Parasomnias are a group of abnormal behaviors that can occur when falling asleep, during sleep or upon waking. The particular behaviour is specific to a phase within the sleep cycles, Non-REM or REM sleep. Parasomnias not only impacts the quality of life for the sufferer but also for family or friends

NREM Parasomnias

This group usually occurs in stage 3 (SWS) sleep which is our deep sleep phase

1. Night Terrors

Night terrors are where the person appears to wake up screaming, kicking or shrieking although they are not coherent or responsive and actually remain asleep. It can take several minutes to bring the person out of the state and many have no memory of it. More common in children but can be seen in adults subjected to abuse or trauma.

It is believed to occur during the transition phase from deep sleep to REM


Children tend to grow out of it but as an adult, it can impact the daily functioning.

  • Keep a diary and document what was occurring before the episode. Mood, stress or any triggers contributing to the terror
  • Speak with a sleep physician or psychologist who specialises in sleep disorders.
  • Has a sleep study assessment to eliminate a primary sleep disorder such as sleep apnea.

2. Sleepwalking (Somnambulism)

Sleep Walking occurs in Deep, Non-REM sleep. It is an arousal disorder where the sufferer appears to be awake but are actually asleep. More common in children between 6 – 12 years but can be seen in adults with a history of sleepwalking periodically going through stress, travel or shift work or may have a mental disorder. Some medications have also been linked. Sleepwalking can range from simply walking around the bedroom, urinating in inappropriate places to getting in the car and driving. The person usually has no memory of the event

Little is understood about the cause of sleepwalking although scientists have speculated that it may be the brain attempting to directly transition from deep sleep to wakefulness missing subsequent phases of sleep.



  • Keep a diary
  • Hypnosis if impacting daily life
  • Improve sleep hygiene
  • Speak with a sleep physician, neurologist or psychologist specialising in sleep disorders

3.  Sleep-related eating behavior (SRED)

People with SRED only partially wake up and then binge from the fridge or cupboard. A concern is that a sufferer has been known to eat food they would not normally eat or even something toxic. They have been known to start cooking a meal and then go back to bed without turning off the heating element. It has been linked to eating disorders or mental health conditions.


See a Specialist in sleep or eating disorders if occurring frequently.

4. Confusional Arousals

This NREM sleep disorder is when a person wakes from sleep but their behavior and speech are strange or impaired. They may appear disorientated, confused, panicked or have slow speech similar to stroke symptoms.

They are believed to occur during the transition from deep sleep to light sleep or when woken from a deep sleep.

It is common in chronic sleep-deprived individuals

  • Shift workers particularly rotating rosters
  • Alcohol abuse
  • Drug abuse
  • Mental health disorder such as bipolar
  • Secondary to another sleep disorder such as sleep apnea or Restless legs


  • Keep a diary
  • Consult with a sleep physician if episodes are frequent or escalating
  • Get tested for sleep apnea
  • Strict sleep hygiene practices
  • Avoid alcohol and drugs
  • Speak to your boss to be placed on a permanent shift rather than rotational. Your doctor can give you a letter
  • Change jobs

REM Parasomnias

Occurs in REM Sleep also known as our Dream phase

1.Nightmare disorder:

This disorder is diagnosed when a person has repetitive distressing nightmares which impact their daytime alertness and cause anxiety. They can intensify during periods of high stress, anxiety or depression. At times the primary cause can be linked to other sleep disorders such as sleep apnea or insomnia resulting in chronic sleep deprivation, further exacerbating the nightmares. The frequent episodes can become so terrifying that a person will delay going to bed but then collapse with exhaustion, further escalating the problem.


  • Sleep Physician or clinical psychologist specialising in sleep disorders
  • Medication such as antidepressants or sedation
  • Hypnosis or NLP therapy

2.Rem Behaviour disorder:

This is probably one of the most alarming parasomnias. REM Behaviour disorder (RBD) Is a form of parasomnia occurring in REM sleep and more prevalent in older males over 50. RBD sufferers act out dramatic or violent dreams and can often hurt themselves or their partner. During normal REM phase, the muscles in the body usually enter a state of temporary paralysis but in RBD the paralysis fails to occur allowing the person to act out their dreams.


Sleep Physician specialising in parasomnias is highly recommended. They may perform a supervised sleep study and/or medication

3.Sleep paralysis

Sleep paralysis is where an individual is briefly paralyzed when they wake up. An episode can last from 20 seconds to a minute or so. Sometimes it will occur when a person is woken sharply from REM sleep like a loud external noise. During an episode, you will be aware of being awake but unable to move. Many cultures speak about a dark shadow leaning over them when they wake causing fear and upset. This has yet not been scientifically explained


These occur infrequently and more so during periods of high stress or chronic sleep deprivation.

If you experience an episode, then consciously make an effort to relax. Take some long deep breaths and relax. You are just allowing your body to catch up to your mind.

If you are concerned, then speak with your doctor

Other Parasomnias

1.Sleep Talking ( Somniloquy)

Sleep talking can occur in any phase of sleep and can range from muttering to full lucid conversations. Episodes of talking can happen during high periods of stress, alcohol use, fever and chronic sleep deprivation.

Not much can be done with this parasomnia and many times it is transitional and harmless. Sleep talking can be secondary to another parasomnia.

  • Pay attention to sleep hygiene particularly strict bedtimes and rise times
  • Reduce stress
  • Reduce alcohol intake

2.Bed Wetting

Bedwetting is commonly known as nocturnal incontinence or enuresis. It is common in children and is considered a problem if it extends beyond the expected age of toilet training. The sufferer will generally wake during the episode although if in deep sleep they can sleep through it.


  • Small or weak bladder. Sometimes nerves are slow to mature
  • A traumatic event
  • Renal reflux. Valve to the bladder is not closing fully resulting in repetitive urine infections
  • Hormone imbalance
  • Sleep apnea
  • Diabetes
  • Failure to thrive syndrome in children
  • Medications


It is important to have assessments done to rule out any anatomical or medical abnormalities. Untreated these can lead to long term kidney damage

Teeth Grinding (bruxism)

Teeth grinding is a condition where you grind your teeth or clench your jaw. Bruxism can occur during wake periods where the sufferer is not aware they are doing it or during sleep.  It can cause concern as it wears down the teeth, causes jaw pain, and impacts the strength of the teeth.

The wear and tear on the teeth are observed at a dentist appointment or a partner may comment due to the annoyance of the grinding.


  • Stress or anxiety
  • Habit
  • Maligned jawline
  • Secondary sleep disorder such as sleep apnea or REM behavior


  • Stress management strategies
  • Relaxation exercises such as Meditation
  • Nocturnal denture plate
  • Botox

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