These disorders are much more rare than the dyssomnias. Some of the most frequently-seen parasomnias are:
Sleepwalking – Sleepwalking occurs when a person appears to be awake and moving around but is actualy asleep. The sleepwalker has no memory of their actions. Sleepwalking most often occurs during deep non-REM sleep (stages 3 and 4) early in the night and it can occur during REM sleep in the early morning. This disorder is most commonly seen in children aged eight to twelve; however, sleepwalking can occur among younger children, the elderly and adults.
Sleep-talking – Sleep-talking is a sleep disorder defined as talking during sleep without being aware of it. It may involve complicated dialogues or monologues, complete gibberish or mumbling. Sleep-talkers are not typically aware of their behaviors or speech; therefore their voices and the type of language they use may sound different from their wakeful speech and can occur many times during sleep. Listeners may or may not be able to understand what the person is saying.
Sleep-talking usually occurs during transitory arousals form NREM (Non-Rapid Eye Movement) sleep, which is when the body does not move smoothly from one state in NREM sleep to another, and they become partially aroused from sleep. Further it can also occur during REM (Rapid Eye Movement) sleep at which time it represents a motor breakthrough of dream speck, words spoken in a dream are spoken out loud.
Sleep-talking can occur by itself or as a feature of another sleep disorder such as:
Rapid eye movement behavior disorder (RBD) – loud, emotional or profane sleep talking
Night terror – intense fear, screaming, shouting
Sleep-related eating disorder (SRED)
Rapid Eye Movement (REM) – Normal sleep has two distinct states; non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. NREM sleep is divided into four stages. During REM sleep, rapid eye movements occur, breathing becomes irregular, blood pressure rises, and there is loss of muscle tone (paralysis). However, the brain is highly active, and the electrical activity recorded in the brain by EEG during REM sleep is similar to that recorded during wakefulness. REM sleep is usually associated with dreaming. REM accounts for 20%-25% of the sleep period.
REM Behavior Disorder - In a person with REM sleep behavior disorder (RBD), the paralysis that normally occurs during REM sleep is incomplete or absent, allowing the person to “act out” his or her dreams. RBD is characterized by the acting out of dreams that are vivid, intense, and violent. Dream-enacting behaviors include talking, yelling, punching, kicking, sitting, jumping from bed, arm flailing, and grabbing.
Diagnosis – A polysomnography (PSG) sleep study is performed to document the abnormal REM sleep behavior during sleep.
Nightmare Disorder – Nightmares are vivid nighttime events that can cause feelings of fear, terror, and/or anxiety. Usually, the person having a nightmare is abruptly awakened from REM sleep and is able to describe detailed dream content, and usually has difficulty returning to sleep.
Sleep Terror Disorder – A person experiencing a night terror or sleep terror abruptly awakes from sleep in a terrified state. They may appear to be awake, but is confused and unable to communicate. They do not respond to voices and are difficult to fully awaken. Night terrors last about 15 minutes, after which time the person usually lies down and appears to fall back asleep. They usually don’t remember the events the next morning. Night terrors are similar to nightmares, but night terrors usually occur during deep sleep.
People experiencing sleep terrors may pose dangers to themselves or others because of limb movements. Night terrors are fairly common in children occurring in approximately 5% of them mostly between the ages of three to five. Children with sleep terrors will often also talk in their sleep or sleepwalk. This sleep disorder, which may run in families, also can occur in adults.
Bruxism – grinding teeth during sleep – Bruxism is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth together during the day or grind them at night, which is called sleep bruxism.
Sleep Eating Disorder – Sleep-eating disorders are characterized by abnormal eating patterns during the night. It can occur during sleepwalking. People with this disorder eat while they are asleep. They often walk into the kitchen and prepare food without a recollection for having done so.
Confusional Arousals – Confusional arousals takes place as you wake up or just after waking. You act in a way that is very strange and confused. It appears 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, and blunt responses to questions or requests
Factors that increase your risk:
If a relative also has it Rotating shift work
Night shift work Not enough sleep
Bipolar and depressive disorders Alcohol consumption
Other sleep disorders (hypersomnia, insomnia, circadian rhythm sleep disorders)
To determine if you have confusional arousals, your doctor will need to know your complete medical history and you may need an overnight polysomnogram sleep study to evaluate your sleep disorder.