Parasomnias

Parasomnias are disorders of arousal,  and partial arousal.

Sleep Walking

 Sleep walking involves a series of complex behaviours, some may be automatic, whereas others are intentional which occur during non REM sleep.Sitting up in bed may not appear to present any problems, however,  others have been known to prepare food during their sleep and have no recollection of having done so when awakened.

This particular intentional act may present dangers to the subject as well as other members of the household . Other sleep walking acts may involve opening and shutting doors and windows and climbing stairs, these apparently simple acts could also present dangers to the subject because of the risk of falls. Others have been known to perform more destructive acts during their sleep walking, such as smashing furniture, or walking through windows, these destructive behaviours manifest mostly in young males.

The sleep walker is difficult to awaken, may be confused when awakened, and has no memory of the event. Sleep walking mostly occurs in young children between the age of 3-10 years, however, it can occur in older people, and often in these cases the episode has been triggered by a prescription drug refer:Sleep medications and their possible side effects

Sleep Terrors ( parvor nocturnus)

Sleep terrors involve episodes of what appears to be intense fear which are usually accompanied by crying and screaming. Associated symptoms which  occur with these episodes are increased heart and respiratory rate, and a state of confusion and disorientation is usually present. Young children from around the age of 4 years and up to about 10 are the ones most likely to experience night terrors. Some adults may also experience night terrors, however in some cases these may be triggered by drugs, either recreational or prescription ones.

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Paroxysmal Nocturnal Dystonia

This condition refers to an impairment of muscle tone of unknown etiology, although some drugs may cause this problem. The condition may occur during or after arousal from non REM sleep.It is characterized by short episodes, usually lasting no longer than a minute although in rare instances much longer, of repeated movements sometimes violent which can cause injury to themselves or  bed partner.The condition has been observed in both children and adults, and may last for many years.

REM Sleep Behaviour Disorder

This particlar condition is characterized by what  may sometimes be described as violent motor movements during REM sleep. The movements appear to be associated with an enactment of the dream, and may present grave dangers to the person or bed partner . The condition may appear to occur without a known trigger, however, other cases may occur as a result of neurologic disorders, such as multiple scerosis, ischemic cerebrovascular disease, and brainstem neoplasms.REM Sleep Behavior Disorder

Nocturnal Enuresis

Nocturnal enuresis has been associated with deep sleep, children with this problems appear to sleep more deeply than others who don't have the problem. Nocturnal enurersis occurs during the transition from deep sleep to REM sleep,  not during the REM stage as has often been thought. As the child matures the deep sleep period associated with the bladder dysfunction resolves, and the problem is outgrown. Organic causes may have to be considered, the child may have a urinary tract infection, or a disease which increases the urinary output such as diabetes, or a disease which impairs the ability to concenmtrate urine. Enuresis has also  been shown to occur in families, in parents as well as their children.

Read more: Sleep Paralysis

References: Rolak, Loren A Neurology Secrets, 2nd edition. Published Hanley and Belfus Philadelphia 1998.

Rowland, Lewis P Merritt's Textbook of Neurology 9th edition. Published Williams and Wilkins Baltimore 1995.