Parasomnia

Introduction

Parasomnias are unnatural events or experiences that interrupt sleep and incorporate undesired feelings, perceptions, movements, or behaviours. Parasomnia mainly occurs during the deep sleep phase but can also happen while falling asleep. Parasomnia sufferers normally do not remember the events the next day.

Parasomnias prevent sufferers from receiving a solid night’s sleep, and it can affect normal daily activities. Parasomnias might be hereditary or triggered by medications, traumatic episodes, stress, or other sleep disorders.

What is Parasomnia?

Parasomnia is a sleep disorder characterised by significant and undesirable physical events or occurrences that disrupt the sleep cycle. It can occur before, during, or after sleep. Parasomnia sufferers might experience abnormal movements, sleep talk, emotional expressions, or unusual tasks. This is primarily because they are actually asleep, although their partner might think they are awake.

While parasomnias are frequent in occurrence, they do make it troublesome to achieve restful sleep. This behaviour usually disrupts the rest of those people nearby. Furthermore, some parasomnias may become dangerous because sufferers are typically unaware of their surroundings. They may also experience other health-related side effects, including psychological distress.

Like most other recognised sleep disorders, parasomnias can be treated. Read on to learn about the types and causes of parasomnias, along with the various treatment options.

What are the main causes?

According to research studies, the cause of parasomnias can be categorised into either sleep disruption issues or other general health issues.

Disrupted Sleep Issues May Include:

• Incomplete transformation from being awake to the several stages of sleep,
• A lack of regular sleep, irregular sleeping schedules,
• Certain medications, including those that cause sleep, treat depression, treat psychotic disorders, treat high blood pressure, treat seizures, treat asthma/ allergy, and treat infections,
• Medical issues that might disrupt sleep include obstructive sleep apnoea, restless leg syndrome, sleep deprivation, pain, circadian rhythm disorders, and narcolepsy
• Maturity deprivation of the sleep-wake cycle (especially with children suffering from parasomnias).

Other General Health Issues May Include:

• Stress,
• Fever,
• Alcohol or illicit substance abuse,
• Head injury or head trauma,
• Menstruation cycles or pregnancy,
• Genetic predisposition: a family history of parasomnias will increase the chances of suffering from them,
• Inflammatory brain disease – an example is encephalitis,
• Psychiatric or mental illness, including anxiety, depression, or post-traumatic stress disorder,
• Neurological diseases – including Lewy body dementia, Parkinson’s disease, stroke, multiple sclerosis, etc.

What are Some Examples of this Sleep Disorder?

Confusional Arousal: Behaving strangely and with confusion when awakening from sleep by a sudden noise or some other inducement. Sufferers may answer nonsensically to questions and have inadequate memory recollection of the episode.

Sleepwalking: A typical parasomnia in which sufferers awake from bed and move around the bedroom or perform unusual activities in a state of sleep. What is common with sleepwalkers who are regularly confused and angry if awoken is that they may respond aggressively if handled.

Night Terrors: Sufferers who awake in a frightful state are confused and powerless to communicate as they are not entirely awake. They will soon fall asleep again, and they are unable to recall the event the following day.

Nightmares: Sufferers may awake from a bothersome dream and experience emotions such as fear and anxiety. The sufferer who had the nightmare usually experiences difficulty falling back to sleep and constantly recalls the disturbing dream.

Photo by Miriam Alonso

Sleep Paralysis: This experience refers to the temporary inability to move when you sleep or are awake. During these experiences, sufferers will be powerless to speak or move and may undergo hallucinations. Sleep paralysis might last for seconds or minutes or conclude when they are touched or talked to.

REM Sleep Disorder Behaviour: Sufferers with REM sleep disorder perform actions and sometimes violently too – they may even hurt themselves or others.

Other examples of parasomnias include sleep-related eating disorders, bed-wetting, moaning and groaning, and sleep-talking. Parasomnias can happen within all age groups, but sleepwalking, talking, and bed-wetting are mostly prevalent in children.

How is Parasomnia Treated?

Potentially dangerous parasomnias affecting one’s health and daily activities require immediate medical attention. It is essential to discuss the predicament with a specialist sleep professional to evaluate and manage the parasomnia condition. Sleep specialists may request that sufferers start and maintain a sleep diary, periodically review their sleep symptoms, and record them. The specialist may also request the medical history to recognise and diagnose the parasomnia type and the associated condition.

A scientific sleep study—typically using a polysomnogram—is usually discussed and performed. These studies measure sleep breathing patterns, air flow processes, blood oxygen levels, brain electrical activity, muscle activity, heart rate, and eye movements.

Your specialist may prescribe medication, recommend lifestyle changes, or recommend behavioural therapy to treat parasomnia. You will also be instructed on safety measures to reduce the risk of injury associated with some types of parasomnia. Treating the underlying sleep disorder may help improve the symptoms of parasomnia.

Parasomnia treatment depends on the type and severity. Your doctor might recommend the following:

Medication

If these afflictions are constantly occurring, taking medication could be the most suitable option to manage the condition initially. The choice of which drug to try first will depend on the sufferer’s symptoms.

Examples of the medications that are used to treat parasomnias include the following drugs:

• Antidepressants,
• Topiramate,
• Levodopa,
• Dopamine Agonists,
• Melatonin,
• Benzodiazepines, such as Clonazepam.

If the symptoms result from taking a particular medication, the sleep specialist will recommend an alternative option or a different dose.

Cognitive Behavioural Therapy (CBT)

CBT is a standard treatment option to deal with parasomnia. This is because parasomnia is frequently associated with mental health issues, such as stress and anxiety.

Other treatment methods that can be practised alongside CBT include:

• Relaxation Therapy,
• Psychotherapy,
• Hypnosis

Home Remedies and Treatments

There are a few parasomnia treatments that can be performed at home, and they include the following:

• Scheduled Sleep Awakenings: Scheduled sleep awakenings are a controlled activity where the sufferer is woken up from sleep approximately 15 to 30 minutes before they are automatically and spontaneously awake. This process may minimise the parasomnia actions that observe a distinct pattern. This process is mainly adopted for those sufferers of regular sleepwalking events and periodic night terrors.
• Establish a Safer Sleep Environment: If a sufferer occasionally sleepwalks, that person may need to consider sleeping alone and also consider removing any dangerous items from their home. Windows and doors should be locked, the mattress placed on the bedroom floor, and extra padding made available when sleeping.

Conclusion

This malady can make it very difficult to achieve quality restful sleep. It can enhance the risk of accidents and health problems occurring due to the lack of rest. Fortuitously, parasomnia is treatable, so consulting a sleep doctor is imperative if you experience these unusual sleep behaviours. Sleep specialists can investigate the underlying causes and implement and administer the best treatments available for symptoms of parasomnia.