{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:19:23Z","timestamp":1791238763557,"version":"4.1.0"},"reference-count":80,"publisher":"American Association for the Advancement of Science (AAAS)","issue":"3819","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Science"],"published-print":{"date-parts":[[1968,3,8]]},"abstract":"<jats:p>In summary, the classical sleep disorders of nocturnal enuresis, somnambulism, the nightmare, and the sleep terror occur preferentially during arousal from slow-wave sleep and are virtually never associated with the rapid-eye-movement dreaming state. Original data are reported here which indicate that physiological differences from normal subjects, of a type predisposing the individual to a particular attack pattern, are present<jats:italic>throughout<\/jats:italic>the night. The episode, at least in the case of enuresis, appears to be simply a reinforcement of these differences to a clinically overt level.<\/jats:p><jats:p>A number of features are common to all four sleep disorders. These had been shown previously to be attributable to the arousal itself. New data obtained by means of evoked potential techniques suggest that these common symptoms of the confusional period that follows non-REM sleep are related to alterations of cerebral reactivity, at least of the visual system.<\/jats:p><jats:p>The symptoms which distinguish the individual attack types (that is, micturition, prolonged confusional fugues, overt terror) appear to be based upon physiological changes present throughout sleep which are markedly accentuated during arousal from slow-wave sleep. These changes may in some way be related to diurnal psychic conflicts. But, to date, it has proved impossible to demonstrate potentially causal psychological activity, dreaming or other forms of mental activity, or even a psychological void in sleep just preceding the attacks.<\/jats:p><jats:p>The presence of all-night or even daytime predisposing physiological changes and the difficulty in obtaining any solid evidence of a preceding psychological cause explain, no doubt, why the results of efforts to cure the disorders at the moment of their occurrence (for example, by conditioning procedures in nocturnal enuresis) have been far from satisfactory.<\/jats:p><jats:p>I stress the points that the attacks are best considered disorders of arousal and that the slow-wave sleep arousal episode which sets the stage for these attacks is a normal cyclic event. Indeed it is the most intense recurrent arousal that an individual regularly experiences.<\/jats:p><jats:p>The most fruitful possibilities for future research would appear to be more detailed studies of those physiological changes that predispose individuals to certain types of attacks when they undergo intense arousal or stress; the reversal of these changes by psychological or pharmacological means; and more refined investigations of the physiological and psychological characteristics of the process of cyclic arousal from non-REM sleep.<\/jats:p>","DOI":"10.1126\/science.159.3819.1070","type":"journal-article","created":{"date-parts":[[2006,10,5]],"date-time":"2006-10-05T11:50:27Z","timestamp":1160049027000},"page":"1070-1078","source":"Crossref","is-referenced-by-count":522,"title":["Sleep Disorders: Disorders of Arousal?"],"prefix":"10.1126","volume":"159","author":[{"given":"Roger J.","family":"Broughton","sequence":"first","affiliation":[{"name":"Assistant professor in the department of neurology and neurosurgery, McGill University, Montreal, Canada, and clinical neurophysiologist, Montreal Neurological Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"221","reference":[{"key":"e_1_2_1_1_1","first-page":"591","volume":"40","year":"1930","unstructured":"ANDERSON, F.N., AM J DIS CHILD 40: 591 (1930).","journal-title":"AM J DIS CHILD"},{"key":"e_1_2_1_2_1","first-page":"270","volume":"56","year":"1956","unstructured":"ANDRE-BALISAUX, G, ACTA NEUROLOGICA ET PSYCHIATRICA BELGICA 56: 270 (1956).","journal-title":"ACTA NEUROLOGICA ET PSYCHIATRICA BELGICA"},{"key":"e_1_2_1_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1152\/jappl.1955.8.1.1","volume":"8","year":"1955","unstructured":"ASERINSKY, E, 2 TYPES OF OCULAR MOTILITY OCCURRING IN SLEEP, JOURNAL OF APPLIED PHYSIOLOGY 8: 1 (1955).","journal-title":"JOURNAL OF APPLIED PHYSIOLOGY"},{"key":"e_1_2_1_4_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1152\/jappl.1955.8.1.11","volume":"8","year":"1955","unstructured":"ASERINSKY, E, A MOTILITY CYCLE IN SLEEPING INFANTS AS MANIFESTED BY OCULAR AND GROSS BODILY ACTIVITY, JOURNAL OF APPLIED PHYSIOLOGY 8: 11 (1955).","journal-title":"JOURNAL OF APPLIED PHYSIOLOGY"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.118.3062.273"},{"key":"e_1_2_1_6_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/0022-3999(61)90020-4","volume":"5","year":"1961","unstructured":"BENTAL, E, DISSOCIATION OF BEHAVIORAL AND ELECTROENCEPHALOGRAPHIC SLEEP IN 2 BROTHERS WITH ENURESIS-NOCTURNA, JOURNAL OF PSYCHOSOMATIC RESEARCH 5: 116 (1961).","journal-title":"JOURNAL OF PSYCHOSOMATIC RESEARCH"},{"key":"e_1_2_1_7_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1126\/science.137.3530.601.a","volume":"137","year":"1962","unstructured":"BERGER, R.J., EYE MOVEMENTS DURING ACTIVE AND PASSIVE DREAMS, SCIENCE 137: 601 (1962).","journal-title":"SCIENCE"},{"key":"e_1_2_1_8_1","doi-asserted-by":"crossref","first-page":"240","DOI":"10.5694\/j.1326-5377.1962.tb25853.x","volume":"1","year":"1962","unstructured":"BOSTOCK, K.J., MEDICAL JOURNAL OF AUSTRALIA 1: 240 (1962).","journal-title":"MEDICAL JOURNAL OF AUSTRALIA"},{"key":"e_1_2_1_9_1","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/0013-4694(64)90060-4","volume":"16","year":"1964","unstructured":"BROUGHTON, R.J., POLYGRAPHIC SLEEP STUDIES OF ENURESIS NOCTURNA, ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 16: 625 (1964).","journal-title":"ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY"},{"key":"e_1_2_1_10_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/0013-4694(61)90132-8","volume":"13","year":"1961","unstructured":"CIGANEK, L, EEG RESPONSE (EVOKED POTENTIAL) TO LIGHT STIMULUS IN MAN, ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 13: 165 (1961).","journal-title":"ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY"},{"key":"e_1_2_1_11_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1113\/jphysiol.1960.sp006474","volume":"152","year":"1960","unstructured":"COBB, W.A., THE LATENCY AND FORM IN MAN OF THE OCCIPITAL POTENTIALS EVOKED BY BRIGHT FLASHES, JOURNAL OF PHYSIOLOGY-LONDON 152: 108 (1960).","journal-title":"JOURNAL OF PHYSIOLOGY-LONDON"},{"key":"e_1_2_1_12_1","unstructured":"de Manaceine M . 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