1287 Screen Time to Dream Time: A Novel Case of Technology-Associated Parasomnia (TAP)

Abstract Introduction While the negative impacts of technology on sleep architecture are well-documented, parasomnias involving digital devices remain underrecognized. We present the first video-documented case of persistent smartphone use during sleep and propose diagnostic criteria for a novel parasomnia subtype: Technology-Associated Parasomnia (TAP). This case highlights the potential for technology to trigger and perpetuate sleep disturbances through behaviors during sleep. This report also underscores the need for clinical recognition of this increasingly relevant sleep disorder in our technology-saturated society. Report of case(s) A 26-year-old male presented with difficulty falling asleep, non-restorative sleep, nocturnal awakenings, and daytime sleepiness. He reported habitual phone use in bed but denied parasomnia history. Video-polysomnography (v-PSG) revealed prolonged sleep latency, decreased sleep efficiency, and sleep fragmentation. Video showed 225 minutes of awake phone use after lights off and 143 minutes of continued phone holding after sleep onset, including 51.5 minutes with the screen inactive. The patient repositioned the phone and maintained a screen-viewing grasp, even during stage R sleep, exhibiting REM without atonia (RWA). RWA Index was 19.6% with chin EMG and 37.0% with chin and tibialis anterior EMG. These behaviors spanned all sleep stages. The patient had no recollection of these behaviors the following morning. There was no sleep-disordered breathing or periodic limb movements of sleep. Conclusion This case provides objective, video-based evidence of technology-driven behaviors persisting into sleep, contributing to arousals and sleep fragmentation. We propose formal diagnostic criteria for TAP as a distinct parasomnia subtype. This report underscores the importance of recognizing TAP, particularly given the lack of patient recall, which may lead to underdiagnosis and chronic sleep disruption. Further research is needed to fully characterize the clinical implications of TAP and develop effective interventions. Support (if any)