Symptoms
Symptoms vary widely depending on the specific type of parasomnia, but common examples include:
Sleepwalking (somnambulism)
Sleep talking (somniloquy)
Night terrors (sleep terrors)
REM sleep behavior disorder (RBD) - acting out dreams
Sleep paralysis
Confusional arousals
Sleep-related eating disorder (SRED)
Nightmares
Teeth grinding (bruxism)
Bedwetting (nocturnal enuresis - primarily in children)
Causes
The causes of parasomnias are often multifactorial and can include:
Genetics/Family history
Stress
Irregular sleep schedules
Certain medications
Substance use (alcohol, drugs)
Underlying medical conditions (e.g., neurological disorders, sleep apnea, restless legs syndrome)
Fever (especially in children)
Psychiatric disorders (e.g., anxiety, depression, PTSD)
Medicine Used
Medication is not always necessary, but when used, options include:
Benzodiazepines (e.g., clonazepam) - often for REM sleep behavior disorder
Melatonin - for various parasomnias, especially in children
Antidepressants (e.g., SSRIs) - for RBD or parasomnias related to mood disorders
Other medications to address underlying conditions (e.g., sleep apnea treatment)
Is Communicable
Parasomnias are not communicable. They are not caused by infectious agents and cannot be spread from person to person.
Precautions
Precautions depend on the specific parasomnia and its severity, but general recommendations include:
Ensuring a safe sleep environment (e.g., removing hazards for sleepwalkers, padding sharp corners)
Maintaining a regular sleep schedule
Managing stress
Avoiding alcohol and drugs, especially before bed
Locking doors and windows (if sleepwalking is a concern)
Seeking professional evaluation and treatment.
How long does an outbreak last?
Parasomnias aren't outbreaks in the traditional sense. They are recurring events.
The duration of individual episodes varies from seconds to minutes to sometimes longer.
The frequency of episodes can vary from night to night or week to week, or can be triggered by specific events.
The overall course can be chronic (ongoing) or episodic (occurring in periods), depending on the underlying cause and individual factors.
How is it diagnosed?
Diagnosis typically involves:
A thorough medical history and physical examination.
Detailed information about the sleep disturbance from the patient and/or bed partner.
Polysomnography (sleep study) - monitoring brain waves, heart rate, breathing, and muscle activity during sleep.
Video recording during sleep to document behaviors.
Psychological evaluation to assess for underlying mental health conditions.
Timeline of Symptoms
The timeline of symptoms varies significantly based on the specific parasomnia. Examples:
Night terrors: Typically occur in the first third of the night during deep, non-REM sleep.
REM Sleep Behavior Disorder: Occurs during REM sleep, usually in the later portion of the night.
Sleepwalking: Can occur at any point in the night, often in the first few hours of sleep.
Sleep paralysis: Occurs upon falling asleep or waking up.
Important Considerations
Parasomnias can significantly impact quality of life and safety.
Accurate diagnosis is crucial to determine the underlying cause and appropriate treatment.
Co-existing sleep disorders or medical/psychiatric conditions should be addressed.
Safety measures are important to prevent injury during parasomnia episodes.
Family members and bed partners may require education and support.