Disclaimer:  This information is given to advise people with sleep symptoms and does not replace a doctor’s assessment.  Please use the information wisely and don’t self- treat.

Parasomnias - Sleep Walking, Talking and Night Terrors

Parasomnias are the strange events that occur during sleep usually without the sufferer being aware of them happening.

There are two main types depending on the type of sleep when they occur:

Slow Wave Sleep - this is the deep sleep that occurs at the beginning of the night so these parasomnias usually occur in the first half of sleep. Sleep talking and sleep walking as well as night terrors are slow wave sleep parasomnias which are well known. Less well known are sleep-eating and sleep texting. They are quite common in children (11%) but fade away after puberty. The parasomnias may reoccur in adults during a time of intense stress. If they are regular in adults with a poor quality of sleep then the sleep needs to be investigated for a sleep disorder as this is unusual.

REM Sleep (Rapid-eye-movement) - this is also a deep phase of sleep with long patches during the second part of the night. The two main parasomnias occurring in REM sleep are nightmares and REM behaviour disorder. There can be confusion between nightmares and night terrors. Night terrors occur in the first half of the night and the child refuses to be comforted. There is also no memory of the terror when woken during the terror or the following morning if they continue sleeping. Nightmares have very clear visual imagery, and children are frightened and cling to their parents. The content of the nightmare is very clear and can be remembered for years.

REM Behaviour disorder usually occurs in older men and presents as them acting out their dreams. The activity may appear illogical but once they are awake the activity makes sense in the context of the dream. Paralysis of all the muscles in usual during REM sleep which prevents acting out of dreams but in these patients that paralysis goes on and off during sleep. Patients with this disorder often injure themselves and other people so the disorder can be quite dangerous. It is important to get the diagnosis correct as there is an increased risk of other neurological. There is medication which prevents the activity during REM sleep.

There is no specific treatment for the other parasomnias except if they become very disruptive.