Tuesday, June 30, 2015

Length of time awake has no effect on my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of the amount of time spent awake that day. This is based on studies showing that sleep deprivation could be a triggering factor for sleepwalking.

The amount of time being awake (my daytime length) does not correlate with any of my sleepwalking scores, as the graphs below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness

Time of falling asleep has no effect on my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of the time at which I fell asleep. One of the goal here is to see if my body has an ideal time at which I should be falling asleep to minimize my sleepwalking.

The time at which I fall asleep does not correlate with any of my sleepwalking scores, as the graphs below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
The decreased average time between events (graph E) in all categories compared to the 21:30-22:00 group is most likely due to the low number of data points in that category and as such should not be considered significant.

Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Thursday, June 25, 2015

Physical activity has no major effect (if any) on my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of the physical activity I performed that day.
There are many reasons to look at this, among them to indirectly measure my tiredness level, the "reward" feelings associated with physical activity and all other mental benefits.

Having some physical activity (PA) during the day and its intensity does mostly not correlate with any of my sleepwalking scores, as the graphs below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

PA levels are classified as followed:
  • Level 0 = no significant PA
  • Level 1 = mild PA (walking around for at least 1h, commuting by bicycle, etc...)
  • Level 2 = prolonged but not "cardiologically" intense PA (mostly rock climbing)
  • Level 3 = prolonged PA with significant cardiac involvement (running, biking, etc for at least 30 min)
The complexity of my events is significantly increased on days with a level 2 PA intensity (graph C).
Because a level 3 PA does not lead to a statistically significant increase in event complexity, the trend observed in graph C might be due to a combination of factors.
But here again the goal was to see if there is any strong correlation with my sleepwalking, which is not the case.

Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Tuesday, June 23, 2015

My general mood is not correlated to my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of my mood at the time of going to bed. This is the best measure I have so far to identify some psychological component being my sleepwalking.

My overall mood at the time of going to bed does not correlate with my sleepwalking, as the graphs below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
This is a weak criteria to use as defining my mood is inherently subjective. But here again the goal was to see if there is any strong trend, which is not the case.
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Cepacol does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of Cepacol. Cepacol is an over the counter throat pain killer which I don't expect to impact my sleepwalking. But I want to verify that hypothesis so as to be able to include those nights into the "no drugs" category.

Cepacol has no effect on my sleepwalking, as shown on the graphs below.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Monday, June 22, 2015

Turmeric does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of turmeric because of its vague link with sleep benefits.

Turmeric has no effect on my sleepwalking, as shown on the graphs below. Some trends are visible but none are statistically significant.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Fish oil pills might delay my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of fish oil because of omega 3 fatty acids vague link with sleep benefits. 

Taking fish oil pills correlates with a small decrease in my average number of sleepwalking events per night, as shown on the graphs below (see graph A).
None of my other sleepwalking scores is affected by fish oil.
Those pills being a blend of different molecules (Omega 3 in general, including DHA, and EPA to name just a few) it is hard at this point to determine which component might be having a beneficial affect
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Eating green leaves does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of green leaves vegetables because of the vague link between antioxidants and sleep benefits. 

Eating green leaves (salad type) has no effect on my sleepwalking, as shown on the graphs below.
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Eating grapes does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of grapes because of the vague link between antioxidants and sleep benefits.  

Eating grapes has no effect on my sleepwalking, as shown on the graphs below.
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Eating berries has no effect on my sleepwalking events

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of berries because of the vague link between antioxidants and sleep benefits.  

Eating berries has no effect on my sleepwalking, as shown on the graphs below.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Watching movies has no impact on my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of watching movies. This is an open question as to see if movies have a relaxing or tensing effect. A more thorough investigation would be by subdividing movies into those 2 categories but this is a complicated process as the same movie could be relaxing or unnerving depending on other environmental parameters. So I just looked at the general effect of that special time associated with watching movie, good or bad.
This is potentially of particular impact as I don't have a TV and so the only thing I will watch (beside my computer for many hours at work) are movies.

