Sleeping with Parasomnias

Insomnia is the most common sleep disorder; it affects 30% of North Americans and can cause a many difficulties beyond persistent exhaustion, like weight gain or an increase in accidents.

But there are a lot of other types of sleep problems called parasomnias just as debilitating as insomnia (and, no, I’m not talking about the arrival of an infant in your home). Parasomnias are grouped into a category of abnormal behaviours or physiological events associated with sleep, sleep stages, or sleep-wake transitions. Here is a brief description of some of the more common iterations that you or a friend might have experienced.

Nightmare Disorder: repeated occurrence of frightening dreams, which typically focus on imminent physical danger or personal failure.

  • Occur during REM sleep later in the night and happen frequently
  • Most people will have difficulty falling back asleep after this type of dream
  • Generally cause significant subjective distress due to the detailed recall of frightening images and story lines
  • Are strongly correlated [i.e., have a relationship] with depressive and anxious symptoms and are more common in children and women

Sleep Terror Disorder: these are nightmares or scary dreams characterized by abrupt awakenings that begin with a panicky scream or cry and include incoherent vocalizations.

  • Typically occur within the first third of a sleep cycle.
  • Are accompanied by intense fear and difficultly in awakening
  • There is an inability or great difficulty in being comforted by a co-sleeper
  • The episode is not remembered in the morning
  • Associated with psychopathology in adults (e.g., PTSD)
  • Highly correlated with a family history of sleep terrors or sleep walking
  • More common in male children but are equally common in male and female adults

Sleepwalking and Sleeptalking Disorder: repeated episodes of motor behaviour or talking during sleep

  • Occur in the first third of night
  • The person, although seemingly awake, is unresponsive to others but can often talk and do simple tasks well
  • There is some confusion and difficulty re-orienting to the waking state, which will take several minutes to a half hour to occur
  • Psychosocial stressors, fever, alcohol, and sedative use can increase sleepwalking
  • Sleepwalking can occasionally lead to violent episodes, sleep-eating, and sleep-sex in adults
  • Quite common for children: 10-30% will have at least one episode
  • The peak occurrence of sleepwalking is at age 12 and a positive family history of it increases the odds for other family members
  • For adults: 1-7% will experience at least one occurrence in their lifetime

Parasomnia NOS (Not Otherwise Specified):

REM sleep behaviour disorder: motor activity of a violent nature

  • Occurs during REM sleep later in the sleep cycle
  • Characterized by total dream recall
  • People who have been violent in their sleep will remember it as a dream

Sleep paralysis: inability to perform voluntary movement during period between sleeping and waking.

  • Being fully awake but unable to move your body can be an intensely fearful and anxiety-provoking experience
  • Terrifying images and hallucinations can accompany the ‘paralysis’
  • Can last for a few minutes to a half hour, and sometimes even longer
  • It is thought that this occurs when your REM sleep has finished but the mechanism that ‘paralyzes your body’ during REM sleep (so you don’t live out your dreams) does not shut off appropriately during the first while of awakening
  • Very common in adults; between 20-60% of people have experienced this
  • Anxiousness and depressive symptoms may increase the risk, as does shift-work and alcohol use.

If you have experienced one or more of these sleep disrupters, I would recommend that you speak to a doctor and arrange for a sleep test. It will reveal a lot about your overall sleep architecture, sleep problems, and will provide some strategies for reducing anything that’s interrupting restful sleep on a regular basis. As well, many parasomnias are correlated with other psychological factors like depressive and anxious symptoms or even childhood trauma. So, it is important to check it out with a health professional.

Good sleep for you and your household,
Shari van Spronsen, MC, RCC, CCC
Twitter: @gottasecond

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