Parasomnias : Types, Symptoms, & Causes | Sleep Foundation

The most common NREM-related parasomnias are known as disorders of arousal. These parasomnias are characterized by recurrent episodes of ... Opensinanewwindow Share: Home /SleepDisorders /Parasomnias Parasomnias Whattheyare,whotheyaffect,theirdistincttypes,andwhichtreatmentscanhelp UpdatedMarch11,2022 Writtenby DaniellePacheco,StaffWriter MedicallyReviewedby Dr.AnisRehman,Endocrinologist FactChecked Ourdedicatedteamrigorouslyevaluateseveryarticle,guide,andproducttoensuretheinformationisaccurateandfactual.LearnMore Ourdedicatedteamrigorouslyevaluateseveryarticleandguidetoensuretheinformationisfactual,up-to-dateandfreeofbias. Ourmedicalreviewteamhasrecentlyevaluatedthispagetoensureaccuracy.Wewillcontinuetomonitorandrevisethisarticleasnewliteratureispublishedonparasomnias. “Parasomnia”isacatchalltermforunusualbehaviorsthatpeopleexperiencepriortofallingasleep,whileasleep,orduringthearousalperiodbetweensleepandwakefulness.Thesebehaviorsvaryconsiderablyintermsofcharacteristics,severity,andfrequency. Historically,parasomniaswereconsideredadefinitivesignofpsychopathology,butsomecontemporaryresearchersarguethesephenomenaoccurasthebraintransitionsinandoutofsleep,aswellasbetweenrapideyemovement(REM)andnon-rapideyemovement(NREM)sleepcycles.Parasomniasaremorecommoninchildrenthanadults,butthesebehaviorshavebeenrecordedacrossdifferentagegroups.     TypesofParasomnia Whileeachparasomniacarriesdistinctsymptomsanddiagnosticcriteria,thesebehaviorscanbecategorizedintothreegeneralgroups:NREM-related,REM-related,and“other.” NREM-RelatedParasomnias Non-rapideyemovementsleepconstitutesthefirststageofone’ssleepcycle,knownas“shallow”sleep,andthesecond,third,andfourthstages,duringwhichthesleepbecomesgraduallydeeper.Collectively,thesestagesusuallylastabout90minutes. ThemostcommonNREM-relatedparasomniasareknownasdisordersofarousal.Theseparasomniasarecharacterizedbyrecurrentepisodesofincompleteawakening,limitedresponsivenesstootherpeopleattemptingtointerveneorredirectthesleeper,andlimitedcognitionduringtheepisode.Mostpeoplewhoexperiencedisordersofarousalhavelittletonomemoryoftheirepisodes.Thesedisordersinclude: Confusionalarousals:Thesleeperexhibitsmentalconfusionorconfusedbehaviorinbed.Mostpeoplewhoexperienceconfusionalarousalsdisplayverylittleautonomicarousalintheformofmydriasis(dilatedpupils),tachycardia(acceleratedheartbeat),tachypnea(acceleratedbreathing),orperspiration.ConfusionalarousalsarealsoknownasElpenorsyndrome. Sleepwalking:Alsoknownassomnambulism,sleepwalkingoccurswhenpeoplegetoutofbedwhilestillasleepbutexhibitlimitedawarenessorresponsivenesstotheirsurroundings.Theymayexhibitothercomplexbehaviorssuchassortingclothes.Sleepwalkingcanalsoleadtoinjuriesiftheindividuallosestheirbalanceorcollideswithotherobjects. Nightterrors(orsleepterrors):Peoplewhoexperiencenightterrorsoftenscreamintheirsleep,thoughmostarenotresponsivetooutsidestimuliandwillhavenorecollectionofthesourcefortheirterroruponwaking.Mostnightterrorepisodeslastbetween30secondsandthreeminutes. Sleep-relatedsexualabnormalbehaviors:Knowncolloquiallyas“sexsomnia,”thisspecificparasomniasubtypeischaracterizedbyunusualsexualbehaviorsduringsleep,suchasaggressivemasturbation,initiationofsexualintercourse,andsexualnoises. Studieshaveshownthatmalesandfemalesareequallysusceptibletodisordersofarousal,thoughageappearstoplayarole.Parasomniashavebeenreportedinroughly17%ofchildrenagesthreeto13.Forchildrenandadults15andolder,theprevalenceratefallsbetween2.9%and4.2%. AnothercommonNREM-relatedparasomniaissleeprelatedeatingdisorder,whichischaracterizedbyepisodesofdysfunctionaleatingthatoccurafterarousalfromsleep.Mostpeoplewiththisconditionexhibitlimitedresponsivenessduringtheireatingepisodes,andhavelittletonomemoryoftheevents.Hazardsassociatedwithsleeprelatedeatingdisorderincludeingestionoftoxicsubstances,injuriesfromcookingorpreparingfood,andphysiologicaleffectsofunhealthyorexcessiveeating. RelatedReading SleepDiary WhatIs"RevengeBedtimeProcrastination"? Chronotypes REM-RelatedParasomnias RapideyemovementsleepoccursfollowingthefirstfourNREMstagesofthesleepcycle.Followingthefirstcompletesleepcycle,NREMandREMstageswillrepeatinacyclicalfashionevery90minutesorsofortherestofthenight.Asthenamesuggests,aperson’seyeswillmoverapidlybeneaththeireyelidsduringREMsleep.Theywillalsoexperiencefasterbreathing,andincreasesinboththeirheartrateandbloodpressure. CommonREM-relatedparasomniasinclude: REMsleepbehaviordisorder:Thisdisorder–RSBDforshort–ischaracterizedbyunusualvocalizationsormovementsduringREMsleep,oftenasareactiontoadream.Itisusuallyattributedtodysfunctioninthemusclesresponsibleforskeletalmuscleatonia,theextremelyrelaxedstatethatoccursintheREMstage.PeoplewithRSBDmayundergopolysomnographyexaminationsthatrecordbrainactivityduringtheREMstage.Thisconditionismostcommoninpeopleaged50orolder.ClinicalfindingsofRSBDmaybenotedinpatientstakingcertainanti-depressionmedications. Recurrentisolatedsleepparalysis:Peoplewiththisconditionfeelcompletebodilyatrophyduringsleeponset–theperiodbeforetheyfallasleep–oruponwaking.Theywillnotbeabletomoveanypartofthebodyduringtheseepisodes,whichnormallydon’tlastmorethanafewminutes.Sleepparalysiscanleadtoanxietyordistressaboutfallingasleep. Nightmaredisorder:Everyonehasunpleasantdreamseverynowandthen.Nightmaredisorderislimitedtothosewhoexperiencerecurrent,vividdreamsdefinedbythreatstosurvivalorsecuritythatresultinfatigue,distress,reducedcognition,andotherdaytimeimpairments.NightmaredisorderisacommoncomponentofPost-TraumaticStressDisorder(PTSD).Motoractivityisoftenlimitedduringnightmareepisodes.Forchildrenwithnightmaredisorder,severepsychosocialstressorsareoftentoblame. OtherParasomnias The“other”categoryforparasomniasisdedicatedtobehaviorsthatoccurduringthetransitionbetweensleeporwakefulness,aswellasthosethatcanoccurduringNREMorREMsleep.Theseparasomniasinclude: Explodingheadsyndrome:Alsoknownassensorysleepstarts,peoplewiththisconditionwillhearaloudnoiseorfeelanexplodingsensationintheirheadwhentheywakeup.Theymayalso“see”animaginedflashoflightuponwaking.Thissensationcanleavethesleeperwithlingeringfeelingsofpalpitation,dread,andanxiety,butitisusuallypainless.Somepeoplemayexperiencemultipleepisodespernight. Sleeprelatedhallucinations:Peoplewiththisconditionexperiencehallucinationseitherduringsleeponset(hypnagogic)orwhentheywakeup(hypnopompic).Thesehallucinationsmaybevisual,auditory,tactile,orkineticinnature.Inextremecases,sleepersmayleavetheirbedinanattempttoescapewhattheyareexperiencing.Thehallucinationsmaypersistforuptoseveralminutesafterthesleeperawakens. SleepEnuresis:Knownthroughouttheworldas“bedwetting,”sleepenuresisreferstoinvoluntaryurinationduringsleep.Bedwettingisquitecommoninyoungchildren.Tobeconsideredaparasomnia,itmustoccurinpeopleagesfiveandolderandoccuratleasttwiceperweekforatleastthreemonths.Primarysleepenuresisreferstopeoplewhoneverwakeupfeelingdry,whilesecondarysleepenuresisoccursinindividualswhohavenotpreviouslyexperiencedbedwettingepisodesforatleastsixmonthsbeforethefirstepisodeoccurs. Thislistofparasomniasisnotexhaustive,butmerelyreflectiveofthemostcommonparasomniatypes.Ifyoubelieveyouareexperiencingaparasomnia,consultwithyourphysiciantolearnaboutpreventiontipsandparasomniatreatmentoptions. Wasthisarticlehelpful? YesNo AboutOurEditorialTeam DaniellePacheco StaffWriter Daniellewritesin-deptharticlesaboutsleepsolutionsandholdsapsychologydegreefromtheUniversityofBritishColumbia. Dr.AnisRehman Endocrinologist MD Dr.Rehman,M.D.,isaboard-certifiedphysicianinInternalMedicineaswellasEndocrinology,Diabetes,andMetabolism. Share: References +5 Sources 1. Schwab,R.(2020,June).Parasomnias.MERCKMANUALConsumerVersion. https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/sleep-disorders/parasomnias?query=parasomnia 2. Markov,D.,Jaffe,F.,&Doghramji,K.(2006).UpdateonParasomnias:AReviewforPsychiatricPractice.Psychiatry(Edgmont),3(7),69-76. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958868/ 3. AmericanAcademyofSleepMedicine.(2014).InternationalClassificationofSleepDisorders(ThirdEdition),228-279[E-book]. https://learn.aasm.org/Users/Catalog.aspx 4. OfficeofCommunicationsandPublicLiaison,NationalInstituteofNeurologicalDisordersandStroke,NationalInstitutesofHealth.(2019,August13).BrainBasics:UnderstandingSleep.NationalInstituteofNeurologicalDisordersandStroke. https://www.ninds.nih.gov/Disorders/patient-caregiver-education/Understanding-sleep 5. Kierlin,L.,&Littner,M.R.(2011).Parasomniasandantidepressanttherapy:areviewoftheliterature.Frontiersinpsychiatry,2,71. https://doi.org/10.3389/fpsyt.2011.00071 LearnmoreaboutParasomnias Sleepwalking UpdatedBy EricSuni | March11,2022 SleepParalysis By EricSuni | June24,2022 SleepTalking By EricSuni | March11,2022 NightTerrors By DaniellePacheco | March18,2022 HypnicJerks By JaySummer | June17,2022 REMSleepBehaviorDisorder By DaniellePacheco | March18,2022 ExplodingHeadSyndrome By JaySummer | April13,2022 SleepTexting By JaySummer | May10,2022 Sexsomnia:WhattoKnowAboutSleepSex By DaniellePacheco | April18,2022 ConfusionalArousalsandSleepDrunkenness By DaniellePacheco | April25,2022 OtherArticlesofInterest Insomnia LearnAboutInsomnia WhatToDoWhenYouCan'tSleep? 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