The term “parasomnia” refers to a wide range of disruptive sleep-related events. These behaviors and experiences generally occur during sleep, and in most cases are infrequent and mild. At times, however, they may become so bothersome that medical attention is indicated.

Common parasomnias include:

• Confusional Arousals are most common in infants and children, and often begin with crying and thrashing around in bed. The sleeper appears to be awake and seems to be confused and upset, but resists attempts to comfort or console.
• Sleepwalking is commonly seen in older children and can range from simply getting out of bed and walking around the bedroom to prolonged and complex actions such as going to another part of the house or even outdoors.
• Sleep-related Eating is a rare variation of sleepwalking. It is most common in young women, and can occur often enough to result in significant weight gain.
• Sleep Terrors are the most extreme and dramatic of the arousal disorders, and the most distressing to witness. It often begins with a blood-curdling scream or shout and can produce signs that suggest severe terror.

As disturbing and frightening as these episodes are to an observer, the sleeper usually has no conscious awareness of the event and generally doesn’t remember it upon waking.

TREATMENT OPTIONS

In typical childhood occurrences of arousal disorders, medical evaluation is unlikely to be needed unless the child’s disturbed sleep causes potentially dangerous behavior, extreme disturbance of other household members or excessive sleepiness during the day.

Simple precautions should be taken to ensure safety for people with arousal disorders. Clearing their bedroom of obstructions, securing windows, sleeping on the ground floor and installing locks or alarms on windows and doors can add a degree of security.

In cases severe enough that the sleep disorder leads to injury or involves violence, excessive eating or disturbance to others, therapies such a medication or behavior modification through hypnosis may be used.

Because disorders of arousal are relatively uncommon after childhood, adults suffering from these disorders should seek evaluation at a sleep disorders center.