Stress in adult DoA: A web- based survey

Background and aims: Disorders of Arousal (DoA) are NREM parasomnias, encompassing three main clinical entities: sleepwalking (SW), confusional arousals (CA), and sleep terrors (ST). Clinical evidence suggests a bidirectional relationship between stress and DoA, wherein stress exacerbates parasomnia episodes, and the episodes themselves may contribute to psychological stress, impacting quality of life. The aim of our study was to evaluate the prevalence of these three DoA entities and their relationship with subjective perception of distress within a university population. Methods: A web‐based survey was conducted among students aged 18 to 35 at Bicocca University of Milan between May and June 2023. The survey collected data on sociodemographic characteristics and lifestyle habits, along with responses to two validated Italian questionnaires: the Arousal Disorder Questionnaire (ADQ), used to assess the occurrence of DoA (1), and the General Health Questionnaire (GHQ‐12), a widely utilized tool for measuring current psychological distress (2). Results: A total of 1,039 students completed the survey (259 males, 780 females), with a median age of 23.0 years (IQR: 21.0–25.0). The prevalence of SW, ST, and CA was 2.7%, 3.0%, and 5.9%, respectively. The overall GHQ score was 6.0 (IQR: 5.0 ‐ 8.0). Comparing subjects with or without DoA, perceived distress was significantly higher in individuals with ST (p=0.0359) and CA (p=0.0034), whereas no significant differences were observed for SW. Conclusion: These findings align with prevalence rates reported in broader adult populations and confirm an association between DoA and stress, claiming for new targeted therapeutic strategies.