Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Neurology and Art Eur Neurol 2010;63:116–121 DOI: 10.1159/000277609 Sleepwalking in Italian Operas: A Window on Popular and Scientific Knowledge on Sleep Disorders in the 19th Century Michele Augusto Riva a, b Vittorio Alessandro Sironi a Lucio Tremolizzo c Carolina Lombardi d Giovanni De Vito b Carlo Ferrarese c Giancarlo Cesana b a Research Centre on the History of Biomedical Thought, b Research Centre of Public Health, Department of Clinical and Preventive Medicine, and c Neurology Section, Department of Neurosciences and Biomedical Technologies, University of Milano-Bicocca, Monza, and d Department of Cardiology, S. Luca Hospital, IRCCS, Istituto Auxologico Italiano, Department of Clinical and Preventive Medicine, University of Milano-Bicocca, Milan, Italy theories on sleepwalking, from demoniac possession to mental disorder and sleep disease. At the same time, this analysis throws some light on the history of psychological illnesses. Copyright © 2010 S. Karger AG, Basel Introduction Together with confusional arousal and sleep terrors, sleepwalking is classified as a disorder of arousal charac- terized by short simple behaviour or longer wandering episodes [1]. Disordered-arousal mechanisms with in- ability of the brain to fully awaken from slow-wave sleep are thought to lead to motor automatisms, including leav- ing the bed and walking [2] . Sleepwalking episodes usu- ally occur during the first 2 or 3 h of sleep, when sleep stages 3 and 4 are most prevalent. Sleepwalking episodes usually begin abruptly; patients show a blank expression, indifferent to the environment, with a low level of aware- ness and reactivity. In the state of somnambulism, pa- tients are confused, disoriented and unresponsive; they fail to achieve full consciousness and are extremely dif- ficult to wake up. They move around and perform normal actions as when awake (walking, cleaning, talking and Key Words Sleepwalking  History of neurology  Italian operas  Shakespeare Abstract There is little knowledge on sleepwalking in ancient times even though it is a very common condition. The aim of this report is to describe the backgrounds of medical knowledge on somnambulism in the 19th century, a key period in the development of neurosciences, by analysing its representa- tion in two famous Italian operas: La Sonnambula by Vincen- zo Bellini and Macbeth by Giuseppe Verdi. The 19th-century operas may be considered as a crossing point between the popular and intellectual world because they mirror popular answers to phenomena that were still awaiting scientific ex- planations. Shakespeare’s play Macbeth was also considered. In Shakespeare’s play and in Verdi’s Macbeth, sleepwalking is looked upon as a neuropsychiatric disorder, a manifestation of internal anxiety. In La Sonnambula by Bellini, this condi- tion is considered as common disorder that anticipates sci- entific theories. The analysed Italian operas provide two dif- ferent views on sleepwalking, probably because they are based on texts belonging to different periods. Their exami- nation allows one to understand the gradual evolution of Received: July 17, 2009 Accepted: November 22, 2009 Published online: January 26, 2010 Michele A. Riva Research Centre on the History of Biomedical Thought (Centro Studi sulla Storia del Pensiero Biomedico, CESPEB), University of Milano-Bicocca Villa Serena, via Pergolesi 33, IT–20052 Monza (Italy) Tel. +39 039 233 3098, Fax +39 039 365 378, E-Mail michele.riva @ unimib.it © 2010 S. Karger AG, Basel 0014–3022/10/0632–0116$26.00/0 Accessible online at: www.karger.com/ene