Sleep Disorders; Parasomnias: Types,Causes,Epidemiolgy and Treatment

                   

Atypical actions, activities, or physiological occurrences during sleep or sleep-wake transitions are characteristics of a class of sleep disorders called as parasomnias.

Different types of insomnia are categorized using rapid eye movement (REM) and non-REM sleep phases (NREM).

Emotions, dreams, and autonomic activity, in addition to simple or complex aberrant movements like sleepwalking, sleep talking, and dream enactment, may be symptoms.

The diagnosis requires a thorough history from the patient and anyone who witnesses the movements or actions.

In some cases, polysomnography may be required, especially if concurrent sleep disorders are suspected.

A comprehensive history from the patient and anyone who observes the movements or behaviors is necessary for the diagnosis.

Polysomnography may be necessary in some circumstances, particularly if concomitant sleep disorders are suspected.

There are some conditions that become better on their own over time.

Options for those who need intervention include dietary or risk-reduction changes, various types of counseling, and pharmaceuticals.

Epidemiology

Children are more often than adults to experience insomnia.

NREM parasomnias are more frequent in children than REM parasomnias.

Among these, the prevalence rate of confusional arousals is 17.3% in children aged 3 to 13 and 6.9% in those aged 15 or older.

The prevalence of sleepwalking among children under the age of 12 is 17%, and the prevalence of sleep terror is 6.5%.

Children between the ages of 10 and 50 frequently experience nightmares.

Children who have underlying neurologic and psychiatric conditions including epilepsy, attention-deficit hyperactivity disorder (ADHD), or developmental problems are more likely to experience parasomnias.

Different Parasomnias

The most typical behaviors linked to parasomnias are as follows:

Other types of parasomnias:

Sleepwalking: Once believed to be dreams playing out, sleepwalking actually occurs during a deep sleep (not REM sleep, when dreams typically occur).

Sleepwalkers frequently carry out daily tasks like cleaning and getting dressed.

In youngsters, sleepwalking is fairly frequent, and it affects 1% of adults as well.

Sleepwalking episodes can be brought on by stress, worry, drinking too much alcohol, or epilepsy.

Night terrors: During these acute bouts, people—typically children—appear to awaken and scream out of panic or fright.

These people, however, are frequently inconsolable and frequently fail to remember the incident the next day.

When a person falls asleep and mutters solitary sentences or entire dialogues, they are said to be sleep talking.

It happens throughout all stages of sleep and is linked to other conditions such sleep apnea and REM-related parasomnias that induce small awakenings.

Sleep-eating disorders: Similar to sleepwalking, these episodes take place during brief partial awakenings from deep sleep and cause people to eat without being aware of what they are doing or remembering what they have eaten.

Parasomnias connected to REM

People who have sleep paralysis are unable to move or open their eyes as they are about to fall asleep or awaken.

You may be more susceptible to REM-related parasomnias if you don't get enough sleep, have an erratic sleep-wake cycle, or are stressed.

Dream disorder:

This depicts frequent, frightening dreams followed by feelings like fear, rage, or disgust.

Because the patient can vividly recall their dreams and finds it difficult to fall asleep again, these nightmares differ from sleep terrors.

Both non-REM and REM sleep can experience nightmares, which are common in people with acute stress disorder and post-traumatic stress disorder (PTSD).

Even if other PTSD symptoms have subsided, the dreams may continue.

Depending on how severe the disorder is, counseling, medication, or a combination of the two may be used to treat it.

Sleep disorders risk factors

There are numerous potential risk factors that could influence the development of parasomnia.

The following are some of the most typical:

Age: Given that parasomnias like bedwetting and sleepwalking frequently occur throughout childhood, age would undoubtedly be a significant component.

Stress: Stress has a significant role in a variety of parasomnias, including sleepwalking, night terrors, eating disorders linked to sleep, sleep paralysis, and others.

Genetics: Genetics can also have a significant impact.

You are most likely to experience any types of parasomnia that your parents experience.

