What Is Parasomnia?

A parasomnia is a sleep condition characterized by strange and unpleasant physical events or experiences that interfere with your sleep. A parasomnia can occur before, during, or after sleep arousal. You may have strange movements, talk, express feelings, or do weird things if you have parasomnia. Most times, you are actually sleeping, however your bed mate may believe you are awake.

Types of Parasomnias

Parasomnias are classified according to the state of sleep in which they occur. Sleep is divided into two stages: non-rapid eye movement (Non-REM) sleep and rapid eye movement (REM) sleep. Other parasomnias come within the category of “other.”

Non-Rapid Eye Movement (Non-REM) Sleep

Non-rapid eye movement (Non-REM) sleep is the first three stages of sleep, lasting from the moment you fall asleep to the first half of the night. Non-REM sleep disorders are sometimes known as arousal disorders.

Physical and verbal activity are involved in non-REM parasomnias. During these episodes, you are not fully awake or aware, you are not responsive to others’ attempts to interact with you, and you usually do not recall or just partially remember the incident the next day. Non-REM parasomnias are most common in children aged five to twenty-five. Non-REM parasomnias are more common in those with a family history of similar parasomnias.

Non-REM sleep parasomnias include the following:

Sleepwalking (somnambulism)

A sleepwalker gets out of bed and moves around with their eyes wide open, but they are actually asleep. You may mumble or speak (sleep talking). You may engage in difficult activities such as driving or playing a musical instrument, or you may do unusual things such as urinate in a closet or move furniture. Because you are ignorant of your surroundings, sleepwalking can be harmful and result in injury as you can collide with items or fall.

Confusional Arousals

If you have this sleep problem, you appear to be half awake but are bewildered in time and place. You stay in bed, may sit up, keep your eyes open, and cry. You speak slowly, have difficulty understanding inquiries, and react in a reasonable manner. The event can last anything from a few minutes to several hours. Confusional arousals are typical in childhood and diminish in frequency as one gets older.

Sleep Terrors

If you have this sleep disorder, you will wake up in a panicked mood. You may scream or cry out in terror. Sleep terrors are typically brief lasting for 30 seconds, although they might linger for many minutes. Other symptoms of this illness include a racing heart, wide eyes with dilated pupils, rapid breathing, and excessive sweating.

Sleep-Related Eating Disorder

This sleep problem causes you to eat and drink while you are partially awake. You may consume meals or food combinations that you would not consume if you were awake such as uncooked chicken or slabs of butter.  Eating inedible or toxic meals, eating unhealthy or too much food, or being injured while preparing or cooking foods are all risks.

Rapid Eye Movement (REM) Sleep

Rapid eye movement (REM) sleep occurs after the three non-REM stages of the sleep cycle. REM sleep causes your eyes to move rapidly beneath your eyelids, as well as an increase in your heart rate, breathing rate, and blood pressure. This is a season for vivid dreams. Your body cycles through and repeats non-REM and REM sleep every 90 to 110 minutes.

Parasomnias occur at the end of the night. If you were awakened during the event, you would most likely be able to recall part or all of the dream.

The following are examples of REM sleep parasomnias:

Nightmare Disorder

Nightmare disorder is characterized by vivid nightmares that elicit sensations of fear, panic, and/or worry. You may detect a danger to your safety or survival. If you are awakened during a nightmare, you will be able to explain it in full. You frequently have difficulty getting back asleep. Nightmare disorder is more likely to occur if you are stressed or have experienced a traumatic event, if you are ill or have a fever, if you are extremely exhausted, or if you have consumed alcohol.

REM Sleep Behavior Disorder (RSBD)

This sleep condition occurs when you act out, vocalize (e.g., talk, swear, laugh, shout), or perform aggressive motions (e.g., punching, kicking, grasping) in response to a violent dream. This sleep disorder is more prevalent in older persons. Many persons with this illness have neurological diseases such Parkinson’s, Lewy body dementia, multiple system atrophy, or stroke.

Recurrent Isolated Sleep Paralysis

This sleep disorder causes you to be unable to move your body or limbs while sleeping. Scientists believe the paralysis is the result of an extension of REM sleep—a period in which muscles are already relaxed. This occurs either before you fall asleep or when you awaken. Episodes can last from a few seconds to a few minutes and are upsetting, generating anxiety or panic.

Other types of parasomnia include:

• Exploding head syndrome: If you have this sleep problem, you will hear a loud bang or an explosive crashing sound in your head as you fall or wake up. You may also experience an illusory flash of light or a quick muscle jolt.
• Sleep enuresis (bedwetting): This is not the same as bedwetting in young children. This bedwetting must occur at least twice a week for at least three months in order to be classified as a parasomnia.
• Sexsomnia: People who suffer from this sleep ailment engage in sexual activities while sleeping. Intercourse, masturbation, sexual assault, fondling your bed partner, or sexual vocalizations are examples of these sexual activities.

What Causes Parasomnia?

The following conditions may enhance your chances of having parasomnias:

• genetics, as well as having a first-degree family who suffers from parasomnia
• syndrome of restless legs (RLS)
• limb movements at regular intervals
• obstructive sleep apnea
• insomnia
• a lack of sleep
• chronic pain syndromes
• psychiatric disorders
• certain drugs, such as sedatives
• alcohol misuse
• substance use disorder (addiction) or withdrawal
• inflammatory diseases such as encephalitis
• psychiatric disorders such as depression, anxiety, and post-traumatic stress disorder.
• neurological disorders: Parkinson’s disease, Lewy body dementia, stroke, multiple system atrophy, multiple sclerosis, brain tumors, migraines, and spinocerebellar ataxia type three.
• head injury
• menstruation or pregnancy

Symptoms of Parasomnia

Each type of parasomnia has its own set of symptoms and triggers, however, some of the most prevalent symptoms are as follows:

• Sleeping during the night is difficult
• Having a confused or disoriented awakening
• Being exhausted during the day
• Discovering cuts and bruises on your body for which you have no memory of the source
• Displaying gestures, expressions, vocalizations, or behaviors that you do not remember, as told to you by your bed partner

How to Treat Parasomnia

The treatment process begins with identifying and treating any underlying sleep difficulties or health conditions, as well as examining drugs that may be causing the parasomnia.

General care strategy for both Non-REM and REM sleep disorders are as follows:

• Following good sleep hygiene practices (getting 7-9 hours of sleep per night; turning off lights, TV, and electronic gadgets; keeping room temperature cool; avoiding caffeine and intense exercise before bedtime)
• Maintain your normal sleep-wake cycle. Maintain a regular bedtime and wake time.
• Limit or avoid the use of alcohol and recreational substances.
• Take all drugs as advised by your healthcare practitioner.

Now that you Know…

Although certain causes of parasomnia are unlikely to be avoided, such as those caused by neurological illnesses, mental health difficulties, or genetics, others may be avoided by employing some of the treatment strategies outlined in this article. These include getting seven to nine hours of sleep per night, maintaining normal bedtime and wake-up times, and limiting alcohol and recreational drug usage. Also, request that your existing drugs be reviewed by your healthcare physician. Many things can interfere with sleep. If this is the case, different medications may be suggested.