What is Parasomnia: A Complete Guide to Nighttime Behaviors

a blindfolds wearing parasomnia patient holding pillow while standing
collage of parasomnia affected individuals representing its different types
 

Sleep disorders disrupt the body’s natural rest cycle, impacting physical and mental well-being. From trouble falling asleep to unusual behaviors during sleep, these conditions affect millions of people. One such sleep disorder, known as parasomnia, involves unusual behaviors that can occur during different stages of sleep.

What Is Parasomnia?

Parasomnia refers to disruptive sleep disorders that occur as you’re falling asleep, during sleep, or when waking up. These episodes can include behaviors like sleep-talking, sleepwalking, or experiencing intense, frightening dreams that leave your heart racing.

If you’ve ever acted out a dream, talked in your sleep, or felt scared upon waking, you’ve encountered a parasomnia episode. These experiences, which are more common than many realize, can impact anyone at any age. Though often harmless, parasomnia sleep disorders can be unsettling and frustrating.

In some situations, parasomnias pose risks, such as when movements during sleep accidentally harm the sleeper or their partner. Rarely, parasomnia might indicate an underlying health issue that needs attention.

What Causes Parasomnias?

Parasomnia disorders, though not always linked to one clear cause, may be triggered by a variety of factors.

  • Sleep deprivation is a primary trigger, as lack of rest can disrupt sleep stages, heightening the risk of parasomnia. Additionally, disturbed sleep from conditions like sleep apnea, restless legs syndrome, or chronic pain can lead to these episodes.
  • Stress and anxiety are also common culprits. High-stress levels or recent negative life events often bring about parasomnia episodes.
  • Medications, especially some antidepressants, can make parasomnias more likely.
  • Inherited traits can play a role, meaning those with a family history of parasomnia sleep disorders may be at higher risk.
  • Mental health disorders such as depression or PTSD can increase the likelihood of experiencing parasomnias as well. Similarly, neurological conditions like narcolepsy, multiple sclerosis, or Parkinson’s disease may contribute to these sleep disturbances.

What is Parasomnia and How It Relates to Sleep Cycles

Parasomnias, often misunderstood, are disruptive sleep disorders causing abnormal movements, behaviors, or emotions during sleep. Classified by sleep stages, parasomnias are either linked to non-rapid eye movement (NREM) or rapid eye movement (REM) sleep. Certain types can even occur during transitions into or out of sleep.

Types of Parasomnias

Parasomnia disorders can be categorized into the following types:

NREM-Related Parasomnias

Disorders of Arousal

NREM-related parasomnias occur in the first three stages of sleep and are often called “disorders of arousal.” These episodes can involve a partial wake state where the person might look alert but lacks memory of their actions.

Night Terrors

During night terrors, individuals wake suddenly in fear, often screaming or gasping. Most episodes happen in the first hours of sleep. These intense experiences cause rapid breathing, sweating, and increased heart rate. Night terrors are most common in children, affecting about 39.8% between ages 2.5 and 6. While unsettling, individuals usually do not remember them afterward.

Sleepwalking

Sleepwalking drives individuals to perform complex activities, such as walking, dressing, or cooking, while still asleep. This disorder usually occurs in the deep sleep stage (N3) during the night’s first third. Sleepwalking can lead to injuries, as people may wander outside or trip. Blocking stairs and securing the sleep environment can prevent accidents.

Sleep-Related Eating Disorder (SRED)

In sleep-related eating disorders, individuals may consume unusual or potentially harmful substances, such as raw meat or cleaning products. SRED episodes can lead to other health issues.

REM-Related Parasomnias: Intense Dreaming Experiences

REM-related parasomnias usually occur later in the sleep cycle, during the rapid eye movement (REM) stage. Unlike NREM parasomnias, individuals often recall these episodes.

Nightmare Disorder

For many people, nightmares—vivid and unsettling dreams that disrupt sleep during REM sleep—persist into adulthood. These disturbing dreams can trigger anxiety and distress, impacting mental health. Around 20% of children and up to 6% of adults experience frequent nightmares, sometimes severe enough to qualify as nightmare disorder. In a British study of about 800 participants, nearly 1 in 20 adults reported having nightmares every week.

REM Sleep Behavior Disorder (RBD)

REM sleep behavior disorder (RBD) leads people to physically act out dreams, which can be intense or even violent. Common symptoms include kicking, punching, or talking while dreaming. RBD episodes, often associated with neurodegenerative conditions, can lead to self-injury, so individuals should ensure a safe sleep environment.

Sleep Paralysis

Sleep paralysis creates a sense of being frozen while waking up, often triggering fear. People may experience hallucinations during these episodes, further intensifying the distress.

Other Parasomnias: Unusual Phenomena Across Sleep Stages

Certain parasomnias do not fit neatly into REM or NREM categories. These include unique experiences occurring as one falls asleep or wakes up.

Bedwetting

In adults and children over five, frequent bedwetting may indicate a parasomnia disorder. This can result from genetic, psychological, or sleep-related factors.

Exploding Head Syndrome

People with exploding head syndrome perceive loud noises or flashes of light while falling asleep or waking. Although distressing, this syndrome is not painful or physically harmful.

Sleep-Related Hallucinations

Some individuals experience visual or auditory hallucinations upon waking or falling asleep. Common in people with narcolepsy, these hallucinations can cause considerable confusion.

Understanding parasomnia involves recognizing these diverse manifestations, each affecting specific sleep stages or transitions. By recognizing the symptoms, individuals can take precautions, seek treatments, and create safer sleep environments.

The Role of Sleep Studies in Parasomnia Diagnosis

A sleep study, or polysomnography, can be helpful for diagnosing and treating parasomnia. Sleep studies are often recommended when parasomnias are frequent, severe, or associated with dangerous behaviors like sleepwalking, night terrors, or REM sleep behavior disorder, where individuals may unknowingly harm themselves or others.

Conclusion

In conclusion, understanding what is parasomnia is essential for recognizing the impact of these sleep disorders on individuals and their well-being. Parasomnias encompass a range of unusual nighttime behaviors that can disrupt sleep and pose risks to both the sleeper and their surroundings. Identifying the types and causes of parasomnia can help individuals take appropriate precautions and seek professional help if needed. With the right strategies and treatments, those affected can manage their symptoms effectively, leading to improved sleep quality and overall health. Awareness and education are crucial steps toward addressing the complexities of parasomnia.

Picture of Home Sleep Center Team

Home Sleep Center Team

The Home Sleep Center team specializes in diagnosis and treatment of sleep disorders, such as sleep apnea and insomnia in California. We offer convenient in-home sleep testing services, providing personalized care and solutions to improve your sleep quality.