Parasomnias

It's not uncommon to talk in your sleep once in a while, and you may even know someone who sleepwalked as a child. However, sometimes these strange sleep behaviors can affect your daily life. If your nightly disruptions are creeping into your day and making it hard to feel like your best self, our sleep medicine doctors can help.

What is parasomnia?

Parasomnia is a sleep disorder that causes abnormal behavior during sleep, including sleepwalking, sleep talking and other unusual activities. These behaviors can occur at any stage of sleep, making it difficult to get restful sleep and often disrupting the sleep of others. 

Common types of parasomnia sleep disorders

There are several types of parasomnia, each with unique symptoms. Understanding the different types can help you recognize if parasomnia is affecting your sleep.

Sleepwalking (somnambulism) 

Sleepwalking is one of the most common parasomnias. It involves walking or doing other activities while asleep, sometimes accompanied by sleep talking. Sleepwalking typically occurs during deep sleep, but it can also happen during naps. 

Sleep talking

Sleep talking, or somniloquy, involves speaking during sleep, ranging from mumbling to full conversations. This behavior can occur at any stage of sleep, although it’s more understandable during lighter sleep phases.

Sleep-related groaning (catathrenia)

Sleep-related groaning involves making loud groaning or humming noises during sleep. This sound, which often happens when exhaling, can be mistaken for snoring but is unrelated to breathing issues.

Nightmares and nightmare disorder

Nightmares are vivid, disturbing dreams that can cause anxiety and make it difficult to fall back asleep. In more severe cases, nightmare disorder occurs, where frequent and intense nightmares significantly disrupt sleep and daily life. 

Night terrors (sleep terrors)

Night terrors cause a person to suddenly wake up in a terrified state, often accompanied by crying, screaming and an elevated heart rate. Unlike nightmares, night terrors happen during non-REM sleep and usually don’t involve dream activity. 

Bedwetting (nocturnal enuresis)

Bedwetting is involuntary urination during sleep and is most common in children under six years old. While some cases have no clear cause, bedwetting can also be linked to other conditions, such as urinary tract infections. 

Confusional arousal

Confusional arousal happens when a person wakes up feeling extremely confused, with difficulty understanding where they are or what they’re doing. It can be accompanied by slow speech, poor memory or slow reaction time.

Teeth grinding (sleep bruxism)

Teeth grinding during sleep can lead to soreness in the jaw, face, or neck, and tooth pain or sensitivity. This parasomnia can also cause headaches and damage to teeth over time. 

Sleep-related eating disorders

A sleep-related eating disorder causes a person to binge eat or drink while partially or fully conscious during non-REM sleep. People may consume unusual or even dangerous foods, like uncooked meat.

REM sleep behavior disorder (RBD)

In REM sleep behavior disorder, people act out their dreams while sleeping. This can include kicking, shouting  or even punching, but the individual often doesn’t remember the episode when they wake up.

Other uncommon types of parasomnia

Some unusual forms of parasomnia include:

• Sleep texting: Sending text messages while asleep.
• Exploding head syndrome: Hearing a loud noise just before falling asleep.
• Sexsomnia: Engaging in sexual behavior while asleep.
• Sleep driving: A rare but dangerous form of sleepwalking involving driving while asleep.
• Sleep-related hallucinations: Seeing or hearing things that aren’t real while waking up or falling asleep. 

Symptoms and causes of parasomnia

The symptoms of parasomnia vary depending on the type but may include:

• Sleep paralysis: Temporary inability to move or speak while falling asleep or waking up.
• Waking up feeling confused or disoriented.
• Not remembering actions performed during sleep.
• Finding unfamiliar cuts or injuries on the body.
• Daytime sleepiness or fatigue due to sleep disturbances.

Several factors can trigger parasomnia, including:

• Anxiety or stress
• Depression
• Irregular sleep schedules or sleep deprivation
• Medications or substance use
• Post-traumatic stress disorder (PTSD)
• Neurological conditions
• Other sleep disorders, such as insomnia or narcolepsy 

Diagnosis parasomnia

To diagnose parasomnia, your primary care doctor may start by reviewing your medical and sleep history. You may be referred to a sleep specialist for further evaluation. A sleep study, where your sleep patterns are monitored, can provide detailed information about your sleep behaviors and help determine the appropriate treatment plan.

Treatment for parasomnia

The treatment for parasomnia depends on the type and severity of the disorder. Common treatment options include:

• Medication: In cases of recurring parasomnia, medications like antidepressants, melatonin or benzodiazepines may be prescribed.
• Cognitive behavioral therapy (CBT): This therapy helps manage mental health concerns such as stress and anxiety that may trigger parasomnia.
• Other therapies: These may include psychotherapy, relaxation therapy and hypnosis.

Home remedies for parasomnia

In addition to medical treatments, some home remedies can help reduce parasomnia episodes:

• Scheduled awakenings: Waking a person just before they usually experience an episode, like sleepwalking or night terrors, can help prevent these occurrences.
• Creating a safer sleep environment: Remove dangerous objects, lock doors and windows, and sleep with extra padding to reduce injury during parasomnia episodes.

When to see a doctor

If parasomnia is affecting your sleep quality or daily life, it’s important to talk to a doctor. Our sleep medicine specialists at Banner Health are here to provide a personalized treatment plan and help you achieve better sleep.