These disruptive sleep-related disorders arise from rapid eye movement (REM) sleep or arousals from non-rapid eye movement (NREM) sleep. They are characterized by undesirable physical or emotional experiences, such as walking or talking in association with specific sleep stages or sleep wake transitions.
What are the symptoms of parasomnias? There are many different types of parasomnias, including: Nightmares: Vivid dreams that can cause feelings of fear, terror and/or anxiety. Usually, the person is abruptly awakened from REM sleep and can recall details of their nightmare. Illness, anxiety, loss of a loved one or medications can cause nightmares.
Sleep terrors/night terrors: Abruptly arousing from a deep sleep in a terrified state. The person may appear awake, but is confused and unable to communicate. Lasting for about 15 minutes, the individual usually lies down and falls asleep afterwards, not remembering the event the next morning. Sleep terrors or night terrors are common in children between the ages of 4 to 12 years old, and may affect adults. Sleep terrors/night terrors are sometimes caused by emotional tension, and alcohol can increase their occurrence.
Sleepwalking: Occurs when a person appears to be awake, with eyes open, but the person is actually in a deep sleep. Sleepwalking is common in children between the ages of 6 to 12 years old, as well as in older
adults. The length of episodes varies, and individuals have little or no memory of their actions.
Confusional arousals: Occurs when a person is awakened from deep sleep during the first part of the night. It involves an exaggerated slowness or trouble comprehending upon waking.
Sleep eating: Characterized by abnormal eating patterns during the night without full awareness.
REM sleep behavior disorder (RBD): Acting out dramatic and/or violent dreams during REM sleep. RBD usually occurs in men who are 50 years or older, but it may occur in women and younger people.
Sleep enuresis (bedwetting): When a person is unable to maintain urinary control while asleep. Bedwetting may be primary (from infancy onward) or secondary (new onset condition) caused by medical conditions or psychiatric disorders.
How are parasomnias diagnosed? Frequent episodes that are disturbing to sleep or affect the household or cause injury require evaluation by a sleep expert. Primary care providers can diagnose and manage straightforward cases.
How are parasomnias treated? Many parasomnias are more common in children and do not require treatment, as they tend to resolve them in time. However, some parasomnias, such as RBD and confusional arousals in adults, may require treatment
such as medications. Enuresis is treated with behavioral modification, alarm devices and medications.