Introduction
Slow wave sleep (SWS) is deep sleep and occurs in the non- rapid eye
movement (NREM) stages 3 and 4[1]. Frequent
arousals during this stage leads to sleep walking (SW)[2]. SW and SRED are 2 separate entities but both
are classified as parasomnias[3]. Serotonin
receptors are involved in maintaining sleep and causing muscle hypotonia
during sleep[2].. Atypical
antipsychotics are commonly used in psychiatric and primary care
practice and place patients at risk of parasomnias such as SRED and this
condition may go undetected especially among psychotic patients where it
may be mistaken for psychosis[2]. Quetiapine,
olanzapine, chlorpromazine and clozapine which act through serotonin
receptors are often used off label to aid in
sleep[3]. Medication induced SW and SRED have been
reported with quetiapine being the most
implicated[4]. The prevalence of SRED in the adult
psychiatric population ranges from 1-5%[5].
Prevalence of SW is 6.9%[6]. Both conditions are
little discussed during follow up visits and are generally not detected[1, 2].
Quetiapine [2,5,7,8,9] ,
olanzapine[2] and other atypical antipsychotic
medications[2], have been associated with SW and
have been reported to be associated SRED. It is important to discuss
this potential adverse effect with patients of these medications to
prevent injuries and weight gain in the patient.