Delirium Tremens and Other Withdrawal Syndromes

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Delirium tremens complicates sudden alcohol withdrawal after chronic alcohol abuse and carries a mortality of 5-15% [156]. The main symptoms are agitation, tremor, increased autonomic activity and an acute confusional state with polymodal hallucinations and dream enactment.

Polysomnography in acute alcohol withdrawal syndrome may show a markedly reduced sleep efficiency, reduction or absence of NREM sleep and long periods of wakefulness alternating with abruptly emerging periods of REM sleep without atonia observed by Plazzi et al. [157]. The patient repeatedly presented with intense enacting dreams with violent fighting behavior, jerks and talking throughout the night and also during daytime episodes of drowsiness. Whenever awakened he reported vivid dream content.

Acute withdrawal from barbiturate and benzodiazepine can also be complicated by visual hallucinations and vivid dreaming.

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