Parasomnia Sleep Disorder: Types, Causes, and Treatments

Parasomnia disorders are some of the most complicated sleep problems. They come in many different forms and can be distressing to the patient and those around them. During my study, I have come across many different research papers on these disorders and have developed a deep understanding of the condition.

Such disorders typically occur in children, and if you are a parent, you should not be alarmed by these issues. Because of the limited understanding of the condition, many people have developed superstitions to explain them. 

But as far as the medical community understands, there are no health effects caused by parasomnia on children. You only need to ensure that you keep kids from injuring themselves when they experience episodes. Eventually, they will grow out of the condition and sleep peacefully.

Parasomnia is rare in adults, but when it occurs, it can be a bit scary. I want to share how to manage adult parasomnia in this article. Below, you will find a detailed explanation of these disorders, the different types of parasomnia, their causes, and the available treatments.

What is a Parasomnia Sleep Disorder?

I find it hard to define parasomnia in a single sentence. It is because the term parasomnia serves as a collective name for events, emotions, perceptions, and behaviors that occur during sleep. They can also happen when you are falling asleep or as you transition out of sleep. 

The disorders can also recur during sleep and may not affect the entire sleep session. Many people experience this condition in their sleep and do not have any memory of it. However, they may still find it hard to fall asleep at night. Parasomnia can occur in different forms. Let’s take a look at the most common types.

Confusional Arousal

I haven’t had a chance to meet a person with an extreme case of confusional arousal, but mild cases are very common. They are often interlinked with parasomnia sleepwalking. 

People who experience confusional arousal can act as if they have foggy memories and don’t respond properly to questions or requests. During the episode, their speech is slow, and they act confused. The patient may seem to be awake and even handle part of their normal routine, although in a strange way.

Mild episodes last for a few minutes, while serious ones can take several hours. Usually, the attack may happen when someone tries to wake you up. Some common behaviors seen during these episodes include shouting and grinding of teeth, and a few people can even be hostile and aggressive. Typically, patients do not have any memory of the events that happened at such times.

Sleepwalking and Sleep Terrors

Woman in pajamas walks in a dream

These conditions are one of the most common parasomnia types. Sleepwalking can make you get up during sleep and perform complex activities. 

I have noticed that sleepwalking occurs more often in children, especially those under the age of seven. When experiencing such a condition, adults can even go out of the house for long distances. They may even drive to faraway places, then come back to the house, and go back to bed. Also, this disorder is common among people who experience sleep apnea and sleep deprivation.

Sleepwalking often comes along with another example of parasomnia, namely sleep terrors. When they occur, the patient may scream and experience intense fear in their sleep. Sleep terrors on their own may last for a few seconds to a few minutes. Almost half of all children experience sleep terrors but typically grow out of them.

Sleep-Related Eating Disorder

In this example of parasomnia, patients may wake up at night and engage in compulsive binge eating and drinking. The memory of these episodes is usually partial or non-existent. 

The condition may especially be scary since the patient typically gets angry when stopped. The disorder is not triggered by hunger or thirst, and some adults may even wake up multiple times to have a bite. Most cases do not involve the consumption of alcohol, and some people may have slight to severe injuries as they attempt to cook their food.

REM Sleep Behavior Disorder

Rapid eye movement sleep behavior disorder is a condition that causes a person to act out their dreams while being in a deep sleep during the episodes. Although REM sleep is characterized by paralysis, the problem is that a person with this disorder can move around.

Mild cases of this condition involve simple twitches of body parts, but in more severe cases, patients may show complex and coordinated movements. In some situations, the disorder can lead to screaming, laughing, shouting, crying, punching, and even jumping uncontrollably. REM sleep behavior disorder can be dangerous as the movements may lead to injuries to the patients or people near them.

Recurrent Isolated Sleep Paralysis

Sleep paralysis occurs when going to sleep or almost waking up. While experiencing this condition, patients can’t move their muscles.

During sleep, the muscles usually relax and stay still, but for some people, the muscles will remain blocked even after they wake up or just before they fall asleep. The condition is said to be isolated when it occurs without any other symptoms of narcolepsy paralysis.

