Parasomnias: Things That Go Bump in the Night

IMAGE A mother is awakened in the middle of the night by aterrifying scream. She races to the room of her 3-year-old son. He is sitting up in bed with tears running down his face, his heartpounding. The more she tries to soothe him, the more agitated hebecomes. A college student walks into her parents' bedroomwhile they are sleeping and pours a glass of water into her mother'sdresser drawer.What these two situations have in common is that, in the morning,they do not remember a thing.These stories—all true—are examples of parasomnias, which are defined as unpleasant or undesirable behavioral or experiential phenomena during sleep.

Defining Parasomnia

Abnormal things that can happen to people while they are sleeping are called parasomnias. Examples of parasomnias include sleepwalking andnight terrors. While they can be frightening to observe, most parasomnias areharmless and require no treatment beyond some simple safety measuresto keep people from injuring themselves during an episode.Parasomnias are more common in children than in adults because the condition most often occurs during deep sleep, which decreases as we age.

The Difference Between REM and Non-REM Disorders

Parasomnias fall into 2 main categories—disorders of REM sleep and non-REM (NREM)sleep.REM, short for rapid eye movement, sleep is the most active stage of sleep during the second half of the night. This is when most dreams and nightmares occur. During REM sleep, our muscles become relaxed and immobile to keep us from acting out our dreams. In those with REM behavior disorder, the muscles do not relax and people act out their dreams as though awake. Some things that may occur during this time are hitting, punching, or yelling. This disorder can lead to injury of the dreamer or the bed partner. During this time, the dreamer is really asleep.For most of the night, we are in NREM sleep, which includes the deep sleep. This is when sleepwalking and night terrors occur.A major difference between the nightmares of REM sleep andthe night terrors of NREM sleep is that nightmares involve acomplex plot that may be recalled in detail, while the imagesinvolved with night terrors are primitive and simplistic, suchas fire, a monster, or the ceiling falling down that are not recalled.

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