Watching movies has no effect on my sleepwalking, as shown by the graphs below.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Friday, June 19, 2015

Ubiquinol does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of ubiquinol because of the vague link between antioxidants and sleep benefits. 

Ubiquinol has no effect on my sleepwalking, as shown on the graphs below. Some trends are visible but none are statistically significant.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Chocolate does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of chocolate because of the vague link between antioxidants and sleep benefits.  

Chocolate has no effect on my sleepwalking, as shown on the graphs below.
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

My sleepwalking is comparable on work and rest days

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of being at work or not that day. This is another measurement of a potential psychological trigger to my sleepwalking.

Being at work has no impact on my sleepwalking, as the graphs below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Last updated: 24 Sept 2015

Alcohol has no impact on my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of alcohol. The most likely guess is that it would render my sleepwalking worst. And so the main goal here is to see how much alcohol (even a small amount) is a bad idea being a sleepwalker.

Interestingly alcohol has no impact on my sleepwalking, as the graphs below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Additionally, the type of alcoholic beverage drank is not correlated with any of my sleepwalking scores, as graphs G to L below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Last updated: 24 Sept 2015

Multi-vitamin pills do not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of multi-vitamin pills. This is a little bit of a black box testing, to see if one of the many vitamin in those cocktails could be beneficial (or detrimental) to my sleepwalking.

Taking multi-vitamin pills does not affect my sleepwalking as the graphs below show.
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Black tea does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of drinking black tea.This is mostly to determine how safe or dangerous this drink is in correlation with my sleepwalking.

Drinking black tea does not affect my sleepwalking (see graphs A, B, C, D, E and F), at the opposite of coffee.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Sleeping alone or with a partner does not impact my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of sleeping alone or with a partner. This is another measurement of a psychological factor potentially impacting my sleepwalking.

As the data below show sleeping alone or with my partner has no impact on my sleepwalking (see graphs A, B, D, E and F).
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Interestingly, sleeping alone for more than 1 night consecutively has also no impact on my sleepwalking, as graphs G to K below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Mattress type has no impact on my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of sleeping on different mattresses. Since we have 2 different mattresses I compared them to see if that would affect my sleepwalking.

As the data below show it has no impact (see graphs A, B, C, D, E and F).
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Thursday, June 18, 2015

Green tea does not affect my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of drinking green tea.This is mostly to determine how safe or dangerous this drink is in correlation with my sleepwalking.

Drinking green tea does not affect my sleepwalking (see graphs A, B, C, D, E and F), at the opposite of coffee.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness.

Earplugs complexify my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of earplug.
Since I am a relatively light sleeper and get easily waken up by noises I regularly use earplugs.

Having earplugs correlates with events that are more complex (graph C) and last longer (graph D). This could indicative an increased difficulty for me to stop the event, having lost a sense (audition).
Interestingly earplugs do not impact the number of events (graph A), their intensity (graph B), their spread (graph E) or when they start (graph F).
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and are normalized for the effect of coffee and tiredness

Monday, June 15, 2015

Ibuprofen does not impact my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of ibuprofen. This had 2 goals: because ibuprofen is so effective for me with headaches I could only wonder what effect it would have on another head problem: sleepwalking.
The other goal was, if it has no effect, to be able to use those data as part of the "no drugs" group for other comparisons.

Ibuprofen has no effect on any of the scores or sleepwalking parameters monitored.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Data exclude nights with clonazepam and tiredness and are normalized for the effect of coffee.

Tiredness decreases my sleepwalking

After the birth of my second kid I became significantly more tired and noticed an overall decrease in most of the sleepwalking scores.

As shown below the number of sleepwalking events decreased (graph A) as well as the HLL (graph B) and BCSL scores (graph C) while the average time between events was not affected (graph E).
Interestingly the average event length also increased (graph D) but not the average time asleep by which the first event occurred (graph F).

Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
When looking further in details, tiredness slightly increases the intensity of my sleepwalking events (graph G and H) and they appear earlier in the sleep (graph I).

Those data suggest then that tiredness decreases my sleepwalking by decreasing the number of events. At the same time it makes those events more intense and bring them earlier in the night but in an effect marginal enough that my overall sleepwalking decreases.

