Sleep-related Behaviours / Parasomnias

Parasomnias are sleep related disorders that involve unwanted events or experiences that occur while you are falling asleep, sleeping or waking up. Parasomnias may include abnormal movements, behaviors, emotions, perceptions or dreams. Although the behaviors may be complex and appear purposeful to others, you remain asleep during the event and often have no memory that it occurred. If you have a parasomnia, you may find it hard to sleep through the night.
Some examples of parasomnias are the following:

Sleep Walking

Sleepwalking, also called “somnambulism”, is a parasomnia that occurs when you get up from bed and walk around even though you are still asleep. It can also involve a series of other complex actions. More often, it involves actions that are crude, strange, or in the wrong place.
In rare cases, someone who is sleepwalking may experience doing activities that put them, and others at risk. ex. Leave the house and cross the street, drive a car, get injured, become violent.

Episodes of sleepwalking and sleep terrors share many of the same causes. Some of which include sleep deprivation, Hyperthyroidism, Migraine or headaches, Head injury, Stroke, premenstrual period, Bloated stomach, Physical or emotional stress, Obstructive sleep apnea (OSA), Alcohol use and abuse.

REM sleep behavior disorder (RBD)

REM sleep behavior disorder (RBD) is a parasomnia that involves undesired events that happen while sleeping. RBD occurs when you act out vivid dreams as you sleep.
Most of these dreams are often filled with action. They may even be violent. Episodes tend to get worse over time. Early episodes may involve mild activity with later episodes getting more violent than the last one. RBD is often ignored for years but at some point it is likely to result in an injury. Either the person dreaming or the bed partner may be hurt.

RBD can be confused with sleepwalking and sleep terrors. In these other disorders, the sleeper is usually confused upon waking up. He or she does not become rapidly alert. In contrast, it is normally easy to wake a person with RBD who is acting out a dream. Once awake, he or she is also able to recall clearly the details of the dream.

The unusual behavior experienced would always match that of the dram in a RBD episode. These actions may include any of the following: Shouting our screaming, swearing, flailing, grabbing, punching and Kicking, jumping or leaping.

Sleep Paralysis

Recurrent isolated sleep paralysis is a parasomnia. Sleep paralysis causes you to be unable to move your body at either of the two following times:

• When falling asleep (hypnagogic or predormital form)
• When waking up from sleep (hypnopompic or postdormital form)

An episode of paralysis may cause you to be unable to speak. It can also make you unable to move your arms and legs, body, and head. You are still able to breathe normally and are also fully aware of what is happening. An episode can last for seconds or minutes and usually ends on its own.
It can be very scary when you are unable to move. You may feel anxious and afraid. Some people also hallucinate during an episode. They may see, hear or feel things that are not there. They may even think that another person is in the room with them. These hallucinations may also appear without the sleep paralysis.

Sleep paralysis can be one sign of narcolepsy. Other signs include disturbed sleep at night and falling asleep suddenly during the day.

Confusional Arousals

Confusional arousals is a parasomnia or sleep disorder that causes you to act in a very strange and confused way as you wake up or just after waking. It may appear that you don’t know where you are or what you are doing. Your behavior may include the following:

• Slow speech
• Confused thinking
• Poor memory
• Blunt responses to questions or requests

When a confusional arousal occurs, you may seem to be awake even though you have a foggy state of mind. Sleepwalking or shouting during an episode is common. These incidents may last a few minutes up to several hours. People with confusional arousals tend to have no memory recall of these happening. Some people with confusional arousals also grind their teeth. In some rare cases, adults may act very inappropriately or even hostile and aggressive.

Episodes of confusional arousals in children may seem bizarre and frightening to parents. The child can have a confused look on his or her face and “stare right through” you. Children may become more agitated when you try to comfort them. Most episodes last from five to fifteen minutes. But they may last as long as thirty to forty minutes in some youth.

Factors that can increase your risk of experiencing confusional arousals include:
Rotating or night shift work, other sleep disorders (hypersomnia, insomnia, circadian rhythm sleep disorders, not enough sleep, stress, Bipolar and depressive disorders
Potential causes for this disorder include:

Recovery from sleep deprivation, Alcohol consumption, Obstructive sleep apnea (OSA), Psychotropic medication use, Drug abuse, being forced to wake up

Confusional arousals occur at the same rate among both men and women. Rates are high among children and adults under the age of 35. It may occur in as many as 17 percent of children. About three to four percent of adults have confusional arousals.