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.