Saturday, June 13, 2015

Should I record my EEG activity?

Yes.

EEG (electroencephalography) data provide a picture of the activity of different parts of the brain at any time of the night (when asleep vs when sleepwalking for example). So I would love to have this type of data as an additional variable.

What would be interesting with those data?

This would provide an additional angle to describe sleepwalking events (and probably to classify them) but also for example a way to dig deeper into the effect the different drugs I am testing are having.
EEG data might also show some interesting brain activity pattern when I am not sleepwalking but that relate to sleepwalking. And thus provide another window into assessing drugs effect for example.

So why don't I have EEG data?

It turns out to be a little more difficult than buying a video camera or a sleep tracking device.
EEG recording devices are sold to healthcare professionals, not the general public, and cost too much ($3,000 for the cheapest I could find) knowing that I am not sure to gain any additional information using them.

What about general public EEG recording?

There is some activity in that direction, mostly intended for video game use or some more general IT application. One example is Emotiv.
But those devices are not intended for sleep and I believe will move enough around my head during the night to render the data useless.

Friday, June 12, 2015

UP (Jawbone) sleep tracker does not detect my sleepwalking

As with the B1 sleep tracker, UP from Jawbone has the capability to detect sleep interruptions. So here also I looked at the detection rate of my sleepwalking events being labelled a sleep interruptions.
As the graph below show, UP very rarely sees my sleepwalking events as a sleep interruptions (data in purple).
Overall only 8.6% of my sleepwalking events are seen as a sleep interruptions by UP. And for a BCSL at level 5 (the level at which I am going out of bed) the detection rate is 47%.
If I include the "no data" category (when the device temporarily stops recording my sleep, which could be from the software not recognizing a sleep interruption) the rates are 12.1% and 54% respectively.
It is interesting to note that those values are relatively similar to those obtained with the B1 sleep tracker.

B1 (Basis) sleep tracker does not detect my sleepwalking

Among the many sleep tracking devices B1 provides some potentially interesting sleep data, especially sleep interruptions (see image below).
Those interruptions for most people are a trip to the restroom but in my case I wondered if they could be an alternate way to video for identifying my sleepwalking.
As the graph below show, B1 very rarely sees my sleepwalking events as a sleep interruptions (data in purple).
Overall only 5.4% of my sleepwalking events are seen as a sleep interruptions by B1. And for a BCSL at level 5 (the level at which I am going out of bed) the detection rate is 45%.
If I include the "no data" category (when the device temporarily stops recording my sleep, which could be from the software not recognizing a sleep interruption) the rates are 12.2% and 63% respectively.

Interestingly basis feature "toss and turn" does a slightly better job at detecting my sleepwalking, as this count is decreased by clonazepam (see graph below), which decreases my sleepwalking about 50%.

Also the overall the number of "tosses and turns" correlates with the number of sleepwalking events, their intensity and their complexity (see graphs below).
Unfortunately it has a high and variable false positive rate, as graph A shows (for example when 20 to 30 tosses and turns are measured only about 6 sleepwalking events happened), and as such is not a reliable measure of my sleepwalking.

Can sleep tracking devices identify sleepwalking?

Since a growing number of wearable devices and smartphone/tablet apps can monitor our sleep I tested a few to see if they could identify my sleepwalking.

Below is a summary of all the devices/apps I tested. Click on the links, for those that detect sleep interruptions, to see more details.
  • B1 by basis (www.mybasis.com): detects sleep interruptions but only about 5% of my sleepwalking.
  • Peak by basis (www.mybasis.com): this device replaces B1 but has a comparable detection rate of my sleepwalking.
  • UP by Jawbone (jawbone.com): detects sleep interruptions but only about 9% of my sleepwalking.
  • Flex by Fitbit (www.fitbit.com): not enough data to be conclusive yet (ongoing) but so far worst than UP or B1.
  • Beddit by Beddit (www.beddit.com): does not identify sleep interruptions per say but might be suggesting them, with about 22% of my sleepwalking detected then.
  • Sleepcycle by Northcube (www.sleepcycle.com): does not identify sleep interruptions
  • Sleepbetter by Runtastic (www.runtastic.com): does not identify sleep interruptions 
No sleep tracker detects my sleepwalking

