Parasomnias

Introduction

Parasomnia disorder is a sleep disorder that causes patients to make abnormal movements, talk about their emotions and perform unintentional actions without being able to remember them. Certain examples of parasomnia disorder are sleepwalking, sleep-related eating disorders, sleep paralysis and so on.
Read on to learn more about parasomnia symptoms, and parasomnia causes. The Article gives a complete description of what are the causes of parasomnias, what are the symptoms of parasomnias and how are parasomnias treated.

What is Parasomnia?

Parasomnia is a sleep disorder that involves unusual behaviour or experiences that disrupt sound sleep. Parasomnia can occur before sleeping, during sleep or when a person completes his or her sleep. Patients often move, express their emotions or act unusually while asleep. However, they appear to be awake to others despite being in a state of sleepiness.

Common Myths and Misconceptions

Myth 1: Parasomnia disorder can be treated by overeating and overconsumption of alcohol as it causes drowsiness.
Fact 1: False. Parasomnia disorder is a serious psychological condition that needs the attention of an experienced psychiatrist. Certain food items can worsen the quality of sleep but they cannot be attributed as the main cause of the disorder.

Myth 2: Parasomnia disorder can be life-threatening even if patients are going for therapy regularly.
Fact 2: Parasomnia disorder is not considered a life-threatening disorder. However, patients may suffer from injuries in case they hit something during an episode. By following the right precautionary measures, patients can stay safe and lead a normal life.

Myth 3: The normal sleeping patterns of an individual are affected permanently.
Fact 3: By getting treatment for parasomnia, normal sleeping patterns of an individual can be achieved. Patients must adopt a routine and maintain consistency for a long-term recovery.

Statistics and Facts

Sleep disorders are very common among Indians. The prevalence of insomnia in the country ranges between 13.8% to 33%. Studies also mention that this disorder is usually common among senior citizens. Other causes that lead to the problem are hypertension, stress, diabetes and even anxiety.

Are there different types of Parasomnia?

• Non-Rapid Eye Movement Parasomnia
  Non-rapid eye movement occurs during stages of sleep. Sleepwalking, night terrors and confusional arousals often result in incomplete awakening.
• Rapid Eye Movement Parasomnia
  Rapid Eye movement parasomnia is when patients experience vivid dreams. These dreams lead to physical movements when a patient is sleeping.
• Exploding Head Syndrome
  Exploding head syndrome is a rare sleep disorder. Patients experience a loud noise or explosion in the head when transitioning into sleep.
• Sleep Enuresis
  Patients with sleep enuresis involuntarily urinate during sleep. The disorder usually affects children but can also affect adults. Sleep, stress disorders and other medical conditions can be the potential causes.
• Sleep-Related Hallucinations
  Sleep-related hallucinations are when patients have vivid sensory experiences during sleep onset or during waking. Patients often complain of visual, tactile and auditory sensations. These symptoms are often associated with stress, deprivation of sleep or narcolepsy.
• Catathrenia
  Also called Sleep-Related Groaning, patients suffering from this disorder make low-pitched groaning sounds during exhalation in sleep.
• Sexsomnia
  Patients suffering from Sexsomnia indulge in sexual activities when asleep. They cannot recall exhibiting these symptoms when awake and often occur during NREM sleep.

What are the Causes of Parasomnias?

• Frequent Sleep Disruption
  Frequent sleep disruption or an irregular sleep pattern can cause parasomnia. Incomplete transitions between sleep stages or conditions like sleep apnea are another cause. Patients who work night shifts are more prone to developing parasomnia due to lack of night sleep.
• Immature Sleep Cycle
  The immature sleep cycle among children is linked to an underdeveloped sleep-wake cycle. The brain’s ability to fully regulate transitions between sleep stages increases the likelihood of unusual behaviours during sleep.
• General Health Issues
  Stress, fever, substance abuse, hormonal changes and various neurological disorders can lead to parasomnia. Patients suffering from depression and substance use are also prone to developing parasomnia.
• Genetic Factors
  Patients with ancestors who suffered from any sleep disorder are prone to suffering from Parasomnia. Genetic predispositions play a role in certain inherited conditions heightening the risk of sleep disturbances.

What Are the Symptoms of Parasomnias?

There are various signs and symptoms exhibited by patients who are suffering from Parasomnia. The most common symptoms are:

• Patients feel confused and disoriented upon waking up.
• Patients are unsure about their whereabouts when they wake up.
• Patients cannot recollect performing certain actions.
• Patients often suffer from bruises and cuts on their bodies.
• Patients do not maintain their sleep at night and consequently feel sleepy during the day.
• However, all these symptoms must occur more than thrice a week to be termed as a sleep disorder.

How are Parasomnias Diagnosed?

• Polysomnogram
  A polysomnogram is a test that reads the heartbeat of a patient when sleeping along with heart rate and muscle movement. The monitor reads the brain activity of a sleeping patient and other parameters to detect anomalies or any other unusual behaviour.
• Video Electroencephalogram (EEG)
  A video EEG monitors brain activity and records physical behaviour during sleep. The aim is to detect abnormal behaviours that can mimic symptoms of parasomnia. CT Scan is another brain imaging test to identify structural abnormalities. The purpose of these tests is to rule out any other underlying neurological problems.
• Interview and Assessments
  Thorough interviews and assessments conducted by psychologists further clarify the severity of the problem. Psychiatrists try to reach the root cause of the problem by understanding family relationships and other relevant circumstances of a patient before framing a treatment.

How are Parasomnias Treated?

• Medication
  Medication plays a major role when treating parasomnia, especially when symptoms disrupt life. Antidepressants and benzodiazepines are often prescribed to reduce the frequency of episodes. These drugs stabilize sleep patterns and decrease the chances of arousal among patients.
  Separate medication is prescribed to treat distorted REM sleep behaviour. This medication controls physical movements caused because of dreams. Regular check-ups are essential
• Cognitive Behavioural Therapy (CBT)
  CBT is a highly effective therapy to treat parasomnia disorder. CBT is highly recommended for patients who are suffering from the condition due to stress or anxiety. Patients can identify negative thought patterns that could be worsening their condition. Relaxation techniques and cognitive restructuring work well when it comes to improving emotional regulation.
  For CBT to be effective, patients must maintain consistency. For patients suffering from Parasomnia disorder because of a traumatic event, trauma-focused therapy combined with CBT is essential. Certain therapists can also opt for biofeedback to help patients gain control over their physical movement when they are asleep.
• Routine Building
  Patients must make a routine and follow it religiously to maintain their sleep cycle. A disciplined approach is essential for long-term recovery and reducing the number of episodes.
  Triggers like caffeine, alcohol, drugs and other substances must be avoided as they disrupt sleep schedules. Consumption of these items must be specifically avoided before bedtime.

- Scheduled Awakening
Scheduled awakening is a behavioural intervention used primarily before children with parasomnia. Young patients suffering from night terrors or sleepwalking must adopt this technique. This technique also includes waking the individual 15-30 minutes before the usual time of the episode. This disrupts the sleep cycle and prevents parasomnia from occurring.

- Safe Sleeping Environments
Creating a safe sleeping environment is crucial for patients with parasomnia to prevent injuries. For those prone to sleepwalking or REM behaviour disorder, sharp objects must be removed and padding of furniture edges must be done. Bed partners must be educated about the condition to minimise risks.
Movement devices must be installed in the room to alert caregivers. Maintaining a sleep diary makes it easier for therapists to understand the sleeping pattern.

Living with Parasomnias

• Living with parasomnia can be difficult for a patient. Seeking professional help is a must to understand the severity of the problem. Doing so in the primary stages of the problem works better.
• Make sure that the room in which you sleep is clear of all sharp objects. Since patients are prone to walking in sleep, they must stay safe and secure. A safe and comfortable environment must be created for a good night's sleep.
• Establish a consistent sleep routine for maximum relief. Waking up at the right time and sleeping as per schedule is a must for patients to recover. Working out daily can improve the overall health of a patient and settle the sleep-wake cycle.
• Consumption of alcohol, caffeine and other substances must be avoided. Anything that causes excessive drowsiness or delays sleep must not be consumed by the patient as it disturbs the sleep pattern.
• Maintain a sleep diary so that psychologists can diagnose the problem properly. Self-care is a must to track patterns and identify triggers. Efforts on a personal level must be made to maintain mental health.
• Medication must be consumed on time to feel better as soon as possible. However, no medication must be taken without consulting a professional. Educating family and friends is also important to manage emergencies.

How to Support Loved Ones Suffering from Parasomnias?

• Inform the patient about the disorder so that preventive actions can be taken. Learning about the disorder is essential for members of the family to manage emergencies. Passing judgements about their condition must be avoided at all times.
• Make sure that someone sleeps with the patient at night. For instance, patients who sleepwalk must sleep next to someone who can guide them back to bed. This will prevent injuries and make the patient feel more relaxed.
• Patients must not be woken up during an episode as it can cause disorientation and lead to confusion. Caretakers must be careful and gentle. However, patients can be woken up a few minutes before the episode but after professional consultation.
• Encourage patients to seek treatment. Consult a medical and mental health practitioner as soon as symptoms start exhibiting for a fast recovery. However, maintaining consistency and attending sessions regularly is a must for maximum effectiveness.

Jagruti Treatment and Recovery

1. Customised Treatment Plans
A customized treatment plan is a must for complete recovery. Therapists and mental health experts at Jagruti Rehab Centre frame a treatment plan that is fit for patients depending on the severity of the problem. Group therapies, family consultation sessions and other complementary treatment plans are also available.
For patients suffering from Parasomnia disorder, attendants are trained to manage the problem at home. Air condition and non-air-conditioned rooms are available for patients to stay in depending on their condition.

2. Online and Offline Services
Hygienic living conditions and 24/7 nursing staff make it better for patients to recover faster. Patients are provided with nursing staff that keep a check on the patients at night. The nursing staff effectively manages comorbidities that could have caused parasomnia.
Therapists at Jagruti Rehab Centre also offer online consultation to working individuals. Young patients who have to pursue their academics can also opt for the online treatment plan.

3. Medication and Continuous Supervision
Medication and therapy keep the episodes under check. However, neurologists and psychiatrists work together to prescribe the best medication to prevent excessive dependence. Patients are kept under constant surveillance to prevent overdose.
For a comfortable stay, Jagruti Rehab Centre has also empanelled nutritionists. Foods that are particularly helpful in ensuring proper rest are provided to patients.