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Parasomnia: Causes, Symptoms, and Treatment | Sleep Reset

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Some people may exhibit abnormal behaviors during sleep. The umbrella term for these behaviors is parasomnias, and they all have their own sets of symptoms, characteristics, and effects. They can also disrupt your sleep, causing you to wake up during the night or have interrupted sleep stages.

Becoming familiar with the different types of parasomnias and knowing which symptoms to watch for can help you address these issues and get better sleep. Read on to learn about parasomnias and their symptoms, diagnosis, and treatment.

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What Is a Parasomnia?

A parasomnia is a sleep disorder that causes you to have unusual movements or experiences while you sleep. These behaviors can happen while you’re sleeping or in the transition between sleep and waking. When you’re exhibiting these behaviors, you’ll be asleep and unlikely to remember the event even though you may appear to be awake.

What Are the Types?

There are many different types of parasomnias, and they usually fall into two categories: REM sleep parasomnias and non-REM sleep parasomnias. Let’s take a look at some of the most common parasomnias of each.

REM Sleep Parasomnias

REM sleep parasomnia occurs during the final stage of sleep or whenever you enter REM sleep in a sleep cycle. REM stands for rapid eye movement, which is when your eyes move beneath your eyelids and your brain and body activity are similar to their waking levels. REM sleep is also when you have your most vivid and memorable dreams. Usually, these parasomnias will happen later in the night or near the morning hours.

Here are some of the most common REM parasomnias:

Nightmares

Though REM sleep can bring on vivid dreams, you may also experience vivid nightmares that cause you to feel fear or discomfort. Nightmares are easier to remember than night terrors.

Sleep paralysis

Sleep paralysis makes it so you are unable to move your body or limbs while you’re sleeping. Typically, our bodies are restricted when we’re in REM sleep anyway, but sleep paralysis extends those effects to when we’re falling asleep or waking up, which can cause episodes of fear and distress until the sleep paralysis resolves.

REM sleep behavior disorder

REM sleep behavior disorder causes you to vocalize or thrash around during a dream. This disorder is commonly found in people who have a neurodegenerative disease.

Non-REM Sleep Parasomnias

Non-REM sleep parasomnias occur during your first three stages of sleep. They can happen while you’re falling asleep, when you’re in light sleep, and when you’re in the deepest sleep stage. Typically, these will occur in the first three to four hours of the night. 

Non-REM sleep parasomnias will cause you to vocalize or move around during sleep. When you’re exhibiting your parasomnia behavior, you will be very difficult to wake up and be unresponsive to others. You’re unlikely to remember any of these interactions.

The following are some of the most common non-REM parasomnias.

Night terrors

Night terrors can cause you to wake up screaming and flailing. You will also appear to be in a state of intense fear. Though you may be upright, you aren’t technically awake, and you likely won’t remember a night terror episode the following morning.

Sleep eating disorder

This parasomnia causes you to eat and drink while you’re not fully awake. This can sometimes be dangerous, because you may overeat or eat and drink things that are uncooked, toxic, or inedible. You could also hurt yourself trying to make the food.

Sleepwalking

Sleepwalking can cause you to walk around with your eyes open when you’re still asleep. Sleep talking can also happen while you’re sleepwalking. Sleepwalking can be dangerous, because you’re not actually fully aware of your surroundings and you may do things that require full attention, like driving.

Confusional arousals

Confusional arousals may cause you to partially wake and appear confused about your whereabouts and surroundings. Though you may respond to people, you likely won’t understand them or you may respond strangely.

Other Parasomnias

There are various parasomnias that can happen at any phase of sleep. The following are some of the other common parasomnias.

Sleep hallucinations

Sleep hallucinations can cause you to hear or see things that aren’t there when you’re falling asleep or waking up.

Exploding head syndrome

This parasomnia causes you to wake suddenly from hearing a loud crash or noise when you’re falling asleep or waking up. This noise is sometimes accompanied by a bright flash.

Bedwetting

Wetting the bed isn’t classified as a sleep disorder if it happens under the age of five. For individuals age five or older, it must occur two or more times per week for at least three months to be considered a parasomnia.

Sleep talking

Talking during your sleep may be a side effect of another sleep disorder, or it may be something that occurs on its own.

Common Symptoms

There are many types of parasomnias, and many have their own disctintive symptoms, but there are a few common symptoms that may be present in various parasomnias. 

