Parasomnia

PARASOMNIA: GOING BUMP IN THE NIGHT

OVERVIEW: Most people are familiar with someone who talks or walks in their sleep. Parasomnia takes these activities farther. Parasomnia refers to talking and walking, but also to activities like eating, leaving the house, or sexually attacking another person during one's sleep. It is estimated that about 10 percent of all people have some instances of parasomnia. Unchecked, it can be dangerous, causing shame and injury. The episodes of parasomnia sometimes occur with a partial level of wakefulness before, during, or after the episode. Among children, common parasomnias include night terrors and sleep walking. Night eating among adults can entail ingesting up to 3000 calories a night of things like cat food or butter.

CAUSES: The major cause of parasomnia seems to be stress. In children, some things that seem to bring on an episode are fever, medications, irregular sleep schedule and sleep deprivation. It also has a genetic component, running in families. In adults, alcohol and caffeine consumption can make episodes more likely. Shift work is sometimes implicated. People who suffer with parasonmias sometimes have another condition, such as sleep apnea, migraine headaches, or epilepsy. The same person often has more than one type of parasomnia.

SYMPTOMS: Sometimes a person has a parasomnia, such as groaning or crying out in the night, but they don't know they have it. A change in their living situation can alert a roommate to the problem. People who eat in their sleep do so in a messy way. They wake up to a messy kitchen, but don't remember the episode. In children, screaming in the night usually indicates either a nightmare or parasomnia. The nightmare takes place during a dream (during REM sleep.) The parasomnia takes place during one of the deep levels of non-REM sleep. There are parasomnias that take place during REM sleep, in which people act out what they are dreaming.

DIAGNOSIS: One common characteristic of parasomnias is that the person is hard to wake up and they tend to be disoriented for a while upon awakening. It is easier to wake up a person who is having a parasomnia during a dream. Parasomnias are considered to be disorders of arousal, because people seem to be in a mixed state of being asleep and being somewhat awake. Laboratory tests are sometimes ordered to determine the best course of action, although the symptoms of parasomnia are distinctive enough that a diagnosis is not hard to make. Keeping a sleep diary is a good idea if you are planning a visit to talk to a physician about your problem.

TREATMENT OPTIONS: If it is determined that the parasomnia is caused by psychiatric disturbances, counseling is sometimes effective as a way to control the problem. As in other sleep disorders, establishing good sleep habits is a first line of action. This includes having a regular bedtime. The patient can learn to use progressive relaxation techniques to help themselves get to sleep. If the problem is caused by a medical problem, treating the illness can help the parasomnia. Children also respond well to good sleep hygiene.