Different features of parasomnias, including DOAs, SHE, idiopathic RBD and nightmares

DOASHEIdiopathic RBDNightmares
Age of onset (years)3–8Any ageAfter 50Usually 3–6
CourseTends to disappearUsually increasesRare spontaneous remissionVariable
Episodes per nightUsually oneUsually severalOne to severalOne to several
Occurrence during the nightFirst thirdAny timeLast thirdLast third
Episode duration1–30 minSeconds–3 min1–2 minSeconds–minutes
Motor patternVariable: sitting up, pulling at bed clothes, speaking, sleepwalking, screaming, usually with eyes openingHighly stereotyped: complex body movements, kicking or cycling of limbs, rocking body movements, asymmetric tonic/dystonic posturingFinger twitching or flexing to complex dream enactment behaviourMost commonly absent, but rarely can consist of simple movements with preserved REM atonia
Awareness if awakenedUsually absentVariableUsually presentUsually present
RecallUsually absentVariableUsually present, sometimes with vivid detailUsually present, sometimes with vivid detail
PSG featuresCyclic alternating pattern, hypersynchronous delta activity, possible periodic limb movements (confusional arousals/sleepwalking), increased autonomic function (sleep terrors)Epileptiform features on sleep EEGREM sleep without atoniaVariable: may be normal, may display reduced sleep efficiency and increased wakefulness, may identify sleep disrupting pathology

Reproduced and modified from Loddo et al. [33].