PARASOMNIAS

(Sleep Walking, Sleep Talking, and Sleep Eating)

 What are Parasomnias?

The Parasomnias are disorders that intrude into the sleep process and create disruptive sleep-related events. These behaviors and experiences occur usually while sleeping, and are most often infrequent and mild. They may happen often enough or become so bothersome that medical attention is required.

The parasomnias are divided into four groups:

What are Arousal Disorders?

Arousal disorders are parasomnia disorders presumed to be due to an abnormal arousal mechanism. Forced arousal from sleep can induce episodes. The "classical" arousal disorders are sleepwalking (somnambulism), sleep terrors and confusional arousals. Experts believe the various types of arousal disorders are related and share some characteristics. These arousals occur when a person is in a mixed state of being both asleep and awake, generally coming from the deepest stage of non-dreaming sleep. This means a person is awake enough to act out complex behaviors but still asleep and not aware or able to remember these actions.

What are the causes arousal disorders?

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 in sleep. A sleep specialist should evaluate the person's behaviors and medical history.

How are arousal disorders treated?

If it is a severe case that leads to injury or involves violence, excessive eating, or disturbs the bed partner or family, treatment by a sleep specialist may be necessary. Treatment might involve medical intervention with prescription drugs or behavior modification through hypnosis or relaxation/mental imagery.

Confusional Arousals- Sleep Inertia

Confusional arousals consist of confusion during and following arousals from sleep, most typically from deep sleep in the first part of the night.

  Sleepwalking (Somnambulism)

What is Sleepwalking (Somnambulism)?

Sleepwalking (Somnambulism) is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep.

What are the symptoms of Sleepwalking (Somnambulism)?

Ambulation (walking or moving about) that occurs during sleep. The onset typically occurs in pre-pubertal children.

Associated features include:

How Common is Sleepwalking?

Medical reports show that about 18% of the population are prone to sleepwalking. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. The highest prevalence of sleepwalking was 16.7% at age 11 to 12 years of age.  Sleepwalking can have a genetic tendency. If a child begins to sleepwalk at the age of 9, it often lasts into adulthood.

How serious is Sleepwalking?

For some, the episodes of sleepwalking occur less than once per month and do not result in harm to the patient or others. Others experience episodes more than once per month, but not nightly, and do not result in harm to the patient or others. In its most severe form, the episodes occur almost nightly or are associated with physical injury.  The sleepwalker may feel embarrassment, shame, guilt, anxiety and confusion when they are told about their sleepwalking behavior.

It is very important that if the sleepwalker exits the house, or is having frequent episodes and injuries are occurring -- Do NOT delay, it is time to seek professional help from a sleep disorders center in your area. There have been some tragedies with sleepwalkers, don't let it happen to your loved one!

In a few instances, sleepwalking can result in violent behavior. It is very important that a chronic sleepwalker seek professional help and follow the suggestions listed below to prevent having any violent episodes.

What can be done about sleepwalking?

There are some things a sleepwalker can do:

What is sleep talking?

Sleep talking (somniloquy) is the utterance of speech or sounds during sleep without awareness of the event.

What are the symptoms?

Why do some people talk in their sleep?

Nobody knows for sure. Children seem to be prone to it, especially if they sleepwalk too. Some people carry on whole conversations, while others just moan and make other sounds. If the frequency of sleep talking is bothering the family and disrupting sleep for others, there are some things you can keep in mind.

Nocturnal Eating Syndrome (Sleep-Related Eating) is considered a parasomnia, and is a rare type of sleepwalking, a disorder of arousal. People with this disorder experience recurrent episodes of eating during sleep, without being aware of what they are doing. Sleep-related eating might occur often enough to result in significant weight gain. Although it can affect all ages and both sexes, it is more common in young women.

The Merk Manual has night-eating syndrome listed under the heading of obesity and has this to say about the syndrome: The night-eating syndrome consists of morning anorexia, evening hyperphagia (excessive ingestion of food), and insomnia. Attempts at weight reduction in the presence of these 2 conditions are inordinately difficult and may subject the patient to unnecessary distress.

Key Names: Nocturnal Eating Syndrome, Sleep-Related Eating, Sleep Eating Disorder, Night Eating Disorder, Nocturnal Sleep-Related Eating Disorder

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