SAEDNEWS: Parasomnia, or sleep disorder, is a group of sleep disorders in which individuals exhibit unusual behaviors while asleep. Examples include nightmares, sleepwalking, sleep talking, night terrors, teeth grinding, sleep paralysis, and more.
According to Saednews, Parasomnia is a general term used to describe unusual behaviors and experiences that occur before falling asleep, during sleep, or while transitioning between sleep and full wakefulness. People with parasomnia may walk, talk, eat, or perform other unusual activities while asleep. To observers, they may appear awake and alert, even though they are not fully conscious. In many cases, the person has little or no memory of the event after waking.
Parasomnia is a relatively common group of sleep disorders that can affect both the person experiencing it and those around them. In the past, parasomnia was sometimes considered a sign of psychological trauma. Current understanding, however, suggests that many parasomnias occur when the brain is transitioning into or out of sleep or moving between REM (rapid eye movement) and non-REM sleep.
Parasomnias are more common in children than adults, although they can occur at almost any age.
Although each parasomnia has its own symptoms and characteristics, they are generally divided into three broad categories:
Non-REM parasomnias
REM parasomnias
Other parasomnias
Non-REM sleep is the first part of the sleep cycle. It begins with light sleep and gradually progresses into deeper sleep. A complete sleep cycle generally lasts about 90 minutes, after which REM and non-REM stages repeat throughout the night.
Sleepwalking is a type of sleep-arousal disorder in which a person gets out of bed and moves around while still asleep. Their eyes may be open, but they are not fully conscious.
Most people who sleepwalk have little or no memory of what they did. Sometimes, they may wake up during an episode and appear confused, while in other cases they simply return to bed without fully waking.
Sleepwalking usually occurs during deep non-REM sleep, particularly during the first part of the night. Although it can affect children, adults, and older people, it is especially common among children between approximately 6 and 12 years of age.
Sleepwalking can sometimes be dangerous because the person is unaware of their surroundings and may fall, collide with objects, leave the house, or otherwise injure themselves.
Sleep terrors are another type of sleep-arousal disorder. A person may suddenly appear terrified during sleep, often crying or screaming. Other symptoms can include a rapid heartbeat, abnormal or rapid breathing, sweating, and intense fear.
After an episode, the person may remain confused for several minutes and may not respond normally to attempts to communicate with them.
Sleep terrors commonly last 10–20 minutes, although rare episodes may last 30–40 minutes. People who experience them usually do not remember the episode the following morning.
Sleep terrors generally occur during deep non-REM sleep, particularly during the first half of the night. A person may jump out of bed or run during an episode, potentially putting themselves or others at risk. Attempts to comfort or restrain them may sometimes increase their agitation.
Sleep terrors are particularly common among children between 4 and 12 years old. They can also affect adults, with severe emotional stress and alcohol use potentially increasing the likelihood of episodes.
Confusional arousals usually occur when a person partially awakens from deep sleep, particularly early in the night.
The person may sit up in bed, look confused, and appear disoriented because their brain has not fully transitioned into wakefulness. The episode is generally brief, although in rare cases it can last 30–40 minutes.
Trying to communicate extensively with someone experiencing a confusional arousal may prolong the episode.
This condition is particularly common in children and often disappears by around age five. In some cases, however, it can continue into adulthood. Adults may experience confusional arousals in association with stress, other sleep disorders, medical conditions, or sleep deprivation.
After progressing through the stages of non-REM sleep, the brain enters REM sleep. Once the first complete sleep cycle has occurred, REM and non-REM stages continue alternating approximately every 90 minutes throughout the night.
REM sleep is characterized by rapid eye movements and vivid dreaming.
Nightmares are vivid dreams that can cause fear, terror, anxiety, or other strong emotions. They generally occur during REM sleep, and people usually remember the details after waking.
Nightmares are more common during the second half of the night and may make it difficult to return to sleep.
They can be associated with illness, anxiety, emotional trauma, bereavement, stress, or certain medications. People who experience nightmares more than once a week may benefit from discussing them with a healthcare professional.
Sleep paralysis occurs when a person is temporarily unable to move while falling asleep or waking up. The condition results from the temporary persistence of muscle paralysis associated with sleep.
Episodes usually last from a few seconds to several minutes, but they can cause significant fear and anxiety.
Sleep paralysis generally resolves on its own. Some people find that being spoken to or touched by another person helps the episode end more quickly.
The exact cause is not always clear. However, genetics, insufficient sleep, and irregular sleep schedules may contribute to its occurrence.
REM sleep behavior disorder is a REM parasomnia in which a person physically acts out vivid, often frightening or violent dreams.
Normally, muscles become temporarily inactive during REM sleep, a state known as REM atonia. In people with REM sleep behavior disorder, this normal muscle paralysis is reduced or absent, allowing them to move, speak, kick, punch, or otherwise act out their dreams.
The disorder can sometimes be associated with certain antidepressant medications. It is more common in men over 50, although younger people and women can also develop it.