For the devices that precisely provide the sleep stage at the time of a sleepwalking event, I compared those stages between them. For example if device 1 shows a light sleep stage at the time of a sleepwalking event, what is the stage on the other devices?
Only B1, UP and Beddit could be used for this comparison as the other devices do not provide sleep stages or access to the data.
The comparisons (graphs A to F below) show that B1 and UP have the most similar profiles while Beddit differs the most.
In general the light/deep sleep differentiation does not correlate between devices and is roughly a 60%/30% distribution across all devices and all sleep stages in the other 2 devices. This could be due to one device distinguishing light and deep sleep correctly while the other 2 do not. But since the spread of my sleep stages is relatively similar between devices (see graph G below), this is a strong suggestion that the light/deep sleep distinction made by all those devices is irrelevant.
Moreover, the drug clonazepam, which decreases my sleepwalking about 50%, has almost no impact on the distribution of my sleep stages, as shown in graph G and H below.
  
Comparison of sleep onset determination between devices

Since determining my sleep onset is a key parameter of my sleepwalking recording I need some reliable data and as such compared the 6 sleep trackers I am using concomitantly.
The graph below shows the sleep onset average deviation for each device out of 81 nights. Interestingly the most accurate and least variable device is a smartphone app (Sleeptracker), while 2 devices from the same company (B1 and Peak) show the most variability between them.

Are sleep tracking devices even accurate?

As part of the general questions around those consumer health devices, knowing their accuracy is essential. 

I found surprisingly little on that subject, which is already a problem in my hands: my B1 device (www.mybasis.com) is showing some signs of wear and tear but I cannot replace it as this device has been discontinued, and replaced with Peak (www.mybasis.com). As the sleep onset data above show, I cannot use Peak as a replacement of B1 but have to treat them as different devices. Which puts into question all the other data generated by those devices, and by any sleep tracker in general.

If there is no data showing that those devices are comparable to standard approaches to measure sleep they are as good as assessing sleep through a crystal ball. So as fancy as those devices sound at this point they are only useful to give me my sleep onset time (as long as I use multiple of them at the same time) and my heart rate at precise moments of my sleep.

Last updated: 22 Feb 2016

Coffee decreases my sleepwalking

As part of my investigation of what factor impacts my sleepwalking, I looked at the effect of drinking coffee.This is mostly to determine how safe or dangerous this drink is in correlation with my sleepwalking.

Coffee was an obvious parameter to see if there is any correlation with sleepwalking.
To my surprise coffee ... decreases the number of sleepwalking events, by 12% (see graph A below)!!
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Interestingly the average heart rate increase (graph B), event complexity (graph C) and event length are not affected (graph D) while the average time between events (graph E) and the time of the first event of the night (graph F) are both increased.

The next step is to look at correlation between the time of drinking coffee and my sleepwalking scores. Would a morning coffee have a different effect than an afternoon one for example?
As the graphs G to L below show there is no clear time effect, but more data need to be collected to be conclusive.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)


Those data do not include nights with clonazepam and take into account the effect of tiredness.
And the impact of coffee on my sleepwalking is not due to a coffee dependent alteration of my sleep habits, as the graphs M to R below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Last updated: 23 Sept 2015

How is this blog structured?

Thursday, June 11, 2015

About this blog

Who am I?

I am a scientist that was diagnosed a few years ago with sleepwalking. I have a relatively mild version of it: I probably wouldn't know about it if it wasn't for my partner complaining about it!!

What can I do about sleepwalking?

At first I did the regular thing: went to see some sleep specialist and spent a night at a sleep clinic. But nothing came out of it: no one had an idea as to why I sleepwalk, what causes it and what would help/prevent it.
So I started what I do daily: researched the scientific/medical literature to gather what's known about sleepwalking. And realized there isn't that much. Some extreme cases are described, a variety of treatments are suggested and some brain activity data have been established. But there is nothing close to a "mechanism of action" or even a drug regulatory approved for sleepwalking (all the drugs prescribed are approved for ... insomnia!!).
Then I realized that I am a case study to try to further understand sleepwalking and what can be done about it.

