[Daytime sleepiness with recurrent nocturnal fall-related injuries: a case report of somnambulism triggered by severe obstructive sleep apnea].

This article reports a 34-year-old man who presented with snoring for more than 1 year, progressive daytime sleepiness for 6 months, and recurrent nocturnal fall-related injuries for 2 weeks. Video-polysomnography (vPSG) captured a typical somnambulism episode during non-rapid eye movement (NREM) sleep and confirmed the diagnosis of severe obstructive sleep apnea (OSA). After continuous positive airway pressure (CPAP) therapy, somnambulism episodes ceased and sleep architecture normalized. Notably, the result of the multiple sleep latency test (MSLT), which had been positive before treatment, also returned to normal after CPAP, suggesting that severe OSA can cause false-positive MSLT results through severe sleep fragmentation and rapid eye movement (REM) sleep rebound. This case suggests that in patients with sleepiness accompanied by abnormal nocturnal behaviors, vPSG should be performed first to screen for OSA, that OSA should be treated adequately and that MSLT should be deffered until adequate treatment of OSA has been achieved.