Parasomnias – Types of Parasomnias

Posted on August 10, 2009 in Latest News

Parasomnias are disruptive sleep-related disorders that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams during the sleep. These disruptions can occur while falling asleep, sleeping, between sleep stages, or arousal from sleep.

Parasomnias may be classified into primary and secondary.

Primary parasomnias are the disorders of sleep states and are concerned only to the sleep phenomena of the individuals. They can be further classified according to the sleep state of origin, rapid eye movement (REM), or non-rapid eye movement (NREM)

Secondary parasomnias are the disorders of other organ systems that may manifest during sleep. For example arrhythmias, seizures, respiratory dyskinesias, and gastroesophageal reflux.

NREM parasomnias are primary parasomnias that cause sudden arousal of the patient during the stages 3 and 4 of NREM sleep. They are also known as slow wave sleep (SWS) parasomnias. Here there is physiological activation in which the patient’s brain exits from SWS and is caught in between a sleep and waking state. In particular, these disorders involve activation of the autonomic nervous system, motor system, or cognitive processes, during sleep or sleep-wake transitions.

Some of the causes of NREM are alcohol, sleep deprivation, physical activity, emotional stress, depression, medications, or a fevered illness. Some of the disorders that can be put in this category are confusional arousals, somnambulism and night terrors. Other specific disorders include sleepeating, sleep sex, teeth grinding, rhythmic movement disorder, restless legs syndrome, and somniloquy.

REM parasomnias are the behavior related disorders that occur during the REM stage of sleep. Here the subject enacts the dream that includes talking, yelling, punching, kicking, sitting, jumping out of bed, arm flailing, and grabbing.

Other Dramatic Parasomnias:

Following other conditions that should be considered as possible explanations for dramatic behavior at night in children and adults: True nightmares, nocturnal asthmatic attacks, ‘awakenings’ associated with obstructive sleep apnea, nocturnal panic attacks, sleep paralysis, pseudoparasomnias and overlap parasomnias.

Diagnosis and Differential Diagnosis:

Polysomnography, Electroencephalography (EEG) – Postarousal EEG, Electro Myography (EMG), Muscle twitch studies and Actigraphy are the common methods of diagnose and differential diagnose parasomnias.

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