Parasomnia |Types|symptoms|treatment


Parasomnia is a  sleep disorder in which unwanted events or experiences occur while you are falling asleep or waking up.  Parasomnia includes abnormal behaviors, movements, emotions, perceptions, or dreams. If you have Parasomnia, you may find it difficult to sleep through the night and move around, do unusual things or talk during sleeping.

Types of Parasomnia

Some parasomnias occur during non-rapid eye movement sleep and some occur in the first half of the night. Others occur later in the night, during REM sleep

1.NREM-Related Parasomnias

Non-rapid eye movement sleep constitutes the 1st stage of one’s sleep cycle, called “shallow” sleep, and the 2nd, 3rd and 4th stages, during which the sleep becomes gradually deeper. Collectively, duration of these stages is usually about 90 minutes.

Disorders of arousal are the most common NREM-related parasomnias. These parasomnias are characterized by limited responsiveness to other people attempting to intervene or redirect the sleeper, limited cognition during the episode and recurrent episodes of incomplete awakening. If you have experienceof disorders of arousal face little to no memory of their episodes. These disorders include:

Confusional Arousals

This parasomnia is when the sleeper exhibits confused behavior or mental confusion in bed. Confusional Arousals is also known as sleep drunkenness or excessive sleep inertia makes you very slow when you wake up. This parasomnia is also known as Elpenor syndrome. Most people show behavior in the form of tachycardia, mydriasis, perspiration, or tachypnea (accelerated breathing), who experience confusional arousals.

Other behaviors include:

  • slow reaction time
  • slow speech
  • crying
  • poor memory


Sleepwalking also called somnambulism. Its occur when people walk around during sleeping.

Sleepwalking is most commonly occurring early in the night, during a stage called deep non-rapid eye movement (non-REM). During REM sleep, It can also happen in the early morning. It mostly causes problems in children between ages 5 and 12 and stop as children enter the teen years.

It tends to run in families. It’s not dangerous to wake a sleepwalker, but itself can be risky. Other complex behaviors like sorting clothes may exhibit by sleepwalking.

Sleep talking

Sleep talking also known as somniloquy. This is a sleep-wake transition disorder.It happens when people talk while asleep. Unlike sleepwalking, it can occur during any part of the night. In the lighter stages of sleep, the talking is usually easier to understand. Sleep talking usually isn’t dangerous but can disturb family members or bed partners. This parasomnia can involve long speeches or simple brief sounds. The talker mostly won’t remember doing it. Sleep talking can be caused by things like emotional stressfever, or other sleep problems

Night terrors (or sleep terrors)

Night terror (sleep terror) is caused when a person suddenly wake up in a terrified state. The duration of sleep terror can last from 30 seconds to 5 minutes. OR

It is a sleep disorder that caused feelings of dread or panic typically occurring during the 1st hours of stage 3–4 non-rapid eye movement (NREM) sleep and remain for 1 to 10 minutes. They can remain longer, especially in children.

Sleep terrors are also associated with:

  • screaming
  • crying
  • skin flushing
  • sweating
  • fast heart rate

Sleep-related sexual abnormal behaviors

Called colloquially as “sexsomnia,” this particular parasomnia subtype is characterized by unusual sexual behaviors during sleep, like initiation of sexual intercourse, aggressive masturbation, and sexual noises.

Studies have shown that females and males are equally susceptible to disorders of arousal. Parasomnias have been reported in roughly 17% of children ages 3-13. The prevalence rate falls between 2.9% and 4.2%, for children and adults 15 and older.

Sleep-related eating disorder

People with this parasomnia eat while they’re sleeping, often unusual foods such as cake mix or raw meat. It happens because of a mixture of non-REM sleep or wakefulness.

Risk  associated with sleep related eating disorder may include:

  • ingestion of toxic substances,
  • injuries from cooking or preparing food

2). REM-Related Parasomnias

Rapid eye movement sleep occurs following the 1st four Non-rapid eye movement stages of the sleep cycle. Following the 1 complete sleep cycle, REM and NREM stages will be recurring  every 1.30 hour or so in a cyclical pattern for the rest of the night. They will also experience faster breathing, and increases in both their blood pressure and heart rate.

