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{{Infobox disease
| Name = Parasomnia
| Image =
| Caption =
| DiseasesDB =
| ICD10 = {{ICD10|F|51|3|f|50}}-{{ICD10|F|51|4|f|50}}
| ICD9 = {{ICD9|307.47}}, {{ICD9|327.4}}, {{ICD9|780.59}}
| ICDO =
| OMIM =
| MedlinePlus =
| eMedicineSubj = med
| eMedicineTopic = 3131
| MeshID = D020447
}}
''For the 2008 horror film, see [[Parasomnia (film)]]''
'''Parasomnias ''' are a category of [[sleep disorders]] that involve abnormal and unnatural movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Most parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness and [[NREM]] sleep, or wakefulness and [[REM sleep]].
==NREM parasomnias==
NREM parasomnias are arousal disorders that occur during stage 3 (or 4 by the [[Non-rapid eye movement sleep|R&K standardization]]) of NREM sleep—also known as [[slow wave sleep]] (SWS). They are caused by a physiological activation in which the patient’s brain exits from SWS and is caught in between a sleeping and waking state. In particular, these disorders involve activation of the [[autonomic nervous system]], [[motor system]], or [[cognitive processes]] during sleep or sleep-wake transitions.<ref>Bassetti et al., Lancet (2000); 356: 484–485</ref>
Some NREM parasomnias (sleep-walking, night-terrors, and confusional arousal) are common during childhood but decrease in frequency with increasing age. They can be triggered in certain individuals by alcohol, [[sleep deprivation]], physical activity, emotional stress, [[clinical depression|depression]], medications, or a fevered illness. These disorders of arousal can range from confusional arousals, [[somnambulism]], to [[night terror]]s. Other specific disorders include [[sleepeating]], [[sleep sex]], [[Bruxism|teeth grinding]], [[Rhythmic Movement Disorder|rhythmic movement disorder]], [[restless legs syndrome]],{{citation needed|date=November 2011}} and [[somniloquy]].
===Confusional arousals===
With a prevalence of 4%, confusional arousals are not observed very often in adults; however, they are common in children.<ref>Mahowald & Schenck: 1283.</ref> Confusional arousals are occasional thrashings or inconsolable crying among children—they are characterized by movements in bed.
===Sleepwalking (somnambulism)===
[[Sleepwalking]] has a prevalence of 1-17% in childhood, with the most frequent occurrences around the age of eleven-twelve. About 4% of adults experience [[somnambulism]].<ref>Mahowald & Schenck. 1283.</ref>
===Sleep terrors (night terrors)===
{{main|Pavor nocturnus}}
[[Night terror|Sleep terror]] is the most disruptive arousal disorder since it may involve loud screams and panic; in extreme cases, it may result in bodily harm or [[property damage]] by running about or hitting walls. Unfortunately, all attempts to console the individual are futile and may prolong or intensify the victim’s confused state. Usually the victim experiences [[amnesia]] after the event but it may not be complete [[amnesia]]. Up to 3% of adults suffer from [[Night terror|sleep terrors]], and exhibited behavior of this parasomnia can range from mild to extremely violent.<ref>Mahowald & Schenck: 1283.</ref> They typically occur in stage 3 sleep.<ref>Katugampola, M. (2005) Health & Human Development, Pearson Education.</ref>
===Bruxism (teeth grinding)===
[[Bruxism]] is a common sleep disorder where the sufferer grinds their teeth during sleep. This can cause sleep disruption for the sufferer and bed partner, wear and fracture of teeth, and jaw pain.
===Restless legs syndrome & Periodic Limb Movements===
Both of these conditions (RLS and PLM) are classified as dyssomnias according to the DSM-IV. They are considered parasomnias{{by whom?|date=November 2011}}.
