Everything You Need to Know About Parasomnia

Do you often find yourself lucid dreaming? Maybe you feel awake but aren’t fully conscious. You might hear or see something that isn’t actually in the room or perhaps experience the sensation of falling. In some cases, you may speak, eat, or wet the bed without being aware of doing so. If you experience any of these symptoms or have frequent nightmares, you could be struggling with a parasomnia.

What is parasomnia?

Parasomnias are sleep-related disorders that involve abnormal behaviors when falling asleep, during sleep, or when waking up. These uncontrollable episodes can include exhibiting sounds, movements, or more complex activities  during different stages of sleep. They may impact perceptions of reality, sleep quality, and emotions to the extent of warranting treatment.

The following are some of the most common parasomnias. Most occur in children, but can occur in adults as well. Whether or not treatment from a professional is necessary depends on the severity and impact on a person.

Sleep Talking (Somniloquy)

Somniloquy, or sleep talking, occurs when a person speaks out loud while sleeping but isn’t aware of it. This can run the spectrum from mumbling to full conversations with clear sentences. Others in the room may try to respond as if the person is awake.

Sleep_Talking_Somniloquy

Bedwetting (Sleep Enuresis)

Sleep enuresis, or bedwetting, is a defined sleep disorder affecting children over 5 years old who have at least two  episodes per week. Bedwetting runs in families, is more common in boys, and is usually due to a small or still-maturing bladder. Although this condition resolves on its own for many kids, a child cannot control  their bedwetting, so a family’s negative response can be harmful. If it persists, a medical evaluation can look for other health problems, such as incontinence.

Exploding Head Syndrome

Though its name sounds strange, exploding head syndrome doesn’t involve anything going boom. It is a parasomnia that causes a person to experience a sudden loud noise that’s only in their head as they fall asleep.  Although it may be very frightening, the sensation is painless and not related to a major medical issue like a stroke or brain bleed.

Sleep-Related Groaning (Catathrenia)

Catathrenia occurs when a person groans during sleep as  they exhale. Unlike sleep apnea, these breathing noises are not due to failing to get enough oxygen. Although harmless and not disruptive to the sleeper, this condition may be bothersome for bed partners or family members.

Sleepwalking (Somnambulism)

Somnambulism, or sleepwalking, is a commonly known parasomnia that is not completely understood. Episodes may start similar to confusional arousal while  sitting up and looking around confusedly, but the affected person will then get up from bed and continue to perform more complex and seemingly goal-directed actions. These can include walking, running, jumping, cleaning, cooking, eating, and even driving. Sleepwalkers may commonly injure themselves or others. The person may wake up spontaneously when sleepwalking, or return to bed while still asleep . If woken up while sleepwalking, they can become agitated or aggressive. Most sleepwalkers have no memories of the episode. Like confusional arousal, sleepwalking occurs during the first part of sleep, during NREM sleep.

Sleep-Disorders-Sleepwalking

Sleep-Related Eating Disorder

Sleep-related eating disorder is a version of sleepwalking in which a person gets up during sleep and involuntarily eats. The person may be only partially awake, or have no recollection of the episode. Frequently the eating is uncontrollable, such as consuming inedible or toxic items like pet food or cigarettes, eating raw or frozen food, or binging high-caloric foods like syrup. Sleep-eating episodes occur every night in most people affected. This disorder more commonly affects adults, women, and those who have or had a sleepwalking disorder.

Night Terrors

Sleep terrors, or night terrors, occur when a person wakes up suddenly, often screaming or shouting. Unlike with confusional arousal, affected people may be breathing heavily, sweating, appearing tense, or even crying during these distressing episodes. Sometimes people even run out of the house or engage in violent activities. These more intense experiences occur more commonly in adults. As with the previous parasomnias, people who have sleep terrors typically do not remember their experiences, and these episodes occur during NREM sleep.

Sleep_Disorders_Night_Terrors

Confusional Arousals

Confusional arousal occurs when a person appears to wake up and acts in a strange or confused manner. They may appear disoriented and have slowed speech or blunt responses to questions. Unlike sleepwalking, people in a confusional arousal do not leave the bed, but they may perform simple movements. Often, a person doesn’t know what he or she is doing or their location. Confusional arousal is more common in toddlers and children can sit up in bed, appear distressed, and inconsolable. Confusional arousal affects the first part of sleep, called non-rapid eye movement (NREM) sleep.

Rapid Eye Movement (REM) Sleep Behavior Disorder

Sleep_Disorders_REM

This sleep behavior disorder occurs when a person acts out movements from vivid dreams during the dreaming or  rapid eye movement (REM) stage of sleep. A person with this condition may be shouting, punching, kicking, swearing, or thrashing. The sleeper may injure himself or herself, or even their bed partner with these full force movements. Unlike sleep terrors, the sleeper can recall the dream clearly when they wake up. REM sleep behavior disorder rarely affects children and is more commonly diagnosed in men. In young adults, it commonly is related to a medication side effect or from narcolepsy. In older adults, it may precede other medical issues such as Parkinson’s disease.

Nightmare Disorder

Nightmares are not uncommon for most people to have during REM sleep, but those that have them frequently and very vividly may have nightmare disorder. Nightmare disorder describes individuals that have nightmares often and  disturbing enough that they fear to go to sleep or have difficulty functioning during the day. Most often, this leads to sleep deprivation and poor social, occupational, and/or emotional well-being. Sufferers may experience a racing heart, sweating, panic, and anxiety when awakening with vivid recall of the nightmare. Nightmare disorder can be worsened by trauma or stress, mental health issues, and medications.

Sleep_Nightmare_Disorder

Sleep Paralysis

In this parasomnia, a person will be awake, but be unable to move their body or speak while falling asleep or when waking up. Often the person feels panicked or terrified due to  being fully conscious but unable to move, even if the episode is only momentary. For some people, sleep paralysis is accompanied by hallucinations such as hearing, feeling, or seeing sensations that do not exist.

If you suspect you have parasomnia, see a doctor

Any type of parasomnia condition can warrant treatment from a licensed professional, especially if it impedes the quality of sleep.

Sabina Hoque, MD MPH

Medically Reviewed

Sabina Hoque, MD MPH is a board-certified internal medicine physician with 10 years of clinical experience. In addition, she holds a masters in Public Health and has significant experience in teaching and biostatistics. She enjoys distilling complex medical information for audiences of varying levels of health literacy.

All content published on the HealthySleepGuide.com website is credited for informational purposes only. The information should not substitute as medical advice, diagnosis, or treatment. Always consult your doctor or qualified health professional with any questions regarding your health.