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Parasomnia
This document defines and describes different types of parasomnias including nightmares, night terrors, sleepwalking, REM sleep behavior disorder, and sleep paralysis. It notes that parasomnias involve abnormal behavior or psychological events associated with sleep, specific sleep stages, or sleep-wake transitions. Causes, clinical presentations, prevalence, and treatment approaches are summarized for each condition.
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Presentation by Amila Weerasinghe from the Faculty of Medical Sciences, University of Sri Jayewardenepura.
Parasomnia defined as abnormal psychological events related to sleep, sleep stages, or transitions.
Overview of major parasomnia disorders: Nightmares, Night terror disorder, Sleepwalking disorder, and others.
Nightmares characterized by awakening from REM sleep with detailed recall; peak incidence in children aged 5-6.
Nightmares triggered by frightening daytime experiences, PTSD, fever, drugs, and anxiety.
Less common than nightmares, occurs in childhood with terrified behavior and no dream recall.
Management includes bedtime routine, sleep hygiene, and in some cases, medication (Benzodiazepines).
Characterized by automatism during non-REM sleep, prevalence in ages 5-12; 15% have episodes.
Sleepwalkers often have open eyes, perform mechanical actions, difficult to wake, and episodes are brief.
Preventing injury by ensuring safety measures like locking doors and avoiding sleep deprivation.
Includes REM sleep behavior disorder (acting out dreams) and sleep paralysis (inability to move upon waking).
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Parasomnia
- 1. Amila Weerasinghe 21st Batch Facultyof Medical Sciences University of Sri Jayewardenepura Sri Lanka. 22/10/2015
- 2. Parasomnia Definition :- abnormal behaviour/psychological events, associatedwith sleep specific sleep stages sleep-wake transition
- 3. 1. Nightmares (dreamanxiety disorder) 2. Night terror disorder 3. Sleepwalking disorder 4. Other parasomnias
- 5. 1. Nightmares (dream anxietydisorder) An awakening from REM sleep to full conciousness with detailed dream recall. Children – peak age 5-6 years
- 7. Main stimulations for nightmares Frighteningexperiences during day Frequent nightmares usually, during a period of anxiety
- 9. Other causes for nightmares PTSD Fever Psychogenicdrugs Alcohol detoxification
- 10. 2. Night terrordisorder Less common than nightmares Sometimes familial Usually limited to childhood
- 12. Clinical picture –Night terror disorder A few hours after going to sleep/ whlist in stage 3-4 non-REM sleep ; The child Sits up and appears terrified. Screams and appears confused.
- 14. Cnt . Clinicalpicture – Night terror disorder After a few minutes , the child slowly settles and returns to normal calm sleep. A little/no dream recall
- 16. Mx – Nightterror disorder A regular bedtime routine Improved sleep hygiene Benzodiazepines and imipramine – effective in preventing night terrors But avoid prolonged use
- 17.
- 18. 3.Sleep walking disorder Anautomatism during deep non-REM sleep, usually early part of the sleep. Common in 5 – 12 age group
- 19. 15% of thisage group walked at least once during the sleep. Occasionally persists in to the adult life. May be familial
- 21. Cont... Sleep walking disorders Mostchildren don’t actually walk. But sit up and make repetitive movements. Some walk around
- 22. Eyes open In amechanical manner but avoiding familiar objects Don’t respond to questions Very difficult to wake up Usually led back to bed Mostly few seconds – minutes. But rarely an hour.
- 24. Mx - Sleepwalking disorders Sleep walkers can harm themselves Hence need to be protected from injury Lock doors and windows Remove dangerous objects Advice about safety Avoid sleep deprivation Avoid other circumstances that might make them excessively sleepy,
- 25. 4.Other parasomnias 1. Rapideye movement (REM) sleep behaviour disorder 2. Sleep paralysis
- 26. 1.Rapid eye movement(REM) sleep behaviour disorder When behavioural problems (agitation/aggression) occur during night. Normal atonia of REM sleep is lost. So dreams are acted out.
- 27. Commonly in eldermen Associated with neurological disorders Eg – Parkinsonism Clonazipam & donepezil
- 29. 2.Sleep paralysis Inability toperform voluntary movements in the transition between sleep and wakefulness,
- 30. Either At sleep onset (hypnagogic) Atawakening (hypnopompic) Episodes are accompanied