From the Guidelines
Parasomnia refers to abnormal behaviors or movements that occur during sleep, often involving complex actions or emotions, such as screaming or violent movements.
Key Characteristics
- Involves abnormal behaviors or movements during sleep
- Can include complex actions or emotions, such as:
- Screaming
- Violent movements As noted in the study on sleep disorders 1, parasomnias are a type of sleep disorder that can manifest in various ways, highlighting the importance of recognizing and addressing these conditions to ensure proper sleep and overall well-being.
From the Research
Definition of Parasomnia
- Parasomnias are abnormal behaviors and/or experiences emanating from or associated with sleep, typically manifesting as motor movements of varying semiology 2.
- They are defined as unpleasant or undesirable behavioral or experiential phenomena that occur predominately or exclusively during the sleep period 3.
- Parasomnias vary in frequency from episodic events that arise from incomplete sleep state transition 4.
Types of Parasomnias
- Disorders of arousal, such as sleepwalking and sleep terrors, are the most common type of parasomnia 5.
- Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by a loss of REM paralysis leading to potentially injurious dream enactment 6.
- Sleep-related eating disorder (SRED) is characterized by a disruption of the nocturnal fast with episodes of feeding after an arousal from sleep 2, 6.
- Other types of parasomnias include nocturnal seizures, rhythmic movement disorder, and tooth grinding or 'bruxism' 5.
Causes and Risk Factors
- Conditions that provoke repeated cortical arousals, or promote sleep inertia, can lead to nonrapid eye movement (NREM) parasomnias by impairing normal arousal mechanisms 2, 6.
- The use of sedative-hypnotic medications, such as benzodiazepine receptor agonists, can contribute to the development of SRED 2, 6.
- Sleep deprivation and various other factors can exacerbate parasomnias 5.
Diagnosis and Treatment
- Evaluation of parasomnias begins with a careful clinical interview with the sleeper and a family member to elucidate the frequency, duration, description, and timing after sleep onset of these behavioral events 5.
- A formal laboratory sleep study or polysomnogram with an expanded electroencephalographic montage can help distinguish among non-REM and REM parasomnias and nocturnal seizures 5.
- Initial management should focus on decreasing the potential for sleep-related injury followed by treating comorbid sleep disorders and eliminating incriminating drugs 2, 6.
- Medications such as clonazepam, melatonin, and paroxetine may be effective in treating certain types of parasomnias 5, 6.