When it happens, you may not be able to speak, but you will be able to breathe normally. However, you won’t be in a position to move all other body parts. Since such a condition occurs before or after sleep, the patient is always fully aware of it. Episodes typically last for a few seconds, but they may go on for several minutes. Although this type of sleep disorder is scary, it does not have any medical risks.

Exploding Head Syndrome

With exploding head syndrome, you may hear loud sounds as you fall asleep or get aroused from sleep. The noise will sound like a bomb, and it will last for a brief period. This condition is especially distressing to patients as they may think they have a brain problem, but it is not a health concern. This disorder may be temporary and caused by stress or hearing issues. Exploding head syndrome is quite rare, and it affects women more than men.

Classifications of Parasomnia Disorders

Parasomnia disorders can be divided into rapid eye movement (REM) related conditions and non-rapid eye movement (NREM) related ones. NREM-related disorders occur during the third or fourth stage of NREM sleep. At this point, the brain is in the middle of sleep and wake states.

The condition is accompanied by the activation of the motor system, the autonomic nervous system, and various cognitive processes. Some NREM sleep disorders include sleepwalking, night terrors, sleep eating, confusional arousal, teeth grinding, sleep sex, restless leg syndrome, and rhythmic movement disorder.

REM-related parasomnia occurs during deep sleep, but muscle atony or paralysis is absent when it happens. Unlike NREM-related sleep disorder, REM-based one mainly develops in adults, and the mean age of patients is at 55 years. The overwhelming majority of patients are males. Some examples of REM-related parasomnia include nightmare disorder and sleep-related painful erections.

The conditions that occur in REM and NREM sleep are now known as parasomnia overlap disorder. This form of parasomnia is most common for younger males, and in this way, it differs from both REM and NREM disorders.

Is Narcolepsy a Parasomnia?

Narcolepsy is a parasomnia. However, it is not always associated with these disorders since it comes with several other symptoms that do not cause strange behavior before, during, or after sleep.

Presumably, a low level of hypocretin causes narcolepsy. It is a neurotransmitter that prevents your brain from entering a state of deep sleep. However, the disorder was also noticed in people with normal levels of hypocretin, so the real cause is still unknown.

Some signs of this condition include sleepiness during the day, difficulty in focusing or staying awake, and falling asleep suddenly. Sleep paralysis is also a common indicator of narcolepsy parasomnia. As I have noted above, sleep paralysis occurs when you are fully awake and unable to move or speak. A person with narcolepsy usually feels refreshed after sleep but quickly becomes sleepy again.

What Causes Parasomnia?

Now that you know the definition parasomnia got from us and the examples of this condition, let’s move on to the cause of parasomnia. Since the state is not fully understood in the medical community, I want to emphasize the risk factors of the disorder. Let’s take a look at the most common ones:

  • Age – Most parasomnia sleep disorders occur in children, and they often disappear as kids grow up.
  • Genetics – The condition also seems to run in families. 
  • Stress and worry – Some people experience parasomnia sleep disorder when under stress, and the condition disappears as the situation improves.
  • Post-traumatic stress disorder – PTSD is one of the common parasomnia causes. Sleep disorders usually occur within three months of the traumatic experience.
  • Drugs and medications – Certain medications, alcohol, and drugs may lead to parasomnia.
  • Other illnesses – Some diseases and medical disorders can also trigger episodes of parasomnia. For example, children with sleep apnea often experience parasomnia disorders.

Parasomnia Symptoms

In the parasomnia definition, I mentioned that this term describes a group of sleep disorders. Each of these conditions has its symptoms, but a medical professional can diagnose the exact one. The diagnosis of the disorders usually involves the use of a questionnaire.

Doctors can start by ruling out sleep deprivation and the effects of intoxication or withdrawal. They can then examine your medical history, along with that of your family members. You must keep track of the timing of the episodes as it will be crucial for the diagnosis. Your partner can be involved in making records of the incidents since you may not have much memory of the events. The morphology of the episodes will also be necessary.

Proper diagnosis of the disorder is essential since some cases may require medication. Others will simply disappear on their own and will not be a cause of worry in the house.

How to Treat Parasomnia

Despite what you may have seen on TV shows like inspired by parasomnia Teen Wolf, most of these disorders are not dangerous. Still, it may be uncomfortable and emotionally traumatizing to have a screaming or sleepwalking child in the house at night. It is important to note that some people can injure themselves during their episodes since they are not fully conscious of their actions.

