Analyse de l'activité en ondes lentes et des oscillations lentes chez les somnambules

Sleepwalking is a common parasomnia characterized by sudden but incomplete arousals out of non-rapid eye movement sleep during which predisposed individuals display motor behaviours of various complexity, accompanied by mental confusion and altered judgement. A growing body of evidence suggests that this condition could be associated with atypical patterns in slow wave activity and slow oscillations, both markers of the integrity of the homeostasis process and of sleep intensity. However, due to methodological limitations in past studies, the role of these electroencephalographic markers in the pathophysiology of sleepwalking remains unclear.  Our first article aimed at describing slow wave activity and slow oscillations abnormalities in sleepwalkers by comparing whole night sleep in 10 adult sleepwalkers and 9 control participants. In addition, since past studies have shown that increased homeostatic pressure has differential effects on sleepwalkers versus normal controls (e.g., in terms of sleep fragmentation), we compared slow wave activity and slow oscillations during baseline sleep and recovery sleep after 38 hours of sleep deprivation in patients and controls. Results show that sleep deprivation increases slow wave activity power density and slow oscillations density in both groups. However, contrary to our predictions, no group differences were noted on any of the two nights on slow wave activity or slow oscillations. Beyond methodological considerations which may partially account for this unexpected result, this study opens questions as to the homogeneity of sleepwalkers as a clinical population. Our second study focused on transient electroencephalographic fluctuations that may be associated with the onset of sleepwalking episodes. We compared slow wave activity and slow oscillations fluctuations in the moments leading up to spontaneous (that is, occurring without an identifiable internal or external stimuli) somnambulistic episodes recorded in the sleep laboratory in 12 adult sleepwalkers and comparing these patterns  to those observed prior to non-behavioural awakenings observed in the same patients. We showed that when compared to non-behavioural awakenings from the same sleep stage and sleep period, somnambulistic episodes were preceded by deeper sleep, as indicated by higher slow wave activity power density and slow oscillations density. This deepening  of sleepwalkers’ sleep occurs over a relatively long period of time (>3 minutes) before the episode, rather than abruptly in the seconds preceding episode onset.  These findings raise key questions about fundamental mechanisms involved in the occurrence of spontaneously recorded somnambulistic  episodes.   Taken as a whole, the results from the work presented in this thesis show that electrophysiological processes related to slow wave activity and slow oscillations play a role in the occurrence of somnambulistic episodes. However, the functional significance of these electroencephalographic markers in the pathophysiology of sleepwalking remains to be clarified.

Keyphrases: Parasomnies, Sleepwalking, Slow wave activity, Slow  oscillations