This category includes sleep-related conditions that occur during transitions between sleep and wakefulness or during either REM or non-REM sleep.
People with sleep-related eating may partially awaken during the night and eat or drink while remaining only partly conscious.
They often have little or no memory of eating the following day. Because the behavior is largely involuntary, they may consume inappropriate or potentially harmful substances and accidentally injure themselves.
People with exploding head syndrome experience a sudden, extremely loud perceived noise when falling asleep or waking up. The sensation may resemble an explosion, bang, crash, or other startling sound.
Some people also report seeing a brief flash of light.
Although the condition is generally painless and not physically dangerous, it can cause a racing heartbeat, fear, and considerable anxiety.
Sleep-related hallucinations occur while a person is falling asleep or waking up. They can involve visual, auditory, tactile, or movement-related sensations.
In more intense cases, a person may get out of bed or leave the room because they are attempting to escape what they perceive.
These hallucinations can sometimes continue for several minutes after waking.
Sleep enuresis refers to involuntary urination during sleep. It is particularly common among children.
Bed-wetting is generally considered a parasomnia when it occurs in a child aged five or older and happens at least twice a week for at least three months.
There are two main types:
Primary enuresis: The person has never consistently maintained nighttime dryness for an extended period.
Secondary enuresis: The person has remained consistently dry for at least six months and then begins wetting the bed again, occurring at least twice a week for three consecutive months.
People who sleep talk speak aloud while asleep. The speech is often unrelated to anything meaningful and may be difficult to understand.
Sleep talking is common and usually harmless. It can occur during both REM and non-REM sleep.
In some cases, however, frequent sleep talking may occur alongside REM sleep behavior disorder, sleepwalking, sleep terrors, or sleep-related eating.
In addition to unusual behaviors during sleep, parasomnia may involve:
Waking up confused or disoriented
Waking up without recognizing the surroundings
Having no memory of certain activities performed during sleep
Discovering unexplained injuries or bruises
Difficulty sleeping through the night
Excessive daytime sleepiness or fatigue
Several internal and external factors may increase the likelihood of developing parasomnia.
Sleepwalking and bed-wetting are particularly common during childhood. Many childhood parasomnias disappear as children grow older. If symptoms persist beyond childhood or become more severe, medical evaluation may be appropriate.
Some parasomnias appear to have a hereditary component. If sleepwalking, sleep terrors, or other parasomnias occur in a family, other family members may also have an increased likelihood of experiencing them.
Stress can trigger sleepwalking and other parasomnias in some people. In many cases, symptoms improve once the stressful period has passed.
Following a traumatic event, some people may develop post-traumatic stress symptoms accompanied by recurrent nightmares or other sleep disturbances.
Certain medications can cause nightmares or contribute to other parasomnia symptoms as a side effect.
Heavy alcohol consumption and substance misuse may increase the risk of sleepwalking, sleep terrors, and other parasomnias. They can also make existing symptoms worse.
If you experience symptoms of one or more parasomnias, consider consulting a sleep specialist.
Medical evaluation is particularly important when involuntary nighttime behaviors create a risk of injury to you or someone else.
REM sleep behavior disorder and sleep-related eating may require prompt evaluation because of the possibility of physical harm.
A sleep specialist may ask you to keep a sleep diary for approximately two weeks. This can help identify patterns, triggers, frequency, and severity.
During an evaluation, it is also important to provide a complete medical history and mention any medications you currently take or recently started.
Doctors generally try to determine whether the parasomnia is associated with another sleep disorder, a medical condition, medication, mental health condition, sleep deprivation, or substance use.
In some cases, additional sleep testing may be recommended to better understand nighttime behavior and brain and muscle activity.
Treatment depends on the specific type of parasomnia, its severity, and its underlying cause.
A sleep specialist may recommend a combination of medication, behavioral strategies, and lifestyle changes.
For people who sleepwalk or leave their beds during parasomnia episodes, safety measures can reduce the risk of injury:
Keep doors and windows securely closed and locked.
Consider installing alarms on doors and windows.
Remove dangerous objects from the bedroom.
Keep floors clear of objects that could cause trips or falls.
Consider sleeping closer to the floor and avoid high or bunk beds when appropriate.
The following strategies may help reduce or control parasomnia symptoms:
Get enough sleep every night.
Maintain a consistent sleep and wake schedule.
Take sleeping medication only as directed by a healthcare professional.
Avoid alcohol and recreational drugs.
If recommended by a healthcare professional, try scheduled awakenings shortly before the usual time an episode occurs.
Occasional parasomnia may not require treatment, particularly when it is mild and does not cause injury or significant disruption.
However, professional evaluation is recommended when episodes are frequent, become more severe, cause injuries, significantly disrupt sleep, involve dangerous behavior, or begin suddenly in adulthood.
A sleep specialist can help identify the underlying cause and determine the most appropriate treatment and safety measures.
