Parasomnia
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Elmo iscariot
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/* NREM Parasomnias */ Fixed wikilink--now avoids redirect
{{Infobox_Disease |
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DiseasesDB = |
ICD10 = {{ICD10|F|51|3|f|50}}-{{ICD10|F|51|4|f|50}} |
ICD9 = {{ICD9|307.47}}, {{ICD9|780.59}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 3131 |
MeshID = D020447 |
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'''Parasomnias ''' are a wide variety of disorders that revolve around sleep. Most parasomnias are dissociated sleep states which are partial arousals during the transitions between wakefulness and [[NREM]] sleep, or wakefulness and [[REM]] sleep.
==NREM Parasomnias==
NREM parasomnias are arousal disorders that occur during stages 3 and 4 of NREM sleep—also known as [[slow wave sleep]] (SWS). They are caused by a physiological activation in which the patient’s brain exits from SWS and is caught in between a sleep and waking state. In particular, these disorders involve activation of the [[autonomic nervous system]], [[motor system]], or [[cognitive processes]] during sleep or sleep-wake transitions.<ref> Bassetti et al., Lancet (2000); 356: 484–485</ref>
NREM parasomnias are common during childhood but decrease in frequency with increasing age. They can be triggered in certain individuals by alcohol, [[sleep deprivation]], physical activity, emotional stress, [[clinical depression|depression]], medications, or a fevered illness. These disorders of arousal can range from confusional arousals, [[somnambulism]], to [[night terror|night terrors]]. Other specific disorders include [[sleepeating]], [[sleep sex]], [[Bruxism|teeth grinding]], [[Rhythmic Movement Disorder|rhythmic movement disorder]], [[restless legs syndrome]], and [[somniloquy]].
===Confusional arousals===
With a prevalence of 4%, confusional arousals are not observed very often in adults; however, they are common in children. <ref> Mahowald & Schenck: 1283.</ref>Confusional arousals are occasional thrashings or inconsolable crying among children—they’re characterized by movements in bed.
===Sleepwalking (somnambulism)===
[[Sleepwalking]] has a prevalence of 1-17% in childhood, with the most frequent occurrences around the age of eleven-twelve. About 4% of adults experience [[somnambulism]]. <ref> Mahowald & Schenck. 1283.</ref>
===Sleep terrors (night terrors)===
This is the most disruptive arousal disorder since it involves loud screams and extreme panic usually resulting in the victim committing bodily harm or [[property damage]] by running around out of the bedroom or house or hitting walls. Unfortunately, all attempts to console the individual are futile and may prolong or intensify the victim’s confusional state. Usually the victim experiences [[amnesia]] after the event but it may not be complete [[amnesia]]. Up to 3% of adults suffer from [[sleep terror]]s and exhibited behavior of this parasomnia can range from mild to extremely violent. <ref> Mahowald & Schenck: 1283.</ref>
==REM Parasomnias==
[[REM Sleep Behavior Disorder]] (RBD) is the most common REM sleep parasomnia in which muscle [[atonia]] is absent. This allows the individual to act out their dreams and may result in repeated [[injury]]-- [[bruises]], [[lacerations]] and [[fractures]]-- to themselves or others. Patients may take self-protection measures by tethering themselves to bed, using pillow [[barricades]] or sleeping in an empty room on a mattress. <ref> Mahowald & Schenck:1284.</ref>
Demographically, 90% of RBD patients are males, and most are older than 50 years of age. <ref> Mahowald & Schenck :1284.</ref>
===Acