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What is Parasomnia? Causes, Symptoms and Treatment

General Medical

Tammy George
By

Woman laying in bed at night suffering from parasomnia.

We all want a restful night’s sleep, but for many that’s hard to come by. If you’re someone who sleep talks, sleep walks, has night terrors or nightmares, it’s likely you aren’t getting a good night’s sleep. Disturbed sleep not only makes you irritable the next day, but can contribute to accidents and chronic disease such as stroke and heart disease.
 

What is Parasomnia?

Parasomnia is abnormal movements such as talking or behaving strangely while falling asleep or during sleep. In most instances, people don’t recall their unusual nocturnal behaviours the following day.   
 

Parasomnia & Sleep Cycles

Parasomnias can be categorised into three groups depending on when they occur during the sleep cycle:

  • Non-Rapid Eye Movement (NREM)

  • Rapid Eye Movement (REM) 

  • Other

Some parasomnias happen early in the night during Non-Rapid Eye Movement (NREM), while others occur later during Rapid Eye Movement (REM) sleep. Some researchers believe parasomnia occurs when the brain transitions in and out of sleep and sleep cycles.

A man with parasomnia in the NREM stage of the sleep cycle.

Non-Rapid Eye Movement (NREM) Parasomnias

NREM is the first stage of the sleep cycle. During the second, third and fourth stage, sleep becomes deeper. 
 

Sleep Talking

Sleep talking, also referred to as somniloquy, is talking during sleep while not being aware of it. Most sleep talking occurs in the NREM stage, but can occur during the REM stage of sleep. For most people, night talking is harmless and usually lasts less than 30 seconds at a time. Some people talk very clearly in their sleep while others talk gibberish. Clarity of speech can be impacted by the stage of sleep - in the earlier stages, speech is clearer.

Sleep talking is only a concern if an adult begins talking in their sleep, or if the adult is screaming or displays fear or violence in their nocturnal utterances. See your doctor about a referral to a sleep specialist if you’re concerned. It’s quite common for children to talk in their sleep and rarely requires treatment.

You may be prone to sleep talking if you’re taking some medications, suffering from stress, a mental health issue, substance abuse or a fever.

Father and son lie on the living room floor to help the boy’s parasomnia.

Sleepwalking

Sleepwalking, also known as somnambulism, is when a person gets out of bed and performs actions like walking, running, getting dressed or moving items around while mostly still asleep. The sleepwalking episode may last for seconds to 30 minutes, but most last less than 10 minutes. The person may return to bed on their own or wake up properly while out of bed. Most people who sleepwalk won’t remember an episode when they wake up the next morning, with most episodes occurring during the first half of the night.

Sleepwalking is more common in children than adults. A Sleep Foundation study found that 29% of children between the ages of 2 and 13 will sleepwalk. Between the ages of 10 to 13 is when children are most likely to sleepwalk. Only 4% of adults sleepwalk.

Sleepwalking can be caused by tiredness, stress, a fever, family history or triggered by restless leg syndrome, gastroesophageal reflux disease (GERD), some medications and sleep disorders such as obstructive sleep apnea.

Sleepwalking occurs during the deepest stage of non-rapid eye movement sleep. Consult a doctor if the sleepwalking is potentially dangerous to themselves or other people, causes excessive tiredness during the day, or it disturbs the sleep of other household members.

Some sleep walkers also suffer from sleep-related eating disorders where they have unusual eating habits during the night that they can’t remember the next day. They often eat sugary and high calorie foods. This is not the only link between diet and sleep, as there are many things that you can take from or add to your diet to try and combat poor sleep.

A person suffering from parasomnia is sleepwalking through the house.

Night Terrors

While almost every child will have a nightmare at some point, only 3-6% of children will have a night terror. The most common age group for night terrors to occur is four to 12 years. Around 80% of sufferers have a family member who has had a sleep disturbance.

During night terrors, children will sit upright in bed, have a quicker heartbeat, scream or shout out and be upset or scared. It can be difficult for a parent to console their child during a night terror.

Night terrors are most likely to occur in children who are overtired or stressed, taking a new medication or sleeping in a new environment. Parents can reduce the risk by making sure children don’t stay up too late or become overtired and have a bedroom routine that is relaxing.
 

REM-Related Parasomnias

During the REM stage of sleep, our eyes move rapidly behind our closed eyelids, breathing is faster as is our heart rate and blood pressure. Fewer parasomnias are experienced during the deeper REM sleep cycle than the lighter cycle.
 

Nightmares

Nightmares can occur at any age, but are most common in children particularly around the age of 10. A nightmare may be triggered by a scary movie, illness, fever, stress, anxiety, sleep apnea, drugs or alcohol, eating close to bed and medications.

An adult may be able to reduce the frequency of their nightmares by engaging in relaxation techniques before bed, limiting caffeine and alcohol, exercising regularly and establishing a sleep pattern before bed.

Consult a doctor if the nightmares continue over an extended period or make it difficult to function the following day

A young girl who suffers from parasomnia is having a night terror in her bedroom.

REM Behaviour Disorder (RBD)

A person may call out or make unusual movements while dreaming. These dreams are often action packed and even violent. The episodes can become more violent as time goes on. Movements may include shouting, swearing, grabbing, punching, jumping, kicking and leaping. Unlike other parasomnias, people can be easily woken from RBD and clearly remember their dream.

Nightmare disorder also occurs with REM sleep. The disorder causes vivid dreams that involve a person’s survival and is common amongst people who suffer from post-traumatic stress disorder (PTSD).
 

Other Parasomnias

The other category relates to parasomnias that occur while transitioning between sleep and wakefulness or during the other two sleep cycles.
 

Sleep Enuresis

Bed wetting while asleep is considered a type of parasomnia in people over the age of five and occurs at least twice per week for a minimum of three months.
 

Sleep Hallucinations

A person may experience a hallucination during the onset of sleep or when they wake up and can be visual, auditory, tactile or kinetic.  
 

Sensory Sleep

When a person hears a loud noise or exploding sensation in their head when they wake up.
 

Recurrent Isolated Sleep Paralysis

When a person can’t move any part of their body, usually when a person is falling asleep or waking up. 
 

Causes of Parasomnia

Parasomnias often have a genetic link with another family member suffering from parasomnias, or there may be an underlying cause or condition such as:

Treating a potential cause of parasomnia may reduce the number of incidents. Many children grow out of their parasomnia without knowing or treating the cause.

A pharmacist preparing medicine that may cause episodes of parasomnia.

Parasomnia Symptoms

Some people won’t even know they experience parasomnia and have no symptoms. For others though, the disturbance to their sleep during the night makes it hard for them to wake up in the morning feeling rested, meaning they struggle to get through the day without exhaustion.

Those people who wake up after a parasomnia incident may be confused because they’re out of bed (sleepwalking) or sitting upright in bed after sleep talking, a nightmare or terror. It can be difficult to get back to sleep.

People who sleepwalk often bump into objects around the house and when they wake, don’t know why their legs are covered in bruises. A person who sleep eats may notice an injury in the morning after using kitchen utensils to prepare food.
 

Treatment of Parasomnia

Some parents wait until their child grows out of their parasomnia if it’s not causing too much disruption to their child’s life rather than seek treatment.

For children and adults who feel that their parasomnia is having too great an impact on their daily life, they may look for a suitable treatment. Most people will start by talking to their GP who may provide a referral for a sleep study.

Other types of treatment include:

  • Hypnosis

  • Relaxation therapy

  • Cognitive behaviour therapy

  • Psychotherapy

  • Antidepressants

  • Sleeping pills or melatonin supplements

  • Treating breathing issues with a device or surgery

  • Night guard to stop bruxism (teeth grinding)

  • Vitamins such as zinc and vitamin A

Lifestyle changes have also been found to help reduce the frequency of parasomnia episodes such as: 

  • Only working days, not nightshift

  • Going to bed at the same time each night

  • Getting a full night’s sleep

  • Avoiding alcohol and drugs

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How HIF Hospital Cover Can Help 

Some HIF Hospital Plans cover sleep studies. Not all health funds cover sleep studies, but at HIF, we know the importance of getting a good night’s sleep.

Tammy George

Please note: Tammy's blog is general advice only. For further information on this topic please consult your healthcare professional.

Category:General Medical, Healthy Sleep Practices

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