Before you treat the condition, you should make sure that the patient can’t access dangerous items like sharp objects or fires at night. You can then proceed to parasomnia treatment.

Children with parasomnia are not usually medicated or treated in any way, and parents are often advised to be patient as the child grows. For kids, parents can learn how to control the episodes without causing harm to the child or themselves. For reducing the risk of injury, the child can sleep on the ground floor and should not be surrounded by things that can make it trip and fall. Also, you can consider adding locks to your doors and windows.

Adults with dangerous parasomnia need medical intervention. They usually receive medication after a successful diagnosis, but these drugs often come with other unpleasant side effects. Before prescribing the medicines, the doctor checks if the episodes are caused by avoidable substances, medications, or mental disorders.

Dyssomnia Vs Parasomnia

Parasomnia and dyssomnia are both primary disorders and are not commonly caused by external factors, such as drugs or psychological conditions. However, the two terms are completely different.

Dyssomnia is a condition that makes it hard for a person to fall asleep. The most common dyssomnia is sleep apnea. On the other hand, the parasomnia definition covers abnormal activities and behaviors that occur during sleep.

Common Questions on Parasomnia Sleep Disorders

Below, you can read more on parasomnia specifics to learn more about this condition. The answers below cover the most common questions that arise around this term.

A parasomnia is a sleeping disorder characterized by unusual behavior during, before, or after sleep. The condition may occur when a person is partly conscious, and the patient may not remember the episodes clearly.

It may be hard to tell whether you are suffering from parasomnia or not since you won’t remember most episodes. But if you have trouble falling asleep at night, you may be suffering from this condition.
If you find yourself drenched in sweat or feeling tired, you may also be having active episodes at night. Sometimes, patients wake up in unfamiliar locations. If you think that you have parasomnia, I strongly recommend getting a doctor’s help or staying with family or friends for a while.

Non-REM parasomnia is a type of sleep disorder that occurs in the third or fourth stage of non-REM sleep. Unlike REM-related parasomnia, such episodes happen when you are in the middle of sleep. Typical forms of non-REM parasomnia include sleepwalking, sleep talking, and night terrors.

Contrary to popular belief, waking a sleepwalker will not cause a heart attack or brain damage. Usually, there is no need to wake up a person since the patient usually sits on the bed and goes back to sleep after some time. But if you have to wake them up, you should do this by making a loud noise from a distance. Sleepwalkers are usually confused when they wake up and may do unconscious harm to the person who awakened them.

Dyssomnia and parasomnia are both sleep disorders, but they refer to different conditions. Dyssomnia disorder makes it hard for you to fall asleep or stay asleep. On the other hand, parasomnia is what makes you behave in strange ways at night and may occur as you fall asleep or almost woke up.

External factors do not cause parasomnia disorders, and they occur as you fall asleep, during sleep, or when you get aroused from it. The most common types of parasomnia include sleepwalking, sleep-talking, recurrent isolated sleep paralysis, night terrors, and sleep-related eating disorders.

The Final Word

Parasomnia disorders come in many different forms and are characterized by unusual behavior in sleep. People who suffer from parasomnia are not always aware of their actions and may have limited memory of the episodes. Although their eyes may be open during the attack, their brains do not process the vision. Still, people suffering from this disorder won’t usually harm themselves or others. You just need to take some precautions to ensure that they can’t cause harm to anyone near them.

Children typically grow out of their parasomnia disorders. If you experience episodes as an adult, you should consider visiting a doctor for the exact diagnosis and treatment. Mild and harmless cases don’t always need to be treated since the medications may come with unpleasant side effects.

Do you assume that you have a parasomnia disorder? How do you cope with it? Have you ever tried any behavioral or medical treatment for parasomnia? Share your story with me in the comments below.

foto of Catherine Rodgers

I am a certified therapist. The area of my study includes sleep medicine as well. I’ve chosen this field of research not by chance. For years I’ve suffered from insomnia, and have been trying various medicines, including sleeping techniques, natural remedies, and even hypnosis. According to my observations, the quality of sleep depends on numerous external and internal factors that may seem irrelevant at first sight.

Catherine Rodgers

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