


arousal disorders

sleep-wake transition disorders

REM sleep behavior disorders

nonspecific parasomnias


Arousal Disorders

The arousal disorders usually occur in the first third of the night (when NREM is more common than REM).

Sleepwalking or Somnambulism

Night Terrors

Confusional Arousals

Sleep-wake transition disorders

Nocturnal Leg Cramps


Rhythmic movement disorder


REM sleep behavior disorders

Sleep paralysis

REM sleep behavior disorder


Nocturnal Eating Syndrome

Nonspecific parasomnias




Sleep-onset Association Disorder

REM sleep cardiac arrhythmias







A Problemetic Mix of Waking and Sleep

A compelling model of brain functioning involves the flip-flop switch, a systems engineering model of neural network functioning. Whether or not this model is accurate enough, it is clear just from observing people in day-to-day life, that nature gave us a “sleep-wake switch”. A person is either awake or asleep, not both at the same time or mixed – or at least that’s the way we think it should be. Parasomnias, however, represent a pathology of this switch. The sleep and wake states are not stable and waking seeps into sleeping time while sleep occasionally seeps into waking.

Another way to classify parasomnias is between NREM and REM disorders, depending on what type of sleep they arise from. When people wake up from NREM disorders they are confused; people who wake from REM are alert and can often remember their dreams. Reference




Treatment of Parasmonias


Experts generally warn against restraining sleepers in anticipation of confusional arousal, sleepwalking, or sleep terror. The bedroom should be made hazard-free to reduce risk of the person hurting anyone. Psychotherapy can often help reduce the incidence of these events, and sometimes patients are awoken right before their regular occurance of parasomnia to prevent it.

Pharmacological treatment is more common for the rare but serious conditions of REM Behavior Disorder and nocturnal eating disorders.


Epileptic seizures sometimes look like parasomnias - in particular like disorders of arousal from REM sleep. Both the subject’s family members who witness the symptoms first-hand and medical professionals making a first diagnosis are apt to make this mistake. The treatments for seizures (epileptic and otherwise) can involve powerful drugs, so it is important that an accurate diagnosis is made. Parasomnias are rarely dangerous enough to warrant drug therapy. Doctors have to distinguish between the two during diagnosis.


Related Resources

Children's Hospital of Philadelphia

The Journal Pyschiatry

Parasomnias and their mimics.

Nocturnal Frontal Lobe Epilepsy vs Parasomnias.


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