Sleep disorders can occur in different people while they fall asleep, or sleeping or even during their arousal from sleep. Parasomnia is one such disorder. These sleep related disorders can occur in children as well as in adults. Other than sleep apnea, this disorder is clinically diagnosed and is treated generally with some drugs and psychological treatment procedures.
Definition of Parasomnia:
Parasomnia is an undesirable behaviour or a group of sleep disorders that occurs during falling asleep, while asleep and also while arousal from sleep.
Studies have shown that 40% children suffer from night terrors and 15% are seen to have sleepwalking. The children mostly belong to the age group of 2.5 years to 6 years. Even adults experience parasomnias. It is, however, not a difficult disorder that cannot be treated. With proper diagnosis and treatment, people suffering from Parasomnia can be given a better life.
Symptoms of Parasomnia:
Parasomnia refers to any kind of sleep related disorder that occurs while going to sleep, during the sleep cycle or when waking up from sleep. The symptoms of parasomnia may differ in different individuals, but the most common ones that are usually seen to occur in them are –
- Confusion and disorientation when waking up from sleep
- Sudden and partial awakening
- Arousal from sleep with complex motor behaviours
- Sleepwalking, sleep-running, sleep-eating, sleep-talking are some of the symptoms of Parasomnia
- During sleep or towards the end of sleep, occurrence of sleep paralysis
- Grinding of teeth while asleep is also a sign of Parasomnia
- Nightmares and night terrors
Types of Parasomnia:
The symptoms of this sleep disorder vary in different individuals and hence, depending on their types, parasomnia can be categorised.
- Nightmares: It is a type of Parasomnia where feelings of fear, terror and anxiety prevail, when these vivid nocturnal events occur. When this occurs, the individual is able to wake up from sleep and explain the nightmare in details. The difficulty occurs in returning back to sleep.
- Night Terrors: When the individual wakes up from sleep abruptly in an unstable and confused state, unable to communicate what had occurred, it is called night terror, a type of parasomnia. Night terrors do not respond to any voice and hence, it is difficult to wake up from sleep. These last for about 15 minutes, during deep sleep.
- Sleep Walking: When a person appears to be walking, moving around and seems like awake, but is actually asleep, it is commonly known as sleep walking. Sleep walking is a very common type of parasomnia. This mostly occurs early in the morning and the individual generally has no memory of the event. It runs in the family. The person is actually disoriented for a short while, resulting in the walking event.
- Confusional Arousals: When a person is awakened during the first part of the night and from a deep sleep, he or she reacts slowly to commands or experiences difficulty in understanding questions. It is also known as excessive sleep inertia or sleep drunkenness. It is often associated with short term memory loss since the individual does not have any memory of that confusional arousal in the following morning.
- Rhythmic Movement Disorder: Occurring mostly in children, Rhythmic Movement Disorder is also known as 'hand banging'. This is because the child usually lies flat, but lifts the upper part of the body to hit the head on the pillow with rhythmic movements.
- Sleep Talking: During the transition from being awake to falling asleep, some individuals are seen to talk. Sleep talking is a type of parasomnia which is not harmful, but sometimes disturbing for the sleeping partner. The talks can be short or even long speeches. When the person wakes up completely, he has no memory of this session.
- Nocturnal Leg Cramps: This mostly occurs in the older population, who experience a few seconds of leg cramping that can last even up to a few minutes. Long after the cramping has been stopped, the pain may last. Cramping occurs mostly in the calf muscles.
- Sleep Paralysis: While falling asleep or waking up, there are sometimes brief episodes of partial or complete skeletal muscle paralysis. In this disorder, the person is unable to move the limbs or the body. It runs in the family, but is not harmful. However, the person experiencing it can be terrified since he or she is unaware of what is happening. With touch or with a sound, this paralysis breaks and disappears.
- Impaired Sleep-Related Erections: When men fail to sustain their penile erection, they often experience involuntary sleep related erections. If this occurs, it indicates erectile dysfunction.
- Sleep Bruxism or Teeth Grinding: Unconscious, involuntary, excessive grinding and clenching of teeth are common in many people. If this becomes a severe problem, it might cause teeth and jaw muscle injury.
- Sleep Enuresis or Bedwetting: When the individual is unable to control urinary desires during sleep, it is known as Sleep Enuresis, a type of Parasomnia. It usually occurs in children, but may continue even in adulthood. This disorder also runs in the family.
- Sleep Sex: It is a condition where a person, even though asleep, engages in sexual activity like masturbation, having intercourse with somebody, fondling others or themselves or in extremes of cases involves in rapes or sexual assault. This is also known as sexsomnia.
Causes of Parasomnia:
Different medical conditions as well as physical and mental problems are associated with parasomnia as its causes. The most common causes of parasomnia, especially the parasomniac types such as nightmares and night terrors are anxiety, illness, a negative reaction to drugs and medicines or even the loss of a loved one.
Sometimes, it is caused by genetic reasons. If the disorder runs in the family, the sibling or children will have it. In some cases, the disorder is also caused by other medical conditions or diseases such as urinary tract infections, diabetes or sleep apnea.
Parasomnia in Children:
Children, adolescents and those, who are entering adulthood, are most likely to have these sleep related disorders of parasomnias. Sleepwalking, nightmares, confusional arousals and night terrors are most common parasomnias that are seen to occur in children. Children within the age group of 3 to 12 are also seen to have sleep talking, teeth grinding during sleep and also bedwetting disorders.
When children are seen to have disorders such as sleepwalking, there is a high risk of damaging their legs or causing other injuries, when they try to climb up the window or walk down the stairs. They need attention to make sure that this does not happen. In case of confusional arousals, they often react with moaning sounds or agitated behaviours such as loud screams or the children may even start to cry. However, within a few minutes, they cope with this state and stop reacting. It is not harmful or dangerous like the sleepwalking parasomnia. However, one problem that prevails in children is that when they have or experience these parasomnias, it is difficult for them to understand the situation or what is wrong with them. Since the fear prevails due to nightmares and night terrors, it becomes difficult for them to go back to sleep.
Parasomnia in Adults:
Adults, who are engaged in excessive drinking, have to take medications for other medical conditions and are suffering from other diseases, are more likely to have different kinds of parasomnias. In such a condition, it is important that they are assisted with support and proper treatment regime to get rid of the nightmares and night terrors, since if the condition worsens, they might end up having hallucinations that can be seriously difficult to treat.
Treatment for Parasomnia:
The parasomniac disorders are generally associated with underlying neurophysiologic mechanisms and neurotransmitter disorders. Treatments are generally given to assist the individual with their external expression of the disorder. Pharmacologic interventions are given to make behavioural changes and also hypnosis is given to relax the individual. However, if the disorder is associated with some other medical condition, then those conditions must be treated first.
Parasomnia is not a life threatening condition, unless it affects the individual by dragging into a state of involuntary injury. If it occurs, it is important to cater to the problems promptly, to make sure that the person does not suffer from difficulties much.