We all know the cartoon and sitcom characters of a sleepwalker: arms outstretched, eyes closed, mouth open, feet shuffling awkwardly. But while parasomnias – a category of sleep disorders characterized by abnormal behaviors, perceptions, and actions – may seem comical when Ed Norton searches for his long-lost pup in his sleep in The Honeymooners, the reality is no laughing matter.
Parasomnias, says Bruno DiCosmo, MD, FCCP, who is certified in sleep medicine and directs the sleep center of the WESTMED Medical Group, “are arousal disorders – a state between sleeping and waking”. The most common parasomnias include sleepwalking, sleep talking, nightmares, and sleep scares.
Praveen Rudraraju, MD, medical director of the Sleep Center at Northern Westchester Hospital, says, “Parasomnias can occur during NREM. appear [Non-Rapid Eye Movement] Sleep or during REM sleep. ”The difference? “In NREM sleep, your mind is asleep, but your body can move,” he says. “In REM, the mind is very active, but the body is paralyzed and the muscles are toned.” That’s why you rarely act out nightmaresthat occur during REM sleep.
Night terror, on the other hand, “NREM has sudden semi-excitement associated with intense anxiety and getting out of bed, etc.,” says Dr. DiCosmo. As frightening as the night terrors may be to the observer, Dr. DiCosmo says those who experience it “usually have no memory” because the brain is asleep. Still, night terrors can sometimes signal other problems. Dr. Rudraraju says that “nocturnal seizures can mimic parasomnia, so a sleep study should be done to rule this out.”
During the NREM, which has three levels, from mildly and easily excitable (level 1) to deep (level 3), people can drive, cook, eat, smoke, or engage in sexual activities. Dr. Rudraraju has seen patients cook and eat elaborate meals “named because of an NREM parasomnia” Nocturnal Eating Disorder. “Patients with this disorder, he says, are often treated with drugs like Topamax.
In REM behavior disorder (RBD), the paralysis that normally accompanies REM sleep is absent, which allows the person to live out dreams that are often very violent. “People can hit their spouse, fall out of bed, or worse,” says Dr. Rudraraju. RBD can sometimes be linked to Parkinson’s disease.
Another scary but benign parasomnia is Sleep paralysis, “In which the brain is awake but the muscles cannot function because they are still in the REM stage,” says Dr. DiCosmo. Two of the most common parasomnias are speak in sleep (which can range from ramblings to long narratives) and sleepwalking (which is often characterized by a clumsy or unsteady gait).
What about the old adage that waking a sleepwalker is dangerous? It’s partly true, says Dr. Di Cosmo. “When a person is sleepwalking, their brain is still in NREM sleep, but part of their nerve connections are awake, so they walk, eat, etc. Usually they just go back to bed and go to sleep completely,” so guide the nocturnal wanderer just go back to bed without waking him.
What to do if you have parasomnias
Do you do or experience strange things in your sleep and don’t know how to stop? First of all, visit your doctor and describe what happened. Medication and / or therapy may be appropriate. Also, maintain good sleeping habits. “Avoid sleep deprivation and alcohol, ensure even sleep-wake cycles and treat underlying sleep disorders such as sleep apnea or restless limbs,” advises Dr. DiCosmo. If security is a concern, keep the mattress on the floor, use gates and alarms, and remove sharp and dangerous objects. Finally, talk to your doctor about a sleep study that monitors brain waves, breathing, heart rate and rhythm, muscle movements, and eye movements to help pinpoint the problem.