Parasomnias

Sleep is supposed to be a time to recharge mentally and physically. However, for those dealing with parasomnias, bedtime can bring unwelcome surprises like sleepwalking, night terrors or hallucinations.

Parasomnias are unusual, disruptive behaviors that occur during sleep or while falling asleep. People experiencing parasomnias are usually unaware of their actions and often won’t remember what happened when they wake up. Anyone can experience parasomnias, although they are particularly common in children because their brains are not fully developed.

There are several kinds of parasomnias, such as:

• Sleepwalking. Occurring in the deeper stages of sleep, sleepwalking can include a range of behaviors, from sitting up in bed to driving a car.
• Confusional arousals. Lasting between 5 to 15 minutes, these arousals can include slow or slurred speech and disorientation upon waking.
• Night terrors. A person experiencing a night terror may scream or cry and appear to be panicked, yet remain asleep.
• Rapid eye movement (REM) sleep behavior disorder. This sleep behavior disorder prompts people to physically act out their dreams, which are often violent. They may kick or punch or thrash in an attempt to fight off an attacker.
• Hallucinations. Sleep-related hallucinations can occur as a person is falling asleep or waking up. They often induce feelings of fear and can involve a variety of sensations: vision, sound, touch or movement.

Symptoms of parasomnias

Each parasomia may have unique symptoms that range from mild to severe. Symptoms common to many types of parasomnias include:

• Difficulty sleeping
• Feelings of confusion or disorientation upon waking
• Feelings of paralysis as you fall asleep or wake up
• Persistent daytime sleepiness or fatigue
• Unusual behaviors during sleep such as sleepwalking, sleep-talking or sleep-eating
• Bruises, cuts or other injuries on your body that you can’t explain
• Frequent vivid nightmares

Causes and risk factors of parasomnias

Parasomnias can have several causes, such as:

• Genetics — if you have a family history of parasomnias, you may be more likely to experience them
• Sleep deprivation or an irregular sleep schedule
• Neurological diseases, such as Parkinson’s disease
• Other sleep disorders, such as obstructive sleep apnea or restless legs syndrome
• Stress, anxiety and depression
• Medications

Diagnosing and treating parasomias

If parasomnia episodes are disrupting your sleep, or your bed partner’s, you may need to undergo a sleep study in one of MultiCare’s state-of-the-art sleep centers. Our specialists will review your study results and work with you to develop a treatment plan.

Treatment depends on the type, cause and severity of parasomnia episodes, as well as your overall health. Common treatment options include:

• Improving sleep hygiene. People who consistently do not get enough sleep are more prone to experiencing parasomnias than those who are well rested. Forming habits that support sleep, such as establishing a relaxing bedtime routine and limiting evening screen time, are an important part of treating these disorders.
• Creating a safe sleep environment. People experiencing parasomnias can be a danger to themselves or their bed partners due to aggressive behavior while sleeping. MultiCare sleep specialists will strategize safety measures with you, such as placing a mattress on the floor or removing dangerous objects from the bedroom, as part of your treatment plan.
• Taking medications. Some medications are effective at eliminating parasomnias. Your sleep specialist will discuss these options with you.
• Reducing stress. Stress can make parasomnias worse, or in some cases even trigger an episode. Learning techniques for relaxing your mind and body, such as biofeedback or meditation, can improve your ability to sleep and lessen the frequency of parasomnia episodes.