by Kimberly Allen, RN
Parasomnias are sleep disorders characterized by unusual behavior and abnormal motor, verbal and/or experiential behavior that occur during or associated with sleep. Experts estimate that 70% of Americans suffer from some type of sleep disorder. Some researchers state that as many as 40 million Americans suffer from chronic sleep disorders while another 20-30 million Americans suffer from intermittent sleep problems. Sleep disorders increase with age and as our population is getting older the number of Americans suffering with sleep disorders is expected to double with in a few years.
Parasomnias are catergorized into 2 categories, primary and secondary parasomnias. Primary parasomnias are disorders involving the stages of sleep including REM ( rapid eye movement) and non-REM or NREM sleep. There are 4 major types of parasomnias listed by the DSM ( Diagnostic Statistic Manual):
1. Nightmare disorder, which has also been called dream anxiety attacks, usually occur in the latter part of the night during REM sleep. However, there is no motoric dream enactment. Some people esxperience tachycardia, rapid breathing and excessive sweating.
2. Sleepterror disorder is characterized by arousal that usually occurs during the third and fourth stages of NREM sleep. People with sleep terror disorder experience exteme panic and tend to scream loudly while sleeping, they usually have motor involvement like hitting various objects and moving in and out of the bedroom. People with this type of disorder rarely remeber these episodes.
3. Sleep walking disorder is a motor disorder that occurs during the slow-wave stages of NREM sleep. A person with this type of sleep disorder is able to perform complex automatic tasks like wandering around aimlessly, carrying things, going outdoors as well as performing a variety of complex tasks.
4. REM sleep behavior disorder is a disorder involving dream enacting behavior like talking or yelling, punching, kicking, jumping out of bed etc. People withdrawing from alcohol and certain medications tendto develop an acute form of this type of sleep disorder.
Secondary parasomnias are disorders that develop due to problems in other organ systems including siezures, abnormal heart rhythms and gastroesophageal reflux.
There are a variety of factors that can cause sleep disorders including physical problems like uslers, certain medical conditions like asthma, psychiatric disorders like depression and anxiety and environmental issues like alcohol use and abuse.
Treatment of parasomnias depends on the type and cause of the sleep disorder. The first step is to provide an accurate and detailed history of any psychosocial stresses, drug and/or alcohol use as well as any symptoms of depression. A detailed mental status examination should also be performed. Your Dr may prescribe medications to decrease the frequency and/or intensity of episodes. Though there are no medications currently available that are specifically for sleep disorders there are medications that are used to treat other conditions that have been found to help in the treatment of sleep disorders.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.