Other Sleep Disorders

Parasomnias...

The term parasomnia refers to a wide variety of disruptive sleep-related events. These behaviors and experiences occur usually while sleeping, and most are often infrequent and mild. They may, however, happen often enough to become so bothersome that medical attention is required.

The most common type of parasomnias are disorders of arousal, which include confusional arousals, sleepwalking (somnambulism), and sleep terrors. Experts believe the various types of arousal disorders are related and share some characteristics. These arousals occur when a person is in a mixed state of being both asleep and awake, and usually coming from the deepest stage of nondreaming sleep.This means the person is awake enough to act out complex behaviors but still asleep and not aware or able to remember these actions.

Parasomnias are very common in young children and do not usually indicate significant psychiatric or psychological problems. Such disorders tend to run in families and might be made worse when a child is overly tired, has a fever, or is taking certain medications. They may occur during periods of stress and may increase and decrease with good and bad weeks.


Confusional arousals

Confusional arousals often occur in infants and toddlers, but may also be seen in adults.These episodes may begin with a person crying and thrashing around in bed. The individual may appear awake, confused and upset, yet resists attempts by others to comfort or console. It is also difficult to awaken a person having a parasomnia. The episodes may last up to half an hour and usually end with the person calming, waking briefly, and then only wanting to return to sleep.

Because disorders of arousal are less common in older people, adults suffering from these disorders should seek evaluation. In some cases these events are triggered by other conditions such as sleep apnea, heartburn, or periodic limb movements during sleep. A sleep specialist s hould evaluate the person's behavior and medical history.

In typical childhood occurences of arousal disorders, medical evaluation is rarely needed. However, you should contact your physician if a child experiences disturbed sleep that causes;

  1. potentially dangerous behavior that is violent or may result in injury
  2. extreme disturbances of other household members
  3. excessive sleepiness during the day. In these cases, formal evaluation at a sleep center is warranted.

Using simple safety measures can prevent serious injury to those with arousal disorders. Clearing the bedroom of obstructions, securing the windows, sleeping on the first floor, and installing locks or alarms on windows and doors will add a degree of security for the individual and the family. In severe cases, medical intervention may be needed with prescription drugs, behavior modification through hypnosis or relaxation/mental imagery.


Other Parasomnias

Nocturnal seizures

These seizures, which occur only during sleep, can cause the victim to cry, scream,walk, run about, or curse. Like other seizures, these are usually treated with medication.

Rapid eye movement (REM) behavioral disorder

All body muscles (except those used in breathing) are normally paralyzed during REM sleep. In some people, usually older men, this paralysis is incomplete or absent, allowing the person to act out dreams. Such dream-related behavior may be violent and cause injury to the victim or bedpartner. Unlike those who experience sleep terrors, the victim will recall vivid dreams. REM sleep behavior disorder can be controlled with medication.

Sleep starts

Most people have experience the common motor sleep start - a sudden, often violent, jerk of the entire body that occurs upon falling asleep. Other forms of sleep starts also occur just as sleep begins such as;

visual sleep start - usually a sensation of blinding light coming from inside the eyes or head

auditory sleep start - a loud snapping noise that seems to come from inside the head

The different types of sleep starts can be frightening, but these occurences are harmless.

Rhythmic-movement disorder

This condiion is seen most frequently in young children but may also occur in adults. It takes the form of recurrent headbanging, headrolling, or bodyrocking. The individual also may moan or hum. These activities may occur just before falling asleep or during sleep. Medical or psychological problems are rarely associated with rhythmic-movement disorder. Behavior treatment may be effective in severe cases.

Sleep talking (somniloquy)

Sleep talking is a normal phenomenon and is of no medical or psychological importance.

Teeth grinding (bruxism)

Grinding teeth during sleep is a very common occurrence and little evidence suggests that teeth grinding is associated with any significant medical or psychological problems. However, severe bruxism may be associated with sleep disruption. A sleep study can determine the degree of disruption. In severe cases, mouth devices may help or reduce dental injury.


Sleep Paralysis

The characteristics of sleep paralysis are as follows:

  • Inability to move or speak for 30 seconds - 3 minutes
  • Speech is difficult or almost impossible
  • Happens before falling asleep or just after waking up
  • Can be hereditary
  • Can be brought on by stress

Sleep paralysis is the experience of waking up (usually form a dream) and feeling paralyzed, except for being able to breathe and move the eyes. Hypnogogic hallucinations and sleep paralysis may occur together. These conditions are common in people with narcolepsy but can also effect others, particularly people who are sleep-deprived. Although a pretty terrifying event, these events are not physically harmful. There are two major types of sleep paralysis: common (typical) also known as CSP and hallucinatory (hypnagogic) sleep paralysis known as HSP.

Differences between CSP and HSP.

  • CSP is common and universal, HSP is rare and seems to be geographically episodic.
  • CSP is only unnerving for the sleeper but HSP is accompanied by a nightmare like hallucination.
  • CSP is of relatively short duration where HSP can last as long as seven or eight minutes.

One of the most important differences between Night Terrors and CSP is that CSPs occurs in Stage one of sleep and Night Terrors occur in stage four.

Different cultures throughout time have interpreted HSPs as different spirits or events.

  • Ancestral ghosts - Southeast Asians
  • Hag - Irish and Scottish
  • Cats - Chinese
  • Spectral foxes - Japanese
  • Djinn - Arabs
  • Guilt - Romans and the Egyptians
  • Witchcraft - Mexicans
  • Vampires - Europeans
  • Demons - Medieval Europe

HSPs are usually a vision of a small creature that sits on the victims chest. The creature then either compresses the chest or attempts to strangulate the victim. Almost all attacks have been reported by people sleeping on their backs.

For additional information check:
Trionic Research Institute http://www.trionica.com