Sleep disorder : parasomnia

Parasomnias cover a number of sleep disorders that affect 17% of children and 4% of adults. These disorders is classified according to the phase of the nocturnal cycle during which they occur, and are manifested by unusual phenomena such as nightmares, sleepwalking, hallucinations and bruxism.

What is parasomnia?

Parasomnias are one of the sleep disorders, along with hypersomnia and hyposomnia. They are undesirable events that occur during sleep, often involving specific behaviours such as sleepwalking, night terrors or confusional arousals. Although parasomnias generally run in families, they, like many sleep disorders, are influenced by external factors such as stress, sleep deprivation or illness.

Deep slow wave sleep parasomnias

Parasomnias during deep slow wave sleep can be of several types:

• Somnambulism: the sleepwalker moves unconsciously during the night. This phenomenon affects around 17% of children aged between 10 and 13 and around 4% of adults.
• Night terrors: these are uncontrollable anxieties that are accompanied by crying and screaming but leave the sleeper with no memory. Around 1-3% of children under the age of 15 suffer from this disorder.
• Confusional awakenings: this state of partial wakefulness and disorientation is accompanied by automatic behaviour (agitation, crying, grunting).

REM sleep parasomnias

Frequent manifestations of REM sleep parasomnia include :

• Nightmares: these occur towards the end of a sleep cycle, i.e. most often towards the end of the night, and leave the sleeper with an intense memory that makes it difficult to return to sleep.
• Behavioural disorders: these are violent movements caused by the sensation of “living your dream”. They tend to affect men over the age of 50 and may be the first signs of a degenerative disease.
• Sleep paralysis: the sensation of no longer being able to move or speak (especially in the case of cataplexy narcolepsy).

Other types of parasomnia

Other parasomnias occur during the early stages of sleep:

• Sleep rhythms: repetitive movements, sudden movements in the form of jerks, typical of infants.
• Hypnagogic hallucinations: sensory disturbances that are difficult to distinguish from reality (apparitions, noises, movements, etc.).
• Somniloquy: vocalisations during sleep.
• Bruxism: teeth grinding – a common symptom in children, often linked to excessive stress.

Parasomnias are considered to be problematic when they become frequent or continue into adulthood. They can then have serious psychosocial repercussions and disrupt daytime life.

The proposed therapies involve developing better sleep hygiene: balanced nutrition before bedtime, physical activity during the day, weight loss, etc. Drug treatment is only recommended in cases of severe parasomnia.

In order to implement solutions if the problems persist, it is important to establish a diagnosis as early as possible.