Parasomnias

Undesirable disorders of behaviour or experience that occur during sleep or its specific stages, or during sleep-wake transitions

Aetiology

  • Non-REM - most commonly found in children, but can recur in adults when under stress or suffering from a mood disorder
  • REM - mainly affects men, predominantly in the sixth and seventh decades of life, often associated with neurodegenerative disorders

Clinical presentation

  • Non-REM - non-dreaming e.g. confusion arousals, sleep walking, sleep terrors and paralysis
  • REM - enactment of the experience of dreams during REM sleep e.g. kicking, punching, talking, sitting up

Management

  • Non-REM - reassurance
    • Children with night terrors, sleepwalking etc. usually grow out of it before adolescence
  • REM - depends on the underlying cause; in patients in whom there is no underlying disorder, the symptoms are frequently amenable to medication