Treatment options for disorders of arousal: a case series

Abstract

Background: Non-rapid-eye-movement parasomnias or disorders of arousal (DOA) are more prevalent in children, but they do occur in adults. There are no practice parameters published for treatment of DOAs. Methods: After obtaining institutional review board approval, an electronic search was conducted for ICD9 codes related to DOAs in our clinic databases. The resulting charts were reviewed by the authors for accuracy, and 103 out of 232 were included in the final analysis. Results: Sleepwalking is the most common DOA presentation. Treatment with low-dose clonazepam has a response rate of 73.7%. Cognitive behavioral therapy (CBT) for insomnia, sertraline, clomipramine and temazepam may also be effective alternatives. Conclusion: DOAs respond to benzodiazepines, antidepressants and CBT. Large, randomized trials are needed to further assess these therapeutic alternatives.

KEYWORDS: :

• sleepwalking
• sleep terrors
• disorders of arousal
• parasomnia
• clonazepam
• cognitive behavioral therapy
• confusional arousal
• sertraline