General Practice 2022

Parasomnia: what é, main types and what to do

Parasomnia: what é, main types and what to do
Parasomnia: what é, main types and what to do

Parasomnias are sleep disorders that are characterized by abnormal psychological experiences, behaviors or events, which can occur at various stages of sleep. Sleepwalking, night terrors, bruxism, nightmares and movement disorders are examples of parasomnias that should be specifically treated if they affect the person's life.

Parasomnias in early childhood are common and normal, and treatment is usually not necessary, and it is usually sufficient to reassure the child, as most parasomnias tend to disappear during adolescence. However, some parasomnias can be a sign that the person is experiencing a problem or insecurity, and others persist for years and may be associated with stress and anxiety, so in these cases it is very important to identify them and talk to the doctor. doctor.

Although not considered serious, some parasomnias can interfere with day-to-day activities in both children and adults if treatment is not carried out, which can affect behavior and school and work performance.

Parasomnias can be classified according to the stage of sleep they occur, the main ones being:

1. Confusional Awakening

Confusional arousal is common in children between 2 3 5 years of age and usually occurs in the first 2 to 3 hours of sleep, lasting 5 to 15 minutes. During an episode of confusional arousal, the person wakes up confused, disoriented in time and space, responding slowly, and with memory loss. In the case of children, it is possible that there is no memory of waking up.

What to do: Confusional arousal may resolve by age 5 years without treatment.However, in some cases, it is possible for it to continue beyond that age, causing discomfort and interfering with the child's quality of life. Therefore, it is recommended that the pediatrician be consulted so that the appropriate treatment is indicated. In addition, medications that alter sleep should be avoided and it is important to have a proper routine to have a good night's sleep.

2. Sleepwalking

Sleepwalking usually occurs between 4 and 8 years of age and is more common in women. This type of parasomnia usually happens about 1 to 2 hours after the person falls asleep, in which the person gets out of bed and walks during sleep, and can include other more complex behaviors such as picking up objects, walking out of the house, for example..

Sleepwalking may not have a specific cause or be caused by medication use, stress, lack of sleep or be a consequence of not sleeping in the usual place. Learn how to identify and deal with sleepwalking.

What to do: It is important to avoid the factors that cause sleepwalking, in addition to adopting good sleep hygiene. In some cases, it may be necessary to seek medical advice, in which the use of medication, such as benzodiazepines, for example, may be indicated.

Waking up a person who is in a sleepwalking episode can cause confusion, and the person may also exhibit aggressive behavior due to the disorientation of the moment.

3. Night terrors

Night terrors are characterized by awakening with screams or crying, one to two hours after falling asleep, which usually occur in children between 4 and 12 years old, being accompanied by other symptoms, such as fear, tachycardia, skin redness, confusion and disorientation.

Episodes usually last from seconds to minutes, after which the child goes back to sleep and does not remember what happened.

What to do: this situation is usually resolved without the need for treatment, however precautionary measures can be taken, such as providing protection around the bed, to prevent the child from being injured during a night terror episode.

It is important that the child is not woken up during the night terror, as it can worsen the situation and lead to the appearance of more symptoms and agitation, and one should be aware of possible injuries or risks during the episode.

Learn more about night terrors and see what to do.

4. Nightmares

Nightmares are frightening episodes that occur during the REM sleep phase, very common in children and adolescents, although they can happen at any stage of life.

Nightmares can occur for no apparent reason, and in some cases, they can be triggered by fears, stress or anxiety. However, they can also be caused due to the use of certain medications, post-traumatic stress disorder, breathing problems or psychiatric disorders, for example.Nightmares are considered an abnormal event when they occur frequently, causing distress or affecting the person's quality of life.

What to do: Psychotherapy with behavioral techniques has shown good results in the face of frequent nightmares, however, in more severe cases, it may be necessary to consult a psychiatrist, which may indicate the use of medications such as Prazosin, if the nightmare is related to post-traumatic stress.

5. Sleep paralysis

Sleep paralysis consists of the inability to perform movements at the beginning of sleep, during sleep or when waking up, and the person can only move the eyes, and may also have frightening hallucinations. Episodes of sleep paralysis can last from seconds to a few minutes, resolving spontaneously.

Although this parasomnia is more common in teenagers and adults, it can in some cases occur in children and may be associated with stress or poor sleep habits. Learn what to do to prevent sleep paralysis.

What to do: Since sleep paralysis events are short-lived and pose no he alth risk, no treatment is required. However, it is recommended to adopt a routine before bed that guarantees a good night's sleep. In some cases, the doctor may prescribe the use of antidepressants to prevent further episodes.

6. Night bruxism

Bruxism is the unconscious act of clenching or grinding your teeth constantly, leading to tooth wear, joint pain and headache upon waking.

This parasomnia can be caused by genetic, neurological or respiratory factors such as snoring and sleep apnea, or be related to psychological factors such as stress or anxiety. In addition, excessive consumption of caffeine, alcohol, smoking or frequent use of drugs can also increase the frequency of bruxism. Find out what the treatment of bruxism consists of.

What to do: It is recommended to consult the dentist for an evaluation of the teeth, as it may be necessary, in some cases, to undergo treatment.To prevent tooth wear and jaw joint problems, your dentist may recommend wearing a protective plate overnight.

7. Nocturnal enuresis

Nocturnal enuresis is defined by frequent involuntary leakage of urine during the night in children over 5 years of age, which may be related to stunted growth, mental problems, stress or illnesses such as diabetes, for example, being more frequent in boys than in girls.

What to do: behavioral psychotherapy has good results for this type of parasomnia and consists of encouraging the child to urinate during the day and avoiding the consumption of liquids before bed. In some cases, it may be necessary to use drugs such as vasopressin, desmopressin or oxybutynin, for example.

Learn more about bedwetting and what to do to prevent it.

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