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Parasomnia

parasomnia, parasomnia sleep disorders
Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep Most parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness and NREM sleep, or wakefulness and REM sleep

Contents

  • 1 Non-rapid eye movement NREM parasomnias
    • 11 Confusional arousals
    • 12 Sleepwalking somnambulism
    • 13 Sleep terrors night terrors
    • 14 Teeth grinding bruxism
    • 15 Restless legs syndrome & periodic limb movements
    • 16 Sleep sex
    • 17 Sleep related eating disorder SRED
  • 2 REM parasomnias
    • 21 REM sleep behavior disorder
    • 22 Recurrent isolated sleep paralysis
    • 23 Catathrenia
  • 3 See also
  • 4 References
  • 5 Notes
  • 6 Further reading
  • 7 External links

Non-rapid eye movement NREM parasomniasedit

NREM parasomnias are arousal disorders that occur during stage 3 or 4 by the R&K standardization of NREM sleep—also known as slow wave sleep SWS They are caused by a physiological activation in which the patient’s brain exits from SWS and is caught in between a sleeping and waking state In particular, these disorders involve activation of the autonomic nervous system, motor system, or cognitive processes during sleep or sleep-wake transitions1

Some NREM parasomnias sleep-walking, night-terrors, and confusional arousal are common during childhood but decrease in frequency with increasing age They can be triggered in certain individuals, by alcohol, sleep deprivation, physical activity, emotional stress, depression, medications, or a fevered illness These disorders of arousal can range from confusional arousals, somnambulism, to night terrors Other specific disorders include sleepeating, sleep sex, teeth grinding, rhythmic movement disorder, restless legs syndrome,citation needed and somniloquy

Confusional arousalsedit

Confusional arousal has a prevalenceclarification needed of 4% in adults, and is common in children2 Infants and toddlers usually experience confusional arousals beginning with large amounts of movement and moaning, which can later progress to occasional thrashings or inconsolable crying Confusional arousal is a condition when an individual awakens from sleep and remains in a confused state It is characterized by the individual's partial awakening and sitting up to look around They usually remain in bed and then return to sleep These episodes last anywhere from seconds to minutes and may not be reactive to stimuli3 Confusional arousals are not considered dangerous Another sleeping disorder may be present triggering these incomplete arousals4

Sleepwalking somnambulismedit

Main article: Sleepwalking

Sleepwalking has a prevalence of 1-17% in childhood, with the most frequent occurrences around the age of eleven to twelve About 4% of adults experience somnambulism5 Normal sleep cycles include states varying from drowsiness all the way to deep sleep Every time an individual sleeps, he or she goes through various sequences of non-REM and REM sleep Anxiety and fatigue are usually connected with sleepwalking For adults, alcohol, sedatives, medications, medical conditions and mental disorders are all associated with sleepwalking Sleep walking may involve sitting up and looking awake when the individual is actually asleep, and getting up and walking around, moving items or undressing themselves They will also be confused when waking up or opening their eyes during sleep Some individuals also talk while in their sleep, saying meaningless words and even having arguments with people who are not there6

Sleep terrors night terrorsedit

Main article: Night terror

Sleep terror is the most disruptive arousal disorder since it may involve loud screams and panic; in extreme cases, it may result in bodily harm or property damage by running about or hitting walls All attempts to console the individual are futile and may prolong or intensify the victim’s confused state Usually the victim experiences amnesia after the event but it may not be complete amnesia Up to 3% of adults suffer from sleep terrors and exhibited behavior of this parasomnia can range from mild to extremely violent This is very prevalent in those who suffer violent post-traumatic stress disorder PTSD 7 They typically occur in stage 3 sleep8

Teeth grinding bruxismedit

Main article: Bruxism

Bruxism is a common sleep disorder where the individual grinds their teeth during sleep This can cause sleep disruption for the individual and also the bed partner Grinding can wear and fracture the teeth, and also cause severe jaw pain This can lead to migraines, teeth impairment, temporomandibular joint disorder, and other complications Many are not aware of their teeth grinding Teeth grinding may be caused by stress and anxiety; it could also be caused by a non typical bite, or missing teeth Bruxism can sometimes be managed by being fitted with a night guard It is advisable to see a Licensed Dentist, Orthodontist, or Oral Surgeon for proper fitting of the right devices

Restless legs syndrome & periodic limb movementsedit

Main article: Restless legs syndrome

Both of these conditions RLS and PLM are classified as dyssomnias according to the DSM-IV

