A parasomnia is a sleep disorder that causes abnormal behavior while sleeping. The behavior can occur during any stage of sleep, including the transition from wakefulness to sleeping and vice versa.
If you have a parasomnia, you might move around, talk, or do unusual things during sleep. Other people might think you’re awake, but you’re actually unconscious. You typically don’t remember the incident.
While parasomnias are common, they can make it difficult to get restful sleep. The behavior might also disrupt the sleep of other people near you.
Additionally, some parasomnias can be dangerous because you’re unaware of your surroundings. They can also have health-related side effects, such as psychological stress.
Like other sleep disorders, parasomnias are treatable. Read on to learn about the causes and types of parasomnias along with treatment options.
Some parasomnias occur in the first half of the night, during non-rapid eye movement sleep. Others happen later in the night, during REM sleep.
Sleepwalking, or somnambulism, is when you walk around while sleeping. It’s a common parasomnia. It might also involve sleep talking or doing normal activities around the house.
Often, sleepwalking occurs early in the night. It can even happen during daytime naps.
Another common parasomnia is sleep talking, also known as somniloquy. It happens when you talk while asleep.
Sleep talking can involve a wide range of talking, from mumbling to full conversations.
Unlike sleepwalking, sleep talking can happen during any part of the night. The talking is usually easier to understand in the lighter stages of sleep.
Catathrenia is groaning out loud while sleeping. Typically, it happens when you exhale slowly and deeply. The groaning can include different sounds, such as:
- loud humming
- high-pitched cracking sounds
Sleep-related groaning is often mistaken for snoring. But unlike snoring, groaning isn’t related to breathing issues.
Nightmares are troubling, intense dreams that cause anger, anxiety, or fear. If the nightmares frequently occur, it’s called nightmare disorder.
This parasomnia can make it difficult to fall back asleep. In some cases, multiple nightmares may happen in a single night.
Generally, nightmares occur during REM sleep, when you’re more likely to dream.
A night terror, or sleep terror, causes you to suddenly wake up in a terrified state. The terror can last from 30 seconds to 5 minutes.
Night terrors are also associated with:
- fast heart rate
- skin flushing
Unlike nightmares, night terrors usually involve little to no dream activity. Night terrors also typically happen in non-REM sleep.
Bedwetting, or nocturnal enuresis, is involuntarily urinating during sleep. It’s most common in children, especially in kids younger than 6 years old.
Usually, bedwetting occurs when the bladder has more urine than it can hold. Some cases don’t have an underlying cause, while others are due to conditions like urinary tract infections.
Confusional arousal is when you wake up in a very confused state. You might have trouble understanding what you’re doing or where you are.
Other behaviors include:
- slow speech
- poor memory
- slow reaction time
In sleep bruxism, you clench or grind your teeth while sleeping. These behaviors can cause:
- tooth pain or sensitivity
- jaw, face, or neck soreness
- earache-like pain
Sleep-related eating disorder
Sleep-related eating disorder is binge eating and drinking during non-REM sleep. You might be partly or fully conscious.
Often, binge eating episodes happen repeatedly. Specific behaviors include:
- eating unusual foods (like a stick of butter) or food combinations
- eating and drinking quickly
- consuming toxic food, like uncooked meat
REM sleep behavior disorder
In REM sleep behavior disorder (RBD), you have vivid dreams and act them out during REM sleep.
It’s different than sleepwalking or sleep terrors, when the person is often confused. With RBD, you can usually wake up easily and remember the dream.
Typical RBD behaviors include:
Some parasomnias are less common. More unusual types include:
- Sleep texting. Sleep texting is when you send a text message during sleep.
- Sexsomnia. In sexsomnia, you act out sexual behaviors while sleeping.
- Exploding head syndrome. When you’re about to fall asleep or wake up, you imagine a loud, sudden noise in your head.
- Sleep-related hallucinations. This is a hallucination you can see, feel, or hear. It can occur when falling asleep or waking up.
- Sleep-related scratching. Scratching occurs during sleep. You might wake up with scratches, bleeding, or cuts.
- Sleep driving. Though rare, it’s possible to drive while sleeping. This is a form of sleepwalking and can be very dangerous.
There are many possible causes of parasomnia. The disorder might be associated with multiple triggers, including:
- substance use
- certain medications
- irregular sleep schedules, like shift work
- other sleep disorders, like insomnia
- sleep deprivation
- neurological conditions, like Parkinson’s disease
Parasomnia affects more children than adults. It’s most common in children who have neurological or psychiatric conditions, such as epilepsy or ADHD.
Causes like stress and sleep deprivation can also trigger child parasomnia.
However, parasomnia in children usually happens because their sleep-wake cycle is immature. This means the boundaries between wakefulness and sleep are underdeveloped, resulting in a mixed state of consciousness.
Most children grow out of it by adolescence.
Compared to adults, children with parasomnia might experience more crying and fear. They might be scared to go to sleep alone.
If your child has abnormal sleep behaviors, remember that they’re not doing it on purpose. Focus on being supportive instead of punishing them.
For example, if they wet the bed, encourage them to use the bathroom before bedtime.
Aside from the unusual behavior during sleep, parasomnia can cause other symptoms. You might:
- wake up confused or disoriented
- wake up wondering where you are
- not remember doing certain activities
- find unfamiliar cuts on your body
- have difficulty sleeping throughout the night
- feel daytime sleepiness or fatigue
Your primary care doctor can help diagnose parasomnia. They’ll likely have you see a sleep specialist, who can further examine your sleeping behavior.
Diagnosis often includes:
- Medical history. Your doctor will ask about underlying medical conditions, current medications, family history, and lifestyle.
- Sleep history. A sleep diary can show your sleep behavior patterns. If you live with someone, they can observe how you sleep.
- Polysomnogram. In a polysomnogram, you sleep in a lab overnight so a specialist can analyze your sleeping behavior. They’ll record your brain waves, breathing, and heart rate to make a diagnosis.
Parasomnia treatment depends on the type and severity. Your doctor might recommend the following:
If your parasomnia is frequent or recurring, medication can help manage it. The best choice depends on your symptoms.
Examples of medications used to treat parasomnias include:
- dopamine agonists
- benzodiazepines, like clonazepam
On the other hand, if your symptoms are actually due to a certain medication, your doctor might recommend an alternative medication or different dose. Don’t stop taking a medication without your doctor’s OK.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a common parasomnia treatment. That’s because parasomnia is often related to mental health concerns, like stress and anxiety.
Other methods that may be used alongside CBT include:
- relaxation therapy
Some treatments can be done at home. Your doctor may suggest:
- Scheduled awakenings. Scheduled awakenings are when you wake up your child about 15 to 30 minutes before they spontaneously wake up. It may help minimize behaviors that follow a certain pattern. It’s often used for sleepwalking and night terrors.
- Safer sleep environments. If you sleepwalk or have RBD, you might need to sleep alone or remove dangerous items from your home. You can also lock windows and doors, place the mattress on the floor, and sleep with extra padding.
Parasomnia can make it hard to get quality sleep. It may also increase the risk of accidents and health problems due to lack of rest.
Fortunately, parasomnia is treatable, so it’s important to see a sleep doctor if you have unusual sleep behaviors. They can explore underlying causes and provide the best treatment for your symptoms.