What Is Parasomnia, And How Does It Relate To Mental Health?
Around 10% of people in the U.S. live with parasomnias, which can be described as conditions involving unwanted behaviors during sleep. Sleepwalking, sleep paralysis, night terrors, and bedwetting are a few examples. Several parasomnias have been associated with mental illnesses. Often, parasomnias can be treated with a combination of therapy and medical interventions.
What are parasomnias?
A parasomnia can be defined as a sleep disorder involving unusual behavior while sleeping. These behaviors tend to be unwanted and unintentional, and they can be disruptive for both the individual experiencing them and those around them.
Before exploring the different types of parasomnias, it may be worth understanding a bit more about the sleep cycle. You might think all sleep is the same, but there are multiple types of sleep that you can experience during any given night. These sleep types typically fall into two broad categories: REM sleep and NREM sleep.
REM is short for “rapid eye movement.” In general, during rapid eye movement sleep, your eyes dart around rapidly, your brain activity increases, and your heart rate may rise. The REM stage of sleep is when most dreams occur.
NREM is short for “non-rapid eye movement.” During NREM sleep, eye movement, brainwaves, and heartbeat tend to slow. NREM sleep may play a role in memory formation, learning, metabolism, and more.
On any given night, your body typically cycles between REM and NREM sleep multiple times. Certain parasomnias may only happen during REM sleep. Others may only take place during NREM sleep. Let’s look at some examples from each category.
Rapid eye movement (REM) parasomnias
The first category of parasomnias occurs during periods of rapid eye movement (REM) sleep.
- Nightmare disorder:Occasional bad dreams can be common for most people. However, people with nightmare disorder usually have nightmares far more often than average. These recurring nightmares may happen so frequently that they interfere with daily life and make it hard to get enough healthy sleep.
- REM behavior disorder: Usually, when you’re in the REM stage of sleep, your muscles become immobilized. This typically prevents you from getting up and moving around as you’re dreaming. However, people with REM behavior disorder are still able to move during REM. As a result, they may act out their dreams, potentially endangering themselves or others.
- Sleep paralysis: In contrast, some people may wake up too early in the REM stage, while their muscles are still paralyzed. As a result, they may be fully conscious but unable to move. This paralysis is sometimes accompanied by hallucinations or a sense of suffocation.
Non-rapid eye movement (NREM) parasomnias
Parasomnias in this category generally occur during periods of non-rapid eye movement (NREM) sleep.
- Sleep terrors: Also known as “night terrors,” sleep terrors may cause people to suddenly wake with feelings of intense fear. Sleep terrors tend to happen during the first half of the night and can be most common in young children.
- Sleep-related eating disorder: Sleep-related eating disorder (SRED) can involve people eating or drinking while they’re asleep—usually with no awareness of what they’re doing. Sleep eating can be dangerous because people may unknowingly eat uncooked food, toxic chemicals, or other harmful substances.
- Confusional arousal: A confusional arousal can happen when someone seems to wake up from sleep but behaves in unusual ways. During a confusional arousal, a person may seem disoriented, and they might not respond when others speak to them. It can be common to have no memory of these episodes the following morning.
- Sleepwalking: Sleepwalking may involve physically getting up and walking around, but people may also perform other complex activities while sleepwalking. Common sleepwalking behaviors can include getting dressed, moving items around, and doing other routine tasks. Some people may even leave the house or drive, which can be dangerous when they aren’t fully awake.
Other parasomnias
Some parasomnias can happen during either REM or NREM sleep. Others may occur during the transition between sleep and wakefulness. These other parasomnias include the following:
- Sleep-related hallucinations: Sleep hallucinations can happen as you’re falling asleep. These hallucinations may take the form of patterns, shapes, faces, or beings. Sleep hallucinations can also be sounds, like voices or music, or sensations, like those of floating or falling.
