What is a Parasomnia and Is it a Clue to Poor Sleep?

Unusual Sleep​

Have you been sleeping poorly lately? Maybe you’ve just been waking up exhausted or oddly sore. Perhaps a family member has even told you they heard you groaning or yelling in the night. If any of these sound familiar, you might be suffering from what’s known as a parasomnia. So, what is a parasomnia, and how can you treat it? Simply put, these are any unusual behaviors you might show during sleep. While they can affect the quality of your sleep, you should know which parasomnia you have before you take the steps to treat it!

Non-Rapid Eye Movement Parasomnias​

Parasomnias can either be related to Non-REM or REM sleep. Some of the most common and recognizable types occur in non-rapid eye movement 3 (or N3) sleep. This is the “deepest” stage of sleep that children and teens tend to spend a lot more time in than adults. Non-REM parasomnias generally are a result of abnormal transitions from N3 sleep to wakefulness or a lighter stage of sleep. If you suffer from a NREM parasomnia, you may be waking up frequently and have little to no memory of your episodes. Three of the most common NREM parasomnias encountered are:

  • Sleep talking – Sleep talking is also called “somniloquy.” It is the most common parasomnia being present in about 60-65% of people at some point in their life. Sleep talking includes grunts and non-sensical sounds, but also formed words and sentences sometimes resulting in someone appearing to have a full conversation while asleep.
  • Sleepwalking – This is one of the most familiar forms of parasomnia. It involves involuntarily getting out of bed and moving around in a zombie-like state. While sleepwalking, you won’t have much awareness of your surroundings. This can be dangerous, especially if you fall or walk into something.
  • Night Terrors – If someone in your family has told you that you scream in your sleep, then it’s due to night terrors. These make you scream or yell in your sleep, but you’re not responsive to outside interactions. Upon waking up, you won’t even be able to remember why you were screaming.

REM Parasomnias​

Rapid eye movement or REM sleep is a stage of sleep that is characterized by vivid dreaming and atonia, meaning lack of tone or no movement. Similar to Non-REM parasomnias where there are features of sleep and wakefulness the same is true here and may reflect the REM features of vivid dreaming or atonia. These types are often much more disruptive to your sleeping patterns and can wake you up frequently. Some of the more common forms include:

  • REM sleep behavior disorder (RBD) – RBD is frequently characterized as a dream enactment behavior, meaning that the person looks and sounds like they are acting out a dream. It is not uncommon that these dreams may be scary or frightening, such as a person being changed or even attacked. Therefore, the description of RBD may be that a person is running or fighting in their sleep and may even have experienced injury related to this. RBD is more common in adults. When it occurs in children it commonly is associated with medications or may be a presentation related to a diagnosis of narcolepsy.
  • Sleep Paralysis – This condition is the experience of atonia but your mind is completely awake. Therefore, the person experiencing it may describe that they can open their eyes or know they are awake but feel frozen or stuck temporarily (usually less than 2 minutes). While this feeling is temporary, it can lead to anxiety over falling asleep or waking up.
  • Sleep-Related Hallucinations – These are divided into two categories: Ones that occur when you fall asleep (hypnagogic) or when you wake up (hypnopompic). These hallucinations can be visual or auditory – sometimes it can even “feel” real as well! People who experience hallucinations may even be drawn to act on them, increasing their chances of getting hurt.
  • Nightmare Disorder – Nightmares happen to everyone, but frequent recurrent nightmares could mean you have a nightmare disorder. People with nightmare disorders often have dreams that are defined by fights for survival. This in turn leads to poorer sleep, and the fatigue and mental strain that comes with it. These nightmares are often caused by outside stressors, such as school or personal issues.

Other Types of Parasomnias​

There are even some parasomnias that occur during the periods of sleep between the NREM and REM stages. Two of the most common “in-between” parasomnias are:

  • Bedwetting – As children get older, they develop the ability to hold their urine overnight, however, some children and adults may experience accidents while sleeping. This is called bedwetting or nocturnal enuresis. This can be either primary or secondary nocturnal enuresis. Primary nocturnal enuresis means that there has never been 6 months without an accident. Secondary enuresis means there has been at least 6 months of dry nights and then a recurrence of bedwetting. Approximately 10% of 6-year-olds can experience bedwetting with the number of children decreasing as they get older and only 5% at 10 years old.
  • Exploding Head Syndrome – Contrary to the how painful this sounds it is actually an experience of hearing loud noises or an exploding sensation in their head when they wake up. Sometimes you might even imagine seeing a flash of light too. Though it’s usually painless, it can happen multiple times a night and increase your anxiety.

Tips on Treating Your Parasomnia

Treating your parasomnia is key to getting on the path to great sleep! Even the most aggressive type can be managed to provide you with the rest your body needs. Here are a few helpful tips to treat your parasomnia:

  • Stick to Your Sleep Schedule – One of the best ways to help your body and mind stay sharp is to set a sleep schedule and stick to it. That means waking up and going to bed at the same time every day. Even if your parasomnia is affecting your sleep schedule, it still helps to keep your body’s clock in a healthy routine. It does make it that much easier to fall asleep!
  • Gently waking some BEFORE the typical time of the parasomnia event can help prevent the event from happening. With this said, do not try to wake someone during a parasomnia event. This can make the event become more intense and last longer.
  • Follow Good Sleep Habits – We recommend avoiding caffeine, as well as lights and bright screens, before you plan on going to bed. It also helps to keep your room at cooler temperature to help promote comfortable sleep. Above all else, you should be aiming to sleep at least 8-10 hours per night (and that means setting a good schedule).
  • Talk to Your Doctor – Some forms of parasomnia might require a closer look. You can only be sure of your disorder by talking to a qualified doctor. They’ll provide the proper diagnosis and help find the best treatment for your parasomnia.

Now your unexplained sleep issues are no longer a mystery. Though parasomnia is varied and can affect you in different ways, there is help available. By following these tips and staying on top of your sleep habits, you can get the shuteye you deserve!