Are you sleepwalking? Are you screaming in fear? This could be a parasomnia!

Have you ever seen someone in your house wake up and walk around in their sleep? Or suddenly wake up screaming in their sleep? Maybe you have had similar experiences. What are these strange things that actually happen to us while we are sleeping that we are not even aware of? Some people think that these are ghosts. But in medicine, we call these conditions Parasomnias. This is a sleep-related condition. We are talking about this today.

Simply put, what are parasomnias?

Parasomnias are unusual behaviors or experiences that occur during sleep, while falling asleep, or when about to wake up. These can occur in a variety of ways.

If you have a parasomnia, you may experience things like:

• Talking in your sleep.
• Sleepwalking.
• I have nightmares.
• When I wake up from sleep, I feel very confused.
• I don't remember what I did in my sleep in the morning.

Imagine this: A family member wakes up in the middle of the night and goes to the kitchen to look for something. You call and they don't answer. Even though their eyes are open, they don't seem to be awake. When they ask them in the morning, they don't remember anything. That's what happens. To others, you may appear to be awake, but you're actually asleep.

How to classify parasomnias according to sleep stages

We divide these conditions into three main categories based on the stage of sleep in which they occur. Our sleep has stages, like a staircase.

Now let's look at what situations fall under each of these categories separately.

Types of parasomnias that occur during non-REM sleep

These are often related to physical activity.

Types of parasomnias that occur during REM sleep

These are often related to the dreams we see.

Other types of parasomnias

These don't exactly fit into either of the above categories.

• Sleep enuresis / Bedwetting: This is considered a medical condition if the person urinates during sleep at least twice a week for three months after the age of 5.
• Sleep-related groaning/Catathrenia: Continuous groaning or moaning sounds during sleep.
• Exploding head syndrome: When falling asleep or waking up, you may hear a loud bang inside your head . You may also see lights and feel like your body is shaking.
• Sleep-related hallucinations: Seeing, hearing, or feeling things that are not really there while falling asleep or waking up.
• Sleep-related eating disorder: This is when you wake up in your sleep and eat or drink. You may even eat things you would never eat while awake (like raw meat or a piece of butter). This can be dangerous , as you may eat poisonous substances, choke, or burn yourself while preparing food.
• Sexsomnia: Engaging in sexual activities during sleep . This can include masturbation, sexual intercourse, or touching the person in bed.

What can cause parasomnias?

There can't be just one reason for this. There could be many reasons.

Here are some of the main reasons:

• Irregular sleep: Sleep patterns are disrupted due to shift work and traveling between countries (jet lag).
• Genetic influences: If someone in your family has this condition, you are more likely to get it too.
• Certain medications: Certain antibiotics, antidepressants, and high blood pressure medications can cause changes in sleep patterns.
• Other medical conditions:
• Chronic pain
• Obstructive sleep apnea
• Restless legs syndrome
• Mental problems such as stress, depression, and anxiety.
• Neurological diseases such as Parkinson's disease.
• Other causes: alcohol or drug use, fever, sleep deprivation, and stress.

How to recognize this condition?

If you have these symptoms, the best thing to do is see your doctor. Usually, a sleep specialist (somnologist) will refer you for further evaluation.

The doctor will do these things:

1. Asking you and your family for details: They will ask you about your sleep habits, the person you sleep with, or your family members, because you may not remember these things.

2. Medical history: You will be asked about medications you take, family medical history, and alcohol use.

3. Keep a sleep diary: For about a week or two, write down the time you go to bed, the time you wake up, whether you wake up at night, and whether anything unusual happened.

4. Special tests: If necessary, you may be referred for a sleep study (Sleep study / Polysomnogram). This involves spending one night in the hospital. During this time, your brain waves, heart rate, breathing, and eye movements are monitored using machines. You may also be given a video EEG test.

What are the treatments for parasomnias?

There is no single treatment for this. Treatment depends on the type of parasomnia you have and its severity. However, it can often be managed with lifestyle changes.

Basic things you can do

• Maintaining good sleep hygiene:
• Go to bed at the same time every day and wake up at the same time.
• Get 7-9 hours of good sleep a day.
• Keep your bedroom dark, quiet, and cool.
• Avoid drinking coffee and tea close to bedtime.
• Stop using your phone, tablet, or TV before bed.
• Stress management: Things like meditation and yoga can help reduce stress.
• Avoiding alcohol and drugs.

Medical treatment

Non-REM parasomnias (like sleepwalking) are often not treated, especially in children, because they usually go away with age.

However, if the condition is likely to endanger you or others, or if it significantly affects your daily life, your doctor may prescribe medication. Clonazepam, Melatonin, and some antidepressants are used for this.

How can you prevent potential dangers from sleeping?

If you have a sleepwalking condition, it is very important to think about safety.

• In the bedroom, keep sharp-edged furniture, lamps, and other items away from the bed.
• Sleep on the ground floor. Avoid bunk beds.
• Install alarms on doors and windows.
• Keep weapons and dangerous equipment at home locked up and safe.
• If you keep a glass of water in the room, use a plastic cup instead of glass.
• If necessary, install childproof knobs on door locks.

When should you see a doctor?

It may be normal for these things to happen once or twice. However, if you have these things, definitely see a doctor.

• If you feel like you're not getting enough sleep .
• If these behaviors occur frequently in sleep.
• If you feel confused when you wake up from sleep.
• If you feel like you can't move your body when you wake up (sleep paralysis).
• If you or your family have been injured or are about to be injured because of this.
• If this condition makes you feel sleepy and tired during the day and affects your work.

Parasomnia, sleep disorders, sleepwalking, sleep talking, nightmares, sleep paralysis, sleep hygiene