==REM parasomnias==
===REM sleep behavior disorder===
[[REM Sleep Behavior Disorder]] is the most common REM sleep parasomnia in which muscle [[atonia]] is absent. This allows the individual to act out their dreams and may result in repeated [[injury]]-- [[bruises]], [[lacerations]] and [[fractures]]-- to themselves or others. Patients may take self-protection measures by tethering themselves to bed, using pillow [[barricades]] or sleeping in an empty room on a mattress.<ref>Mahowald & Schenck:1284.</ref>
Demographically, 90% of RBD patients are males, and most are older than 50 years of age.<ref>Mahowald & Schenck :1284.</ref>
Typical clinical features of REM sleep behaviour disorder are:
* Male gender predilection
* Mean age of onset 50–65 years (range 20–80 years)
* Vocalisation, screaming, swearing that may be associated with dreams
* Motor activity, simple or complex, that may result in injury to patient or bed-partner
* Occurrence usually in latter half of sleep period (REM sleep)
* May be associated with neurodegenerative disease <ref>Boeve et al.</ref>
Acute RBD, occurs mostly as a result of a side-effect in prescribed [[medication]]- usually [[antidepressants]].
Chronic RBD is [[idiopathic]] or associated with [[neurological disorders]]. There is a growing association of [[Chronic (medicine)|chronic]] RBD with [[neurodegenerative]] disorders—[[Parkinson's disease]], [[multiple system atrophy]] (MSA) or [[dementia]]—as an early indicator of these conditions by as much as 10 years.
Patients with [[narcolepsy]] also are more likely to develop RBD.
===Recurrent Isolated Sleep Paralysis===
Recurrent Isolated Sleep Paralysis is an inability to perform voluntary movements at sleep onset, or upon waking from sleep.<ref>http://infosleep.ca/parasomnias/parasomnias_sleepparalysis.html</ref>
===Catathrenia===
[[Catathrenia]], a rapid-eye-movement sleep parasomnia consisting of breath holding and expiratory groaning during sleep, is distinct from both [[somniloquy]] and [[obstructive sleep apnea]]. The sound is produced during exhalation as opposed to snoring which occurs during inhalation. It is usually not noticed by the person producing the sound but can be extremely disturbing to sleep partners, although once aware of it, sufferers tend to be woken up by their own groaning as well. Bed partners generally report hearing the person take a deep breath, hold it, then slowly exhale; often with a high-pitched squeak or groaning sound.
==See also==
* [[Dyssomnia]]
* [[Insomnia]]
* [[Jactatio capitis nocturna]]
* [[Sleep medicine]]
* [[Sleep paralysis]]
==References==
* Mahowald & Schenck. Insights from studying human sleep disorders. Nature (2005); 437(7063):1279-85.
* Bassetti et al., Lancet (2000); 356: 484–485
* Boeve et al. Journal of Geriatr Psychiatry Neurol 2004; 17:146-157
* Aurora RN et al. Journal of Clincial Sleep Medicine 2010; 6(1):85-95.
* Aurora RN et al. Journal of Clincial Sleep Medicine 2010; 6(4):398-401.
==Notes==
{{reflist}}
==Further reading==
*{{Cite book|title=Fire in the Brain: Clinical Tales of Hallucination|year=1992|first=Ronald|last=Siegel}}
*{{Cite book|title=The Head Trip: Adventures on the Wheel of Consciousness|year=2007|isbn=978-0679314080|first=Jeff|last=Warren}}
==External links==
* [http://www.stanford.edu/~dement/para.html Stanford: Parasomnias - Arousal Disorders Information]
* [http://sleep.health.am/sleep/parasomnias/ Primary Sleep Disorders: Parasomnias]
* [http://www.psychnet-uk.com/dsm_iv/parasomnias.htm Psychnet UK]
* [http://www.sleepwebmd.com/insomnia___parasomnia.htm Insomnia/Parasomnia]
{{Mental and behavioural disorders|selected = physical}}
{{SleepSeries2}}
[[Category:Sleep disorders]]
[[Category:Parasomnias| ]]
[[Categorybg:Medical termsПарасомния]][[Categorycs:ConditionsParasomnie]][[de:Parasomnie]][[el:Παραϋπνία]][[es:Parasomnia]][[fa:خواب گفتاری]][[fr:Parasomnie]][[he:פאראסומניה]][[nl:Parasomnie]][[pl:Parasomnia]][[pt:Parassonia]][[simple:Parasomnia]][[Categorysv:SymptomsParasomni]]
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