Abusing drugs and alcohol will not only damage your liver but also bring on a variety of new parasomnias and exacerbate any already present ones.

Medicine: Regardless of how efficient your drugs are, some of them may cause different kinds of parasomnias as a side effect.

Post-traumatic stress disorder (PTSD): PTSD is usually linked to parasomnias of the nightmare variety.

Nearly half of those with PTSD will experience nightmare disorder for at least two to three months following the trauma.

What causes parasomnias?

The reasons of parasomnia might be varied.

There may be several triggers for the disease, including:

Stress

Anxiety

Depression

PTSD

Use of drugs

certain medicines

Irregular sleeping patterns, such as shift work

Additional sleep problems, such as insomnia

being sleep deprived

disorders of the nervous system, such as Parkinson's disease

Parasomnia symptoms

Depending on the kind you have, parasomnias can cause a variety of symptoms.

However, some widespread signs that most parasomnias share are as follows:

Trouble sleeping

Fatigue throughout the day confusion upon awakening

Displaying odd behaviors while you're sleeping

Often having nightmares

When you have bumps and scrapes, you cannot explain

Problems from parasomnias

Significant side effects of insomnia (e.g. injury)

suspected certain circumstances

Nighttime Seizures REM

Behavior Sleep Disorder

Obstructive

Children with Periodic Limb Movement Disorder and Sleep Apnea

Diagnostic procedures

Your sleep medicine specialist will inquire about your and your sleeping partner's sleep issues.

Your medical background, family history, usage of alcohol, and any drug misuse will also be inquired about.

Your current medicine usage will be questioned.

Your bed partner could be asked to log your sleep events and to keep a sleep journal for you.

Other tests for sleep problems consist of:

You'll be watched as you snooze in a sleep laboratory during a sleep study (polysomnogram).

As you sleep, your breathing, heart rate, eye movements, and brain waves will be monitored.

Your behavior and movements will be captured on camera.

While some sleep tests can be performed at home, an in-lab test will be advised if parasomnia is a concern.

These tests, such as a video electroencephogram (EEG) or a sleep EEG, allow your doctor to observe and document the activity of your brain during a mental experience.

To find brain degeneration or other potential neurologic explanations of your symptoms, a neurologic exam, CT scan, or MRI scan may be necessary.

Medicine and therapy

Treatment for parasomnia is based on the nature and severity of the condition.

Medication can aid in managing parasomnia when it occurs often or repeatedly.

Medications used to treat parasomnia include some of the following:

Drugs for depression Melatonin Topiramate Levodopa,Benzodiazepines

However, if a medicine is to blame for your parasomnia, your doctor can suggest switching to a different drug or dosage.

Cognitive behavioral therapy may also be helpful for parasomniacs.

Stress and anxiety are two mental health issues that this kind of therapy frequently alleviates.

In addition to cognitive behavioral treatment, other techniques like hypnosis, relaxation therapy, and psychotherapy may be employed.

Additionally, there are various treatments that people can try at home, including:

Parents can wake their children up on a scheduled basis, 15 to 30 minutes before they naturally arise.

As a result, patterns of behavior like sleepwalking and night terrors may be reduced.

establishing a secure sleeping environment by doing things like sleeping alone, taking harmful objects out of the house, securing the doors and windows, putting the mattress on the floor, and using extra padding while sleeping.

Because parasomnia episodes might differ from person to person, it's crucial to consult your doctor to get a personalized treatment plan.

You may count on the assistance of our sleep medicine specialists to have a secure and relaxing night's rest.

Prevention of Parasomnias

Although some causes of parasomnias, such as those caused by neurological illnesses, mental health conditions, or inheritance, are less likely to be prevented, others may be prevented by adhering to some of the same treatment strategies outlined in this article.

These include reducing alcohol and recreational drug usage, getting seven to nine hours of sleep each night, and maintaining regular bedtime and wakeup schedules.

Additionally, get a review of your current drugs from your doctor.

Many things can make sleeping difficult.

If so, possibly different medications could be prescribed.

Thank you for reading.