Sleep sexedit

Main article: Sleep sex

Sleep sex, or sexsomnia, is a condition in which a person will engage in sexual acts while still asleep A condition usually occupied by another sleep disorder it can include such acts as masturbation, fondling themselves or others, having sex with another person; and in more extreme cases, sexual assault including rapecitation needed 9

Sleep related eating disorder SREDedit

Main article: Nocturnal sleep related eating disorder

REM parasomniasedit

REM sleep behavior disorderedit

REM sleep behavior disorder or RBD is the most common REM sleep parasomnia in which muscle atonia is absent This allows the individual to act out their dreams and may result in repeated injury—bruises, lacerations, and fractures—to themselves or others Patients may take self-protection measures by tethering themselves to bed, using pillow barricades, or sleeping in an empty room on a mattress10 Demographically, 90% of RBD patients are males, and most are older than 50 years of age11

Typical clinical features of REM sleep behavior disorder are:

  • Male gender predilection
  • Mean age of onset 50–65 years range 20–80 years
  • Vocalisation, screaming, swearing that may be associated with dreams
  • Motor activity, simple or complex, that may result in injury to patient or bed-partner
  • Occurrence usually in latter half of sleep period REM sleep
  • May be associated with neurodegenerative disease 12

Acute RBD, occurs mostly as a result of a side-effect in prescribed medication—usually antidepressants But if not then 55% of the time the cause is unknown the other 45% the cause is associated with alcohol13

Chronic RBD is idiopathic, meaning of unknown origin, or associated with neurological disorders There is a growing association of chronic RBD with neurodegenerative disorders—Parkinson's disease, multiple system atrophy MSA, or dementia—as an early indicator of these conditions by as much as 10 years

Patients with narcolepsy also are more likely to develop RBD

Recurrent isolated sleep paralysisedit

Recurrent Isolated Sleep Paralysis is an inability to perform voluntary movements at sleep onset, or upon waking from sleep14

Catathreniaedit

Catathrenia, a rapid-eye-movement sleep parasomnia consisting of breath holding and expiratory groaning during sleep, is distinct from both somniloquy and obstructive sleep apnea The sound is produced during exhalation as opposed to snoring which occurs during inhalation It is usually not noticed by the person producing the sound but can be extremely disturbing to sleep partners, although once aware of it, sufferers tend to be woken up by their own groaning as well Bed partners generally report hearing the person take a deep breath, hold it, then slowly exhale; often with a high-pitched squeak or groaning sound

See alsoedit

  • Dyssomnia
  • Insomnia
  • Rhythmic movement disorder
  • Sleep medicine
  • Sleep paralysis

Referencesedit

  • Mahowald & Schenck Insights from studying human sleep disorders Nature 2005; 4377063:1279-85
  • Bassetti et al, Lancet 2000; 356: 484–485
  • Boeve et al Journal of Geriatr Psychiatry Neurol 2004; 17:146-157
  • Aurora RN et al Journal of Clinical Sleep Medicine 2010; 61:85-95
  • Aurora RN et al Journal of Clinical Sleep Medicine 2010; 64:398-401
  • http://wwwncbinlmnihgov/pubmedhealth/PMH0001811/

Notesedit

  1. ^ Bassetti et al, Lancet 2000; 356: 484–485
  2. ^ Mahowald & Schenck: 1283
  3. ^ Brandon Peters 2011
  4. ^ Durmer & Chervin 2007
  5. ^ Mahowald & Schenck 1283
  6. ^ ADAMinc2012
  7. ^ Mahowald & Schenck: 1283
  8. ^ Katugampola, M 2005 Health & Human Development, Pearson Education
  9. ^ http://canliiconnectsorg/en/summaries/31808
  10. ^ Mahowald & Schenck:1284
  11. ^ Mahowald & Schenck :1284
  12. ^ Boeve et al
  13. ^ http://wwwemedicinehealthcom/rem_sleep_behavior_disorder/page2_emhtm#REM Sleep Disorder Causes
  14. ^ http://infosleepca/parasomnias/parasomnias_sleepparalysishtml

Further readingedit

  • Siegel, Ronald 1992 Fire in the Brain: Clinical Tales of Hallucination 
  • Warren, Jeff 2007 The Head Trip: Adventures on the Wheel of Consciousness ISBN 978-0-679-31408-0 

External linksedit

  • Stanford: Parasomnias - Arousal Disorders Information
  • Primary Sleep Disorders: Parasomnias
  • Psychnet UK
  • Insomnia/Parasomnia
  • 1
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