A Complete Guide For Parasomnia: Causes, Symptoms, Treatment And Diagnosis

Parasomnias are sleep disorders characterised by abnormal behaviours during sleep.

They include night terrors,  nightmares, sleepwalking, sleep talking, REM behaviour disorder (RBD), confusional arousal, parasomnia due to epilepsy or other medical conditions, and parasomnia due to substance abuse.

Parasomnia is defined as a condition where a person has unusual behaviours during sleep.

These behaviours range from simple movements such as scratching or twitching to complex actions such as  walking around in their sleep.

Parasomnias can occur at any age, although they are more common in children and young adults.

The cause of these disorders is unknown, but some researchers believe that genetics plays a role. Some parasomnias are associated with certain medical conditions, such as epilepsy, narcolepsy, brain injury, or psychiatric illness. Other causes include medications, alcohol, and drugs.

In this blog post, we will discuss the different types of parasomnias, their symptoms, treatments, and prevention strategies.

What Are The Different Types Of REM And NREM Parasomnias?

There are many different types of parasomnias. Some are fairly easy to identify while others may be difficult to distinguish from normal  sleep behaviours.

NREM Parasomnias

Non-REM parasomnias are characterised by physical and verbal activity.

During these episodes, you are not completely conscious or attentive; you are unable to react to others' attempts to interact with you, and you generally don't remember the event the next day.

Non-REM  parasomnias are most common in those between the ages of five and 25. Non-REM parasomnias are more common among individuals with a family history of similar disorders.

REM Behaviour Disorder: Rapid Eye Movement Sleep

The three non-REM stages of the sleep cycle are followed by rapid eye movement (REM) sleep.

During  REM sleep, your eyes move rapidly beneath your eyelids, and your heart rate, breathing, and blood pressure all rise. This is when you experience vivid dreams.

Every 90 to 110 minutes, your body cycles through and recites non-REM and REM sleep. Parasomnias occur late in the evening.

If you are awakened during the incident, you will be able to recall at least part of the dream. Parasomnias that are part of REM Sleep Disorder are:

Recurrent Isolated Sleep Paralysis

You can't move your body or limbs while sleeping if you have this sleep condition.

The paralysis, according to researchers, might be caused by an extension of dream sleep - a phase in which muscles are already relaxed.

This typically occurs before you go to sleep or as you are waking up. Episodes are brief and distressing, and they generally induce anxiety or dread. If your bed partner talks to you or touches you during sleep paralysis, it can be halted.

Some Other Types Of Parasomnias

Nightmare Disorder

These are  nightmares that induce feelings of dread, terror, or anxiety. You could feel like you're in danger of losing your life or freedom.

If you are awakened during your nightmare, you'll be able to recall it thoroughly.

It's tough to fall asleep again after you've woken up. Nightmare disorder is more likely if you're anxious or have experienced a traumatic event, sickness/fever, extreme tiredness, or alcohol consumption.

REM Sleep Behaviour Disorder (Rsbd)

If you have this sleep disorder, you may act out, vocalise (i.e., talk, swear, laugh, shout), or make aggressive gestures (i.e., punching, kicking, grabbing) as a result of a scary dream.

The most common type of sleeping problem is  sleep apnea, which affects mostly older individuals.

Many sufferers of this illness have neurodegenerative disorders such as Parkinson's disease, Lewy body dementia, multiple system atrophy, or stroke.

Parasomnias that are prevalent under Non-REM sleep include:

Night Terrors

A   night terror occurs when someone suddenly awakens out of deep sleep. During a night of terror, the individual seems confused and agitated. He or she may thrash around and make loud noises.

This type of behaviour typically happens only once or twice a month. It's not dangerous, but it can scare the heck out of anyone nearby.

Sleep Walking

Sleepwalking is an involuntary movement that happens while sleeping. You may move around your bedroom without having any memory of what happened after you fall back asleep.

In rare cases, sleepwalkers may get out of bed and wander around the house. Sleepwalking is most likely to happen if you're tired or stressed.

Sleep Talking

Sleep talking is when you say things while you're asleep. It may sound like gibberish, or it may be coherent speech.  Sleep talking is most common between 2-4 AM.

Confusional Disorder

If you have this sleep condition, you seem confused and disoriented about time and place. You stay in bed, sit up, keep your eyes open, and cry.

You take a long time to speak and have trouble comprehending questions or responding appropriately.

The episode can last anything from a few minutes to several hours. Confusional arousals are typical among children and tend to become less frequent  with age.

Nocturnal Eating Syndrome

If you suffer from sleep apnea, you may eat and drink while still half awake. You could consume meals or meal combinations that you would avoid if you were fully awake (such as uncooked chicken or slabs of butter).

Dangers include eating inedible or  hazardous food, consuming excessive meals, and ingesting unhealthy or excessive diets. Cooking or preparing meals can also produce injuries.

Exploding Head Syndrome

You hear a loud noise or an explosion as you fall asleep or wake up if you have this sleep issue. You could also witness an imagined flash of light or experience a sudden  muscular movement.

Sleep Enuresis (Bedwetting)

This is not the sort of bedwetting that affects young children. This  bedwetting must occur in children aged five years old or older and must happen at least two times each week for at least three months to be a parasomnia.

Sleep-Related Hallucinations

Sleep-Related Groaning (Catatonia)

You have recurring instances of groaning noises (long groans followed by sighs or grunts) while sleeping with this sleep problem.

Sexsomnia

People suffering from such types of  insomnia are indulgent in sexual behaviours without knowing, i.e. during their sleep. They may indulge in sexual assault, intercourse, fondling their bed partner, sexual vocalization, or masturbation.

Parasomnia In Children

Parasomnia affects more  children than adults. It is most prevalent in youngsters with neurological or psychiatric disorders such as epilepsy or ADHD. Child parasomnia is caused by factors including stress and lack of sleep.

In contrast, parasomnia in youngsters is generally the result of a  delayed sleep-wake cycle. This means that the lines between wakefulness and sleep are underdeveloped, resulting in a perplexing condition of consciousness.

Parasomnia usually passes in childhood.

In contrast to adults, children with parasomnia may be more prone to crying and worry. They might be afraid to sleep alone. If your child has unusual sleeping patterns, remember that they are not intentional. Instead of reprimanding them, focus on being encouraging.

If they wet the bed, suggest that they use the toilet  before going to sleep.

What Are The Causes Of Parasomnia?

The exact cause of each type of parasomnia is unknown. Some researchers believe that certain brain chemicals called neurotransmitters play a role in causing them.

For example, serotonin plays a role in sleepwalking. Other experts think that genetic factors influence how people develop parasomnias.

According to  NIH, children who have a family history of parasomnias tend to experience more frequent episodes of parasomnias than those whose families don't have this history.

What Are The Symptoms Of Parasomnia?

Some of the symptoms of parasomnias include:

• Uncontrollable limb movements
• Acting out dreams
• Falling down
• Fainting
• Having  nightmares
• Speaking incoherently
• Waking up screaming
• Wandering around the house
• Getting into trouble at school
• Being aggressive toward others
• Repeatedly waking up in the morning
• Not being able to go back to sleep

What Is The Treatment For Parasomnia?

Treatment depends on the specific type of parasomnia.

For example, if you notice your child having an episode of sleepwalking, you can try to stop it by keeping him awake until he  falls asleep again. You can also help prevent future episodes by making sure your child gets enough restful sleep every night.

For children who have  sleep terrors, you can teach them relaxation techniques to control their fear response. Try using a technique called progressive muscle relaxation, where you tense and relax muscles one at a time.

If your child has night terrors, you can try to calm her down by letting her stay in bed with you until  she feels sleepy.

For children who have confusional arousals, you can teach them ways to recognize when they are dreaming. For instance, you can tell them to close their eyes and count backwards from 10 to 1. If they start counting backwards too fast, they are probably still dreaming.

You can also talk to your child's doctor or therapist about other treatments that could benefit your child.

How Does Parasomnia Affect The Body?

People who have parasomnias may not be aware of what is happening while they are acting out their dreams.

This lack of awareness can lead to injuries. For example, someone who is sleepwalking might trip over his own feet and fall. Or, a person who is sleep-talking might bite another person.

Parasomnias can also make it difficult for people to function during the day. For example, a person who is having a dream involving violence might become violent towards other people. A sleepwalking person might wander away from home.

Parasomnias can also interfere with learning. Children who have sleep terrors   often wake up screaming. They may not remember what happened while they were sleeping. This makes it hard for them to learn new things.

Are Certain Parasomnias More Common To A Certain Gender?

Nightmares are more common in women. Males  above the age of 50 are more likely to have sleep terrors, confusional arousals, and sleepwalking.

Sleep terrors, confusional arousals, and sleepwalking occur at roughly the same rate in both genders. Sexsomnia appears more in males than in females.

How Is Parasomnia Diagnosed?

If you and your sleep partner are experiencing similar problems, a sleep medicine specialist will inquire about your  sleeping difficulties.

You'll also be asked about your medical history, family history, alcohol consumption, and any substance abuse... You'll be questioned about your current medicine.

You may be asked to keep a sleep diary, and your bed partner will be asked to record all of your sleep-related activities.

Other  sleep disorders tests include:

• A sleep study (polysomnogram): This is a sleep laboratory where you will be observed while sleeping. Your brain waves, heart rate, eye movements, and breathing will all be tracked as you sleep. The video will capture your activities and behaviour during the study. If there's a concern for parasomnia, in-lab research would be suggested rather than a home-based study.
• Video electroencephalogram (EEG) or sleep EEG: Tests like these assist your healthcare provider in seeing and recording the activity of your brain during a brain event.

A neurologic examination, CT or MRI scan to look for brain deterioration or other possible neurological reasons for your symptoms.

FAQs

Now that you know all about parasomnia, let’s take a look at a few frequently asked questions.

How Do I Know If My Child Has Parasomnia?

Parasomnias are hard to diagnose because they look so much like ordinary  sleep behaviours. Your paediatrician should ask questions about how often these behaviours occur, their duration, whether there are associated symptoms, and whether they interfere with daily life.

What Are The Side Effects Of Parasomnia?

There are no known long-term  health consequences of parasomnias in children. However, some parents report that their children have experienced depression after experiencing parasomniac episodes.

Wrap Up!

The most important thing to do if you suspect you have parasomnia is to seek help from a physician. The best treatment option depends on the type of parasomnia you're dealing with.

Some types of parasomnias can be treated with medications. Others require behavioural therapy. In some cases, a combination of treatments is needed.

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