Why this blog?

After spending some time studying my sleepwalking I want to share my findings and the specifics of my case. By doing so I am hoping to:
  • provide a better picture of what a mild case of sleepwalking looks like.
  • provide longitudinal data of my sleepwalking and different treatment/factors to contribute developing a database of sleepwalking: the best way to fully understand sleepwalking is by collecting as much data about it from as many sources as possible
  • generate more interest toward sleepwalking, particularly from people affected by it. For example by putting sleepwalkers in contact and by developing approaches to further expand that database of sleepwalking
  • contribute to the development of new technologies to identify sleepwalking and parasomnia in general.

What is in this blog?

A compilation of my own research data about sleepwalking. Not done in any GXP way and thus not a definitive answer for any of the subjects covered.
All data presented here are relevant to 1 patient: myself. Every patient is different and thus those data might not be translatable to another patient. But that's why sharing those data and trying to have more people do the same would only help better understand sleepwalking.

How is this blog structured?

See the latest update.

Clonazepam decreases my sleepwalking

Clonazepam is one of the "standard" drug used to treat sleepwalking so it was the ideal starting point to see how it affects my sleepwalking but also to verify that my scoring approaches could capture the drug effect.

Clonazepam decreases my sleepwalking
As the graphs below show, Clonazepam at a dose of 1mg shows a trend toward a 20% reduction of the number of sleepwalking event per night (see graph A below) (more on data representation here).
But those are just trend as none of those values are statically significant.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
Interestingly with a dose 50% higher (1.5mg) the number of events and their average intensity are statistically reduced (see graphs G to L below).
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
This is particularly relevant considering that this data set has even less nights in it compared to the 1mg data set.
It would of course be very interesting to see if an even higher dose of clonazepam would be even more effective.The problem is that 1 day after taking 1.5mg of clonazepam I still see a statistically significant decrease of the number of sleepwalking events per night, as graphs M below shows.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)
This is most likely because clonazepam having a 30-40h half life (see on page 2 of this doc) I still have significantly enough of it in my body the second night to be effective.
One can only wonder then how much clonazepam impairs my daily activities between those 2 nights. And just because of that clonazepam can never become a regular treatment of my sleepwalking, even if it reduces it 100% at a higher dose.
Interestingly there is no clonazepam effect on the 3rd night (so about 48h after taking it), as the graphs S to X below show.
Average values, +/- SEM. % variation and statistical significance are indicated (if less than 1%)

Finding the right drug timing:
Because clonazepam has a plasma peak level of about 1-2h and because of the data in graph H suggesting that clonazepam is most active later in the night, I looked for a potential correlation between the BCSL for each event and the amount of time since taking the drug. As the graph showed below there is no correlation, suggesting that the drug was taken early enough before falling asleep to not "miss" the first sleepwalking events of that night:

Avoiding drug tolerance
Also because chronic use of clonazepam can lead to the development of tolerance (same drug dose becoming less effective) I limited my drug use to every 4 days at the minimum, since clonazepam half-life is about 30-40h.
I also verified that there was no correlation between the BCSL of each night and the number of days between doses of Clonazepam, as illustrated in the graph below:


Last updated: 23 Sept 2015

What affects my sleepwalking?

Medical/scientific literature data suggest that sleepwalking is linked to both genetic and environmental factors. The interplay between those two type of factors will most likely be unique to each individual (each genetic combination, assuming sleepwalking is not link to just one gene).

The complexity (i.e. number of parameters) of what impacts my sleepwalking is such that collecting enough individualized data for each parameter requires an extended period of time.
For example if the day of the week, coffee and the time of falling asleep each have an impact this very quickly becomes dozens of different conditions. If setting a simple goal of collecting just 10 nights for 12 parameters that means 120 nights. So this is a long process and for some parameters I will probably need years to collect enough data.
Added to that the characteristics of my sleepwalking as well as what triggers it is most likely changing over time (let's call it aging, instead of a better definition at this point). So I am also trying to keep time as a factor in the equation, and inversely to see if time or other long term variables (seasons for example) have an impact.

