Parasomnia - Causes, Symptoms & Treatment

Parasomnias can be described as “strange things that go bump in the night”. Parasomnias are disruptive sleep-related disorders that can occur during arousals from REM sleep or partial arousals from Non-REM sleep. REM behaviour disorder , restless legs syndrome , and somniloquy , characterized by partial arousals during sleep or during transitions between wakefulness and sleep. Parasomnias are often associated with stress and depression , and biological factors may also be involved. Many parasomnias are more common in children than in adults. Even though parasomnias occur during different stages of sleep and at different times during the night they are characterized by partial arousals before, during, or after the event. Most parasomnias are precipitated or perpetuated by stress, and an interaction between biological and psychological factors is presumed in many cases.Parasomnia falls into three different categories. They are paroxysmal, rhythmic and static disorders. Paroxysmal disorders that fall into this category appear without warning and recur infrequently. Paroxysmal disorders are bedwetting, nightmares, night terrors and sleepwalking. Rhythmic sleep disorders include head and body rocking and head banging and they range from very mild to thrashing. Other symptoms include rocking on hands and knees and pulling up the knees and raising the torso simultaneously. Young children and babies often suffer from static sleep disorders.

Children may sleep in odd positions, or with their eyes open. Arched backs, heads thrown back or sleeping upside down are all common symptoms. These disorders tend to run in families and are more common in children. Being over tired, having a fever or taking certain medications may make it worse. Because disorders of arousal are less common in adults, having an evaluation is important. In some cases, these disorders are triggered by other conditions, such as sleep apnea , heartburn, or periodic limb movement during sleep. Rather, parasomnias represent the activation of physiological systems at inappropriate times during the sleep-wake cycle. In particular, these disorders involve activation of the autonomic nervous system, motor system, or cognitive processes during sleep or sleep-wake transitions. Primary insomnia is treated with behavioral management to improve sleep habits and restrict time in bed, or with medicines that work on brain chemicals. Restless legs and PLMs are treated with medicines. Parasomnias are treated with appropriate medicines after accurate diagnosis. Most patients on levodopa, after some time, develop a consequence called augmentation. Augmentation is when RLS symptoms appear earlier during the day and involve new parts of the body with increasing severity.

Causes of Parasomnia

Common Causes and Risk factors of Parasomnia

• Stress.
• Depression.
• Biological factors.
• Drugs (Caffeine,Tricyclic antidepressants ).
• Sleep apnea.
• Heartburn.
• Periodic limb movement.

Signs and Symptoms of Parasomnia

Common Sign and Symptoms of Parasomnia

• Snorting.
• Headaches.
• Loss of muscle control (cataplexy).
• Poor concentration and focus.
• Difficulty with memory.
• Impaired motor coordination.
• Irritability and impaired social interaction

Treatment of Parasomnia

Common Treatment of Parasomnia

• Treatment might involve medical intervention with perscription drugs or behavior modification through hypnosis or relaxation/mental imagery.
• Treatment for REM behavior disorder is initiated with clonazepam at 0.5-1.5 mg taken at bedtime. This medication has been shown to be beneficial in the long-term.
• Anti-Parkinson medications, such as levodopa/carbidopa, bromocriptine, and pramipexole (Mirapex), have been used.
• Benzodiazepines, such as diazepam, clonazepam, temazepam, and lorazepam, also have been used.
• Opiates, such as codeine, oxycodone, methadone, and propoxyphene, are other drugs that have been used.
• Clearing a path in areas where a person often is found sleepwalking.
• Locking doors and windows Installing alarms on doors and windows.
• Avoidance of certain drugs, such as tricyclic antidepressants, fluoxetine and lithium.
• Behavioral treatments, such as relaxation therapy, biofeedback, and stress reduction, may be helpful, although they are not universally effective.