What Are Parasomnias?

While you may not be familiar with the clinical term, you are probably familiar with specific parasomnias such as sleepwalking, sleep paralysis, and sleep terrors.

A parasomnia is simply a sleep-related disorder that causes abnormal behavior while sleeping. An onlooker may think the person is awake, but they are asleep.

Some parasomnias are harmless. But others can put a person or those around them in harm’s way.

These sleep disorders can cause intense emotional distress and may be a symptom of an underlying medical condition.

man with parasomnia lying in bed
A man asleep on his desk at work

What Are the Symptoms of Parasomnias?

Each parasomnia is different. However, some common symptoms include:

Types of Parasomnias

Parasomnias occur any time during the sleep cycle — either during non-rapid eye movement sleep (non-REM) or the rapid eye movement stage (REM).

The cycle in which they occur drives their classification as non-REM sleep parasomnias or REM sleep parasomnias.

woman with parasomnia rising from bed to sleepwalk

Non-REM Sleep Parasomnias

This type of parasomnia occurs early in the sleep cycle. It includes the time when you are first falling asleep.

Parasomnias that occur during this time can be physical or verbal. If someone talks to a person with this sleep disorder, they will not respond. The next day, they may not remember their actions.

These disturbances usually occur in people between 5 and 25 years old. Heredity can also play a role.

Sleepwalking (somnambulism)

Sleepwalking occurs in the deep stages of non-REM sleep, early in the sleep cycle. When someone is sleepwalking, they may move freely about and sometimes attempt to perform complex tasks. Sleepwalkers may make serious misjudgments resulting in injury by falling on stairs or driving a car. When they awaken, they have no memory of their actions.

Confusional Arousals

During confusional arousals, sometimes called sleep drunkenness, the person appears awake and confused. They may speak incoherently and will have no memory of anything that occurred. An episode usually lasts for a few minutes, sometimes longer and is most common in young children.

Night Terrors

With night terrors, also called sleep terrors, a person wakes up feeing terrified. They have a racing heart, rapid breathing and may scream and/or cry. The episode usually lasts anywhere from 30 seconds to 5 minutes. A night terror differs from a nightmare in that the individual remains asleep, rather than waking up and remembering the details.

Sleep-related Eating Disorder

People with sleep-related eating disorder eat and drink while they are asleep or only partially awake. They may eat inedible or toxic food, or harm themselves during food preparation, which makes this a dangerous disorder. The individual will have little or no recollection of the event.

woman just woke up in bed from a nightmare with the sheet pulled over her nose and mouth

REM Sleep Parasomnias

REM sleep is part of the sleep cycle when people dream.

Eyes rapidly move under eyelids.

Breathing, heart rate, and blood pressure are elevated.

A complete sleep cycle of non-REM and REM sleep usually takes about 90 minutes.

Nightmare Disorders

The person has dreams that make them feel outright terror or anxiety. If you wake up during these dreams, you will remember it in detail. Stress, traumatic events, fevers, or drinking alcohol can all induce these nightmares.

Sleep Paralysis

This scary sleep disorder makes it temporarily impossible to move any part of your body during sleep. It occurs right before you fall asleep or upon awakening.

Sleep paralysis can last for a few minutes but often lasts for a few seconds. Understandably, the person feels fear, or at least anxiety. It does not pose any risk to the person’s physical health. However, they may seek medical advice because of intense stress caused by the disorder.

Sleep Enuresis

Enuresis is a specific type of bedwetting that occurs in children over the age of five or six. Children with enuresis don’t wake up when their bladder is full. This happens at least several times a week for at least three months.

REM Sleep Behavior Disorder (RSBD)

This disorder causes a person to say things or be physically aggressive (punch or kick). While this will affect the person next to you in bed, the actions are being made as a reaction to a violent dream.

REM sleep behavior disorder is most common in older adults. It can be associated with neurodegenerative diseases, such as Parkinson’s disease or stroke.

Other Parasomnias Include:

What Causes Parasomnias

Parasomnias can be caused by:

Desktop with doctor’s diagnostic tools

Diagnosing a Parasomnia

It’s time to call a doctor if you experience sleep disruption, or if you’re exhibiting behavior dangerous to yourself or others.

Diagnosis involves the doctor taking a complete medical and sleep history. They will ask about your sleep symptoms, family history, alcohol and substance abuse history, and medications you are taking. Tests may include:

Treatment of Non-REM Parasomnias

Non-REM parasomnia episodes are not usually treated with medications. However, sometimes benzodiazepines or antidepressants are helpful.

Cognitive-behavioral therapy, hypnosis, and relaxation techniques have proven effective.

Treatment of REM Parasomnias

Sometimes clonazepam or an antidepressant is prescribed. Melatonin may be recommended. The doctor may recommend certain lifestyle changes and adjustments to sleep hygiene.

Following these recommendations can make a noticeable difference.

If you think you may have a parasomnia

or are experiencing sleep disruption