Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 25-15: Sleep-Wake Disorders + Key Features Download Section PDF Listen +++ ++ Sleep terror, nightmares, sleepwalking, and enuresis more common in children than in adults Distinct from sleep panic attacks Usually seen in preadolescent boys, although it may occur in adults Occur during REM sleep, unlike sleep terror, which occurs in stage 3 or 4 Includes ambulation or other intricate behaviors while asleep Episodes can occur during stage 3 or 4 or REM sleep Causative factors include medical conditions and drugs of abuse Involuntary micturition during sleep occurring in a patient who usually has control Most common 3–4 hours after bedtime, but not limited to a specific stage of sleep + Clinical Findings Download Section PDF Listen +++ ++ Fear, sweating, tachycardia, and confusion for several minutes Abrupt, terrifying arousal in sleep Amnesia for the event Confusion during the event and amnesia after it are common + Diagnosis Download Section PDF Listen +++ ++ Sleep walking is confirmed by a sleep study + Treatment Download Section PDF Listen +++ ++ Benzodiazepines (diazepam, 5–20 mg orally at bedtime, suppresses stage 3 and 4 sleep) Desmopressin nasal spray is likely the treatment of choice for nocturnal enuresis Alternatively, imipramine, 50–100 mg orally at bedtime Behavioral approaches (eg, bells that ring when a pad is wet) have been successful