“Sleepwalkers have been described to be involved in complex motor activities like cooking, eating, driving a car, playing an instrument, stabbing and murder [1]. We describe a case of a 44-year-old woman with idiopathic insomnia almost all her life. She tried various medications, psychotherapy and behavioral techniques for the treatment of her insomnia without any significant effects. She was started on Zolpidem 10 mg 4 years ago. She was able to sleep 4–5 h each night, but then the effects started wearing off. She increased the dose of Zolpidem by herself to 15 mg every night; she would take 10 mg tablet around 10 p.m. and 5 mg around 3 a.m. With this regimen she started sleeping for 5 h every night and felt alert during the daytime. After increasing the dose, she began to have episodes of sleepwalking. During one such episode, she went to bed around 10 p.m., she woke up 2 h later, and walked to the next room on the same floor. She turned on the computer and connected to the internet. She logged in by typing her user ID and password to her email account. She sent three emails to her friend inviting her to come over for dinner and drinks (Fig. 1A and B). Her friend called her the next day to accept the invitation. She said that the emails had strange language. The patient was not aware of these emails. She checked her sent folder and found three emails sent at 11:47 p.m., 11:50 p.m. and 11:53 p.m. They were in upper and lower cases, not well formatted and had strange language. She was shocked when she saw these emails, as she did not recall writing them. She did not have any history of night terrors or sleepwalking as a child. Her overnight video polysomnogram did not capture any episode and was normal. She was advised to reduce her dose of Zolpidem; after which she did not have any more episodes of sleepwalking.”
Bonus Figure:
Fig. 1. (A) Emails written by patient during an episode of sleepwalking. (B) Emails written by the same patient three minutes after the first e-mail (A) during an episode of sleepwalking.
Photo: flickr/Ingorrr
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