These symptoms could include:

  • Feeling tired the next day
  • Waking frequently or having difficulty sleeping
  • Waking up with feelings of confusion
  • Waking with cuts, bumps, or bruises on your body that you don’t remember having the night before
  • Reports from a partner, roommate, or family member about your sleeping behaviors that you may not remember

Common Causes

A variety of factors can cause parasomnias or increase the likelihood of your symptoms occurring, such as:

  • Disruptions during the transition from sleep and wake stages
  • Side effects from medications
  • Sleep deprivation
  • Irregular sleep schedule
  • Symptoms of medical conditions or other sleep disorders
  • Illness from fever
  • Periods of high stress or anxiety
  • Genetics and family history
  • Mood disorders like depression or anxiety
  • Pregnancy
  • Alcohol or drug use

Identifying the cause of your parasomnia can help with treatment and managing symptoms.

Who Experiences Disrupted Sleep?

Anyone can experience a parasomnia, though it’s more common in children. They may occur more frequently in children because they’re still developing, and their sleep-wake cycle, central nervous system, and brain functions haven’t yet matured. Children are also more likely to have a non-REM sleep disorder than a REM sleep disorder.

A child may sometimes outgrow their parasomnia. Children and adults with parasomnias still may want to consult a doctor to ensure there are no additional health risks associated with their sleep disorder.

What Are the Health Effects?

Parasomnias can cause issues with sleep, making it difficult to stay asleep during the night and get quality sleep. Sleep deprivation can cause short-term health effects like irritability, daytime sleepiness, and fatigue. Chronic sleep deprivation may increase your risk for health conditions such as heart disease, diabetes, and weight gain.

Depending on which parasomnia you have, you may also be a physical risk to yourself or others. Violent movements, especially in adults, can cause you to hurt yourself or someone who lives with you or shares a bed with you.

Diagnosis

Diagnosing a parasomnia will require a trip to the doctor or a sleep specialist. They’ll ask you questions about your medical and family history, your sleep habits, your medications, and more. If you have a sleep partner or family member who sees your parasomnia episodes, they’ll want to ask them questions as well. Your doctor may also recommend further testing, such as one or more of the following.

  • Sleep study: You may need to spend the night at a sleep laboratory so your sleep habits can be observed in a controlled environment. The people conducting your sleep study will measure a number of metrics to see what happens while you sleep.
  • Video electroencephalogram (EEG): These tests can monitor brain activity.
  • Computed tomography (CT) scan or magnetic resonance imaging (MRI): These tests can check your neurological health to determine whether a neurological disorder is the cause of your symptoms.

Treatment

Generally, treatment for parasomnias will consist of lifestyle changes, safety precautions, and addressing any medical conditions or sleep disorders that may be causing your symptoms.

Ruling out other sleep disorders and conditions is the first step. If another condition is the issue, that will be treated appropriately, which may reduce or eliminate your parasomnia episodes. You’ll also want to look at the side effects of any medications you take to see if they could be the cause of your symptoms. Consulting your doctor about medication adjustments may be necessary.

Lifestyle changes may include:

  • Keeping a consistent sleep schedule
  • Improving sleep hygiene, which means creating a comfortable sleep environment and forming good sleep habits
  • Limiting or eliminating alcohol use, especially near bedtime 

In some cases, medication may be prescribed to help with a parasomnia, though this is usually the last course of action. Trying cognitive behavioral therapy is another path that may eliminate the need for medications.

Finally, if your parasomnia causes you to move or walk around, you’ll want to take precautions to ensure your safety and the safety of others, such as:

  • Removing dangerous objects from the bedroom
  • Padding hard edges
  • Placing floor pads to soften falls
  • Using motion-detecting alarms if you sleepwalk
  • Putting a lock on the fridge or pantry and securing any raw or indelible foods
  • Sleeping in bed alone if violent movements are common

Start Sleeping Better Today!

When you have a parasomnia, it’s a good idea to develop sleep habits that address any sleep concerns that may be making your episodes worse. Sleep Reset can help! Sleep Reset is a self-sleep clinic you can do at home. You get a personalized sleep solution designed for your lifestyle and sleep concerns. You also get a dedicated sleep coach, sleep tracking, and access to our sleep app.

Sleep Reset is a no-pills, no-supplements solution, so there are no side effects or dependencies. If you’re wanting to sleep deeper, sleep through the night, and wake up refreshed, choose Sleep Reset.

Take our sleep assessment today to find out how Sleep Reset can help you get better sleep.