REM sleep Behavior Disorder (RBD)

This is usually involves sleep paralysis and is characterized by unusual movements or vocalizations during REM sleep, often as a reaction to a dream,  but people with this parasomnia act out violent  or dramatic dreams during that sleep stage. It usually common in men aged 50 and older. It’s different from sleep terrors and sleepwalking because a person who has RBD canrecall vivid details of their dream and can be woken easily.

Typical RBD behaviors include:

  • punching
  • grabbing
  • shouting
  • jumping
  • kicking

Recurrent isolated sleep paralysis

People with this parasomnia feel complete bodily atrophy during sleep onset, the period before they fall asleep or upon waking. During this parasomnia, they will not be able to move any part of the body which normally doesn’t remain more than a few minutes. Sleep paralysis can lead to distress or anxiety about falling asleep.

Nightmare disorder

Nightmares are troubling, vivid, intense dreams that cause anger, terror, anxiety, or fear. It’s called nightmare disorder, when the nightmares frequently occur. Nightmare disorder is limited to those who experience vivid, recurrent dreams defined by threats to security or survival that result in reduced cognition, distress, fatigue, and other daytime impairments

This is a common component of Post-Traumatic Stress Disorder (PTSD).  Severe psychosocial stressors are often to blame, for children with nightmare disorder. The loss of a loved one, anxiety, illness, or reactions to a medication are the causes of nightmares.

3). Other Parasomnias

Another category for parasomnias is dedicated to behaviors that occur during the transition between wakefulness or sleep, as well as NREM or REM sleep.

These parasomnias include:

Exploding head syndrome

Also called sensory sleep starts, people with this parasomnia think that they hear a loud noise like an explosion or a bang, or feel an exploding sensation in their head when they wake up. You imagine a sudden, loud noise in your head. This sensation can leave the sleeper with lingering feelings of palpitation, anxiety, and dread, but it is usually painless.

Sleep related hallucinations

People with this parasomnia experience hallucination during either during hypnagogic (sleep onset) or hypnopompic(wake up). These hallucinations may be auditory, visual, kinetic or tactile in nature. 

Sleep Enuresis (bedwetting)

Sleep Enuresis or bedwetting refers to involuntary urination during sleep. It’s most common in in kids younger than 6 years old.There are two types of enuresis.Primary sleep enuresis refers to people who have never had control of their bladder at night. In secondary form, the person loses bladder control that haspreviously experienced bedwetting. Enuresis can be caused by psychiatric disorders or medical conditions (for example, urinary tract infections, diabetes, and sleep apnea.

Sleep Bruxism (Teeth Grinding)

Sleep Bruxism is when you clench or grind your teeth severely while you are sleeping. This parasomnia can cause

  • sensitivity or tooth pain
  • earache-like pain
  • jaw, neck or face soreness

Parasomnia causes

There are many possible causes of parasomnia. The disorder might be related with multiple triggers, including:

Parasomnia symptoms

Signs and symptoms of parasomnia are following:

  • wake up wondering where you are
  • wake up disoriented or confused
  • find unfamiliar cuts on your body
  • not remember doing certain activities
  • feelfatigue or daytime sleepiness
  • have difficulty sleeping throughout the night

Diagnosing a parasomnia

Diagnosis often includes:

  • Medical history.

Your doctor will ask about underlying current medications, medical conditions,lifestyle andfamily history.

  • Polysomnogram

In a polysomnogram, a specialist can analyze your sleeping behavior; you sleep in a lab overnight. They’ll record your breathing, brain waves, and heart rate to make a diagnosis.

  • Sleep history

A sleep diary can show your sleep behavior and can be observed how you sleep, if you live with someone.

Parasomnia treatment

Parasomnia treatment depends on the severity and type. Your doctor might recommend the following:

·        Medication

If  parasomnia is recurring or frequent , medication may  help to manage it. The best medication depends on symptoms.

Medications may  used to treat parasomnias include:

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a common parasomnia treatment. That’s because parasomnia is often related to mental health concerns, such as anxiety and stress.

Other therapies that can be used alongside CBT include:

Home treatments

Some treatments can be done at home. Your doctor may suggest:

  • Scheduled awakenings

when you wake up a child about 20 to 30 minutes before they spontaneously wake up. It can help minimize behaviors that follow a specific pattern. It’s often used for night terrors and sleepwalking.

  • Safer sleep environments

If you diagnosed with sleepwalking or RBD, you just need to sleep alone or remove dangerous things from your home. You can also place the mattress on the floor, lock windows and doors, and sleep with extra padding.


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