- Sleep enuresis: Sleep enuresis is a technical term for wetting the bed while you sleep. This can be a common experience for young children as they learn to control their bladders. That said, bedwetting has also been found to affect approximately 2.3% of people over age 16.
- Sleep talking:Talking during sleep tends to be one of the most common parasomnias. When people talk in their sleep, they may mumble, speak gibberish, or carry out complex conversations. While sleep talking is typically most common in children and teens, it can also affect adults.
- Exploding head syndrome: Exploding head syndrome generally involves people hearing loud noises when they fall asleep or wake up. These noises can be alarming, often sounding like gunshots, explosions, or thunderclaps.
It may be worth remembering that parasomnias are just one type of sleep disorder. Various other sleep disorders may affect your quality and quantity of sleep. Insomnia, sleep apnea, narcolepsy, and restless legs syndrome are a few common examples.
Parasomnias and mental illness: Is there a link?
Different parasomnias can have different causes. For example, taking certain types of sleep medicine may make people more likely to sleepwalk.
Meanwhile, sleep paralysis may be more common for people who sleep on their backs. However, you might be surprised to learn that parasomnias may also accompany certain mental illnesses.
In 2017, researchers analyzed data from 19 different studies to look for a connection between parasomnias and mental illness. They found that people with psychiatric disorders tended to be significantly more likely to have parasomnias. Of the people in the study who had existing mental illnesses:
- 38.9% had nightmare disorder
- 22.3% experienced sleep paralysis
- 9.9% had sleep-related eating disorders
- 8.5% experienced sleepwalking
- 3.8% had REM sleep behavior disorder
Other studies often support the idea of a parasomnia-mental health connection. According to the Sleep Foundation, people with post-traumatic stress disorder (PTSD) may be more susceptible to nightmare disorder.
PTSD has also been associated with sleep paralysis, alongside other mental illnesses like bipolar disorder, panic disorder, and anxiety disorder.
Meanwhile, periods of high stress may trigger sleep terrors for some people.
In addition, children who experience bedwetting tend to be more likely to have anxiety disorders.
These associations may paint a clearer picture of how mental health can contribute to parasomnias. However, keep in mind that parasomnias themselves may also affect mental health. Having a parasomnia can disrupt sleep or make it hard to get enough sleep. Not getting enough quality sleep may, in turn, raise the risk of mental illnesses like depression and anxiety.
Getting help for parasomnias
If you have concerns about parasomnias, you might want to consult a healthcare provider. Depending on the symptoms you’ve noticed, your doctor may ask you to keep a sleep diary documenting your experiences, bedtime habits, and sleeping times. In some cases, your doctor may also recommend doing a sleep study. During a sleep study, you may spend the night in a lab while technicians record information about your brain activity, movements, oxygen levels, and more. Having a clearer picture of your sleep patterns and behaviors may be helpful for diagnosing possible parasomnias and deciding on a treatment plan.
Living with a parasomnia can be stressful, but it may be easier if you have professional support. Therapy can be a place to learn healthy coping strategies and maintain your mental well-being. However, therapy can be a highly personal experience. Sometimes, it can take time to find a therapist with whom you connect. Online therapy typically lets you change therapists whenever you want, at no extra cost.
Studies show that online therapy can effectively treat mental illnesses that may be linked to parasomnias. In a 2017 analysis, researchers reviewed data from 373 different studies. They found that online therapy could be an effective treatment for panic disorder, bipolar disorder, PTSD, and anxiety.
Takeaway
Parasomnias typically involve unusual, unwanted behaviors during sleep. Different parasomnias may occur during different stages of sleep, leading to sleepwalking, bedwetting, nightmares, and more. Research has found that parasomnias often arise alongside mental illnesses like PTSD, anxiety, and bipolar disorder. Parasomnias themselves may also negatively affect mental health by making it harder to get quality sleep. Speaking to your doctor and working with a therapist, whether in-person or online, can be helpful if you’re experiencing parasomnias or other sleep-related challenges.
- Previous Article
- Next Article