My main goal being to find (at first) major contributors (increasing or decreasing) to my sleepwalking, I have looked at most of the parameters below in a binary way: was that factor present that day or not? For some I quantified the factor frequencies or occurrences that day but for most I did not keep track of the time or dose as I am, so far,  looking for factors that have a clear, significant impact.
It is possible that some factors have very small contributions and that all of those small contributions together might have a significant impact on my sleepwalking. This is of course an interesting idea but not the purpose of this blog (yet).

Below is a summary of the different non-genetic factors for which I have enough data so far to draw some conclusions. Significant effect (text in blue below) was determined by a p-value under 1% using t-test.
Click on the links below to get the details of a specific parameter.

Pharmaceutical drugs:

Environmental factors:
  • Type of mattress: no effect
  • Use of earplugs: renders my SW 15% more complex
  • Blue light: most likely no effect (need more data)
  • Influence of the moon: most likely no effect (need more data)

Lifestyle factors:

Psychological factors:

Physical factors:

Drinks:

Food:

Food supplements:

How to compare sleewalking activity between nights

Having established a setup to identify every sleepwalking events during a night the next step was to find a method to compare nights.
For example to be able to determine if one night was better or worse than another or to identify correlations with potential treatments of influencing factors.

So I used the following approaches to give each night 6 different "scores"
  • Total number of events
  • Average event length
  • Average time between events
  • "Behavior complexity score light" (BCSL)
    • 5 level score where each level represent a defined action:
    • For each level a value of 0 or 1 is attributed
    • This gives each event a value ranging from 1 to 5, with a higher value for a more complex behavior. So the numerical value for that event describes how complex that behavior was.
    • This score is based on pattern observed regularly during my sleepwalking and will probably have to be modified to match each sleepwalker "signature"
  • "Behavior complexity score" (BCS):
    • 11 level score including the 5 levels in BCSL and 6 additional repetitive behavior:
    • For each level a value of 0 or 1 is attributed 
    • As for BCSL the value obtained (ranging from 1 to 11) represents how complex that behavior was.
    • Also as for BCSL, this score is based on pattern observed regularly during my sleepwalking and will probably have to be modified to match each sleepwalker "signature"
  • "Heart rate level increase" (HLL) divided into 5 increment groups (max value observed during event compared to night average value)
 
I then used those 6 scoring methods to analyze the effect of different treatments and factors on my sleepwalking.



What does my sleepwalking look like?

I defined a sleepwalking event as anything ranging from raising my head and staying still with eyes open for at least 7-8 seconds to getting out of bed (with no memories of doing so in all cases).

The graph below, representing over 470 nights, shows all my sleepwalking events, normalized to the time I fell asleep (determined by averaging the time measured by different sleep tracking devices).
Each dot represents 1 event, as identified by video
My sleepwalking fits the described pattern of having most events during the first 3rd of the night but it is interesting to note that there is still a significant amount of events later in the night.

The following graph shows that my first sleepwalking event occurs shortly after falling asleep (within 19 minutes in average).
Each dot represent the first event of that night, as identified by video
The following graphs show that I have an average of 8 events per night, lasting 43 seconds and happening every 37 minutes (more on data representation here).
All data are average values +/- SEM
Those events can be further divided into 5 categories based on their complexity. 
I developed a scoring system ranging from 1 (raising my head and staying still) to 5 (getting out of bed). Scores of 2, 3 and 4 represent increasing complexity of the event, mostly divided as raising my shoulders, sitting in bed and performing some actions. With a sequential logic in the scoring: so sitting in bed requires that I have raised my head and shoulders for example.
But the values 2 to 4 could be different combinations of complexity as my scoring doesn't distinguish between raising my head and performing an action versus raising my head and shoulders.
The graph below shows that about half of my events consist of raising my head and standing still (with eyes open), 25% of the events are level 2 while levels 3, 4 and 5 each represent 8-10% of the events.
Having established an approach to track my sleepwalking activity I developed different scoring systems to compare my sleepwalking activity between nights.