Purpose: To assess the prevalence, types, sociodemographic factors, and reported dangerous activities of sleep-related behaviors likely representing NREM parasomnia episodes, as well as their association with adverse childhood experiences in Hungary. Methods: Cross-sectional survey of 1000 adults (aged ≥18 years) representing the Hungarian population, using a non-probability quota sampling with a random walk method and a structured face-to-face interview. A multi-criterion weighting procedure was applied to correct bias along the main sociodemographic variables to the data available. Binary logistic regression estimated the odds of NREM parasomnia-related behaviors associated with sociodemographic factors and adverse childhood experiences. Results: The prevalence of NREM parasomnia-related behaviors was 2.7 %, and self-reported sleep-eating was 0.1 % of the population (4.6 % of parasomnia-like activities). For middle-aged adults, the odds of sleep ambulation were significantly lower than for younger adults (OR 0.3; P = 0.03). A participant's family occurrence of reported parasomnia-like activity increased their odds of having it by more than 7 times (OR 7.1; P < 0.001). Nine participants out of those 27 people reporting NREM parasomnia-related behavior episodes, reported childhood adverse experiences, increasing the odds of parasomnia-related behavior by more than six times (OR 6.2; P < 0.001) compared to those not reporting it. Conclusion: This is the first population survey in Hungary on adult sleep-related behaviors likely representing NREM parasomnia episodes and the potential association with childhood traumatic events preceding them. The related dangerous behaviors call for safety measures and prevention. The significant association between adverse childhood events and NREM parasomnia-related behaviors needs further analysis.

Objective: To assess the adult Hungarian population's knowledge about and attitude toward epilepsy and compare the present findings with previous ones in 1994 and 2000. Methods: We performed a cross-sectional survey of the Hungarian adult population from 28th February to 8th March 2023. A non-probability quota sampling with a random walk method was used. We applied the computer-assisted personal interviewing (CAPI) method and used a multicriteria weighting procedure to correct for bias along the main sociodemographic variables. To detect changes over time, we used chi-squared tests, and to analyze the effect of sociodemographic characteristics, we applied multivariate logistic regression. Results: One thousand participants (53.1% women, mean age 48.1 ± 16.75 years) representing Hungary's population were interviewed yielding a response rate of 80.3%. 26.3% knew someone with epilepsy (55.9% in 1994 and 51.9% in 2000), and 30.8% saw an epileptic seizure (58% in 1994 and 55.3% in 2000). Compared to the young, fewer adults and elderly people knew someone with epilepsy or had seen a seizure. Like in 1994 and 2000, 16.6% reported objection to their children's interaction with people with epilepsy; however, in the present study, significantly fewer people opposed their children marrying or working together with epileptic people, indicating a change in attitude (p < 0.0001). Rural residents had less objection to their children's interaction with people with epilepsy (p < 0.05). People with secondary education objected significantly more often than those with primary education to their children's interaction (p = 0.037), marriage to people with epilepsy (p = 0.043), or their having equal employment (p = 0.008). Higher education people were as “permissive” as those with primary education. Significance: Certain parameters of familiarity and attitude markers of the Hungarian population toward epilepsy have improved. These tendencies are promising, but work is still needed; our results will hopefully evoke educational programs and campaigns against negative attitudes. Plain Language Summary: The knowledge of the Hungarian population about epilepsy and their attitude toward people with epilepsy has been improved since 1994. People from rural areas have shown more acceptance for people with epilepsy. Those people who completed secondary education were significantly more prone to stigmatization than those with primary education.

Study objective: Finding typical patterns - phenotypes - of sleep behaviors characterizing parasomnias in different age and sex groups. Methods: We analyzed YouTube videos on sleep-related behaviors likely representing parasomnias. We applied the search terms “sleepwalking”, “somnambulism”, “sleep eating”, “sleep sex”, “sleep talking”, and “aggression in sleep” in six languages. We classified those persons shown on the videos into estimated biological sex and age (child, adult, elderly) groups. We scored the activity types by a self-made scale and applied binary logistic regression to analyze the association between sleep behaviors versus sex and age groups by the STATA package, providing a 95% confidence interval and the probability of statistical significance. Results: 224 videos (102 women, 68 children, 16 adults, and 40 elderly people) were scored. Elderly people had significantly (P < 0.012) lower odds of sleepwalking compared to adults and children. Adult females performed complex manual activities during sleepwalking more often than males (P < 0.012). Elderly males had 40-fold odds compared to adults and children, to perform aggressive movements and 70-fold odds of complex movements in bed, compared to adults. Elderly people presented emotional behaviors less frequently than adults (P < 0.004), and females showed them twice as often as males. Adults sleep-talked full sentences more often than children and elderly people (P < 0.001). Conclusion: Our results support the existence of age- and sex-specific parasomnia phenotypes, denoting possible safety measures. The remarkably low odds of sleepwalking in the elderly highlight the possibility of different pathomechanisms in higher age groups compared to children. Brief Summary and study impact: Parasomnias present highly variable clinical forms and often cause injuries. Identifying typical phenotypes may help risk management and imply theoretical conclusions. Our study supports the existence of age-specific parasomnia phenotypes. We found that adult women have a high risk of performing dangerous activities during sleep, and elderly males often move violently in bed, likely representing dream enactment behaviors. Elderly people of both sexes have low odds of sleep ambulation- likely representing somnambulism; compared to adults and children, constituting a descending “age slope” of somnambulism that might reflect different underlying pathomechanisms in children versus adults and the elderly.

Background: Individuals with NREM parasomnias exhibit abnormal slow-wave activity and fragmented sleep. Sleep-state dissociation is the prevailing concept of NREM parasomnia-episodes; typically emerging from N3/N2 stages of NREM sleep’s first cycle at the turning-point of deep sleep and arousal. While these relations provide a frame to understand these conditions, their mechanism and brain-topography remain unclear. Methods: We performed a systematic search of the literature (1/01/2015-20/06/2024) on brain-topographies and morphological changes based on neurophysiological and imaging studies in patients with NREM parasomnias. Results: It was shown that immediately preceding clinical episodes, the EEG spectral power of delta and theta frequency-bands increased in parallel with its reduction in the cingulate, motor, and premotor/supplementary motor cortices. Far from clinical episodes, in NREM and REM sleep as well as in wakefulness, a cortico-cortical sleep-state dissociation occurred, too. In addition, the partial arousals of episodes evolved from ‘deeper’ sleep with lower-amplitude slow waves, compared to episode-free arousals of the same people with NREM parasomnias. A single MR-morphology study revealed decreased grey-matter volume in the left dorsal posterior cingulate and mid-cingulate cortices in patients with mixed NREM parasomnias. Conclusion: Based on recent research, the state-dissociation evidenced in clinical episodes might characterize each vigilance state of people with NREM parasomnias, even outside the episodes, making sleep-wake dissociation a trait-like core feature of NREM parasomnias. The anterior cingulo-frontal regions seem to have central roles. PROSPERO registration ID: CRD42024552562.