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Sleep Problems

Parasomnias

What are parasomnias?

Parasomnias are events or experiences that disrupt your sleep. They happen while you're sleeping or going between different stages of sleep, as you fall asleep or as you wake up. Parasomnias include:

  • sleepwalking
  • confusional arousals
  • sleep talking
  • sleep eating
  • nightmare disorder
  • sleep terror disorder
  • REM sleep behaviour disorder

Most parasomnias happen during the non-rapid eye movement (NREM) sleep stage. Parasomnias are very common in children. Only REM sleep behaviour disorder happens during REM sleep.

Learn about the stages of sleep.

Types of parasomnias

 

Sleepwalking

When you sleepwalk, you get up and move around. You may move suddenly or more slowly. You’re able to do many things that you can do when you’re fully awake, like eating. Your brain is very active but you’re still asleep.

Sleepwalking happens during non-rapid eye movement (NREM) sleep. If you sleepwalk, you may remember parts of sleepwalking or you may not remember anything. Sleepwalking is more common in children and often stops when they become an adult.

Confusional arousals

A confusional arousal is when you appear to be confused or act in a strange or unusual way. With a confusional arousal, you’re actually asleep even though others think you’re awake.

Confusional arousals don’t make you feel afraid or scared. They also don’t cause you to sleepwalk.

Sleep talking

Sleep talking is common and is another type of parasomnia.  It can happen during any sleep stage and many times during the same sleep.

When you sleep talk, others may not be able to understand or make sense of what you’re saying. Sleep talking may not need to be treated, but it’s sometimes a sign of another type of sleep disorder.

Talk with your doctor if you have questions. It’s important to talk to your doctor if you start talking more in your sleep or if you start to feel more tired during the day.

Sleep eating

When you sleep eat, you eat while you’re asleep and don’t remember doing it when you wake up. You may eat very quickly or eat odd combinations of food, foods you don’t normally eat or are allergic to, or eat things that aren’t food. This is why sleep eating can be dangerous.

Sleep eating can cause you to gain a lot of weight. You can even injure yourself from trying to prepare food while you’re asleep.

Some medicines, like those that help you sleep, can cause sleep eating. Sleep eating is more common if you also sleepwalk.

As with sleepwalking, it’s important to make your home safe.  This includes putting locks on drawers that have sharp utensils (like knives) or locks on cabinets that have items or foods that aren’t safe for you to eat.

Nightmare disorder

Nightmare disorder is when you have scary dreams often. With this disorder, your heart beats fast, you breathe faster, sweat, and then wake up. You may also have strong feelings about what happened in your dream and remember clear details of the dream when you wake up.

Sleep terror disorder

Sleep terrors happen during NREM sleep. They cause you to become very scared while you sleep. They’re more likely to happen if you have post-traumatic stress disorder (PTSD).

When you have sleep terror disorder, you may:

  • scream loudly
  • hit things
  • panic, sweat, breathe fast, and have a fast heart rate

REM sleep behaviour disorder

With REM sleep behaviour disorder, you may get violent or act out in a physical way during REM sleep. For example, you may dream about attacking a monster then attack your partner.

Normally, your muscles are blocked from moving during REM sleep (except your eye and breathing muscles). But when you have REM sleep behaviour disorder, you’re able to move your muscles during this stage of sleep. So if you’re dreaming about your body moving, you move. And if you’re running in your dream, you may get out of bed quickly to run and hurt yourself.

What causes parasomnias?

We don't know what causes parasomnias.

How is a parasomnia diagnosed?

A parasomnia is diagnosed based on your history. You'll need to see your healthcare provider and talk about your sleep and what’s happening while you sleep.

They may refer you to a sleep specialist. A sleep specialist will talk to you about your symptoms and let you know which sleep test is right for you.

You may have a test that gathers information about your sleep during each stage of sleep. This is called a level 1 sleep study or polysomnography. It can help find other health problems (like seizures) that may be the cause of what’s happening during your sleep.

What makes parasomnias worse?

Parasomnias are more likely to be worse if you:

  • don’t get enough sleep
  • have trouble sleeping (called insomnia)
  • have a sleep problem, like sleep apnea
  • have stress

If I have a parasomnia, will I need treatment?

Most people don’t need treatment for parasomnias. You may need treatment if:

  • you’re at risk of harming yourself or your partner (like with an REM sleep behavior disorder)
  • it’s very hard for you to deal with having a parasomnia

What are the treatments for parasomnias?

The treatment depends on the type of parasomnia. The most important thing for you to do is get good quality sleep. This means getting enough sleep and sleeping well when you do sleep.

Treatment may include:

  • medicines that help you sleep better, some types of antidepressants, and  medicines that prevent seizures
  • managing sleep apnea and other types of sleep disorders
  • making changes to your lifestyle (like managing shift work, drinking less alcohol, and having less caffeine) or getting cognitive behaviour therapy to help you manage stress

Your healthcare provider will work with you to help you decide which treatment is best for you.

Current as of: May 26, 2021

Author: Respiratory Health Section, Medicine SCN (Strategic Clinical Network, Alberta Health Services)