Assessing heart rate variability and pupil dynamics in patients with NREM sleep parasomnias

Disorders of Arousal (DOA), including sleepwalking, sleep terrors, and confusional arousals, are NREM parasomnias marked by complex behaviors, reduced awarness, and autonomic activation. Though common in children, DOA can persist into adulthood, causing distress, safety risks, and excessive sleepiness. Dysregulated arousal from slow wave sleep is believed to underlie these episodes, with evidence of abrupt autonomic changes during and preceding them.

This project investigates autonomic irregularities in DOA by analyzing heart rate variability (HRV) and pupil dynamics. Using a pre-existing polysomnographic dataset, HRV will be assesed during baseline sleep, parasomnia episodes, and recovery. A pilot study will employ pupillometry to evaluate pupil size, reactivity, and adrenergic fatigue. Statistical analysis will explore links between autonomic dysfunction and parasomnia severity. These findings aim to improve diagnostic accuracy, clarify DOA mechanims, and establish changes in HRV and pupil dynamics as biomarkers for autonomic dysfunction in parasomnias.