnagl, Harald Schennach, Christina Massoth, Svenja Happe, Geert Mayer, Peter Young, Birgit Högl
• Journal: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine (J Clin Sleep Med) Vol. 12 Issue 4 Pg. 565-70 (Apr 15 2016) ISSN: 1550-9397 [Electronic] United States
• PMID: 26951409 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2016 American Academy of Sleep Medicine.

Chemical References

• HLA-DQ beta-Chains
• HLA-DQB1 antigen

Topics

• Adolescent
• Adult
• Aged
• Female
• Genetic Predisposition to Disease (genetics)
• HLA-DQ beta-Chains (genetics)
• Humans
• Male
• Middle Aged
• Parasomnias (genetics)
• Retrospective Studies
• Sleep Arousal Disorders (genetics)
• Sleep Stages
• Somnambulism (genetics)
• Videotape Recording
• Young Adult