Parasomnias are disruptive sleep-related disorders. Abnormal movements, talk, emotions and actions happen while you’re sleeping although your bed partner might think you’re awake. Examples include sleep terrors, sleepwalking, nightmare disorder, sleep-related eating disorder and sleep paralysis. Treatment usually begins with non-medication options.
A parasomnia is a sleep disorder that involves unusual and undesirable physical events or experiences that disrupt your sleep. A parasomnia can occur before or during sleep or during arousal from sleep. If you have a parasomnia, you might have abnormal movements, talk, express emotions or do unusual things. You are really asleep, although your bed partner might think you’re awake.
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Yes. Parasomnias are grouped by the stage of sleep in which they happen. There are two main stages of sleep – non-rapid eye movement (Non-REM) sleep and rapid eye movement (REM) sleep. There are other parasomnias that fall into an “other” category.
Non-rapid eye movement (Non-REM) sleep are the first three stages of sleep – from first falling asleep to about the first half of the night. Non-REM sleep disorders are also called arousal disorders.
Non-REM parasomnias involve physical and verbal activity. You are not completely awake or aware during these events, are not responsive to others’ attempts to interact with you and you usually don’t remember or only partially remember the event the next day. Non-REM parasomnias usually occur in individuals between five and 25 years of age. Non-REM parasomnias often occur in people who have a family history of similar parasomnias.
Parasomnias that happen during Non-REM sleep include:
Rapid eye movement (REM) sleep follows the three non-REM stages of the sleep cycle. During REM sleep, your eyes rapidly move under your eyelids and your heart rate, breathing and blood pressure are all increased. This is a time when vivid dreaming occurs. Your body cycles through and repeats non-REM and REM sleep about every 90 to 110 minutes.
Parasomnias happen during the latter part of the night. If awakened during the event, it’s likely you’d be able to recall part or all of the dream.
Parasomnias that happen during REM sleep include:
Other parasomnias include:
Nightmares appear to happen more often in females. Sexsomnia is seen more often in males. REM sleep behavior disorder is more commonly reported in males over age 50. Sleep terrors, confusional arousals and sleepwalking occur in a similar number of males and females.
Yes. Parasomnias are more common in children than in adults. Non-REM sleep disorders are more common in children than REM disorders. The most common parasomnias in children under the age of 15 are:
Parasomnias are seen more often in children who have neurologic or psychiatric health issues including epilepsy, attention-deficit hyperactive disorder (ADHD) or developmental issues.
Causes of parasomnias can be grouped into those that disrupt sleep and other general health issues.
Issues that disrupt sleep:
Other health issues:
Each type of parasomnia has many unique features and triggers. However, some of the more common symptoms include:
Your sleep medicine specialist will ask you and your sleep partner about your sleep symptoms. You will also be asked about your medical history, family history, alcohol use and any substance abuse. You’ll be asked about your current medications. You may be asked to keep a sleep diary and your bed partner may be asked to keep track of your sleep events.
Other sleep disorders tests include:
Treatment starts with identifying and treating other sleep problems and any other health issues as well as reviewing medications that may trigger the parasomnia.
General management strategies for both Non-REM and REM sleep disorders are to:
Other treatments for non-REM sleep disorders:
Other treatments for REM sleep disorders:
Your healthcare provider will discuss the best treatment options – medications and/or psychologic approaches – for your specific type of parasomnia considering your unique health history and medical issues.
Another discussion you and your healthcare provider will have are suggestions to keep your sleeping environment safe. Tips include:
Non-REM parasomnias are most common during childhood and normally end during adolescence. Usually all that’s needed is calming reassurance from the parents that everything is okay. Medications are rarely needed, but if they are, they’re typically only prescribed for three to six weeks. Medications typically tried include benzodiazepines or anti-anxiety drugs.
Although some causes of parasomnias are less likely to be prevented, such as those due to neurological diseases, mental health issues or heredity, others may be prevented by following some of the same management approaches discussed in this article. These include getting seven to nine hours of sleep a night sticking with consistent bedtime and wakeup times, and limiting alcohol and recreational drug use. (See the treatment section for more tips.) Also, ask your healthcare provider to review your current medications. Many can disrupt sleep. If this is the case, perhaps different drugs can be prescribed.
You should talk to your doctor if you or your family member experiences any abnormal sleep-related behaviors, especially those associated with injuries or sleep disruption.
Last reviewed by a Cleveland Clinic medical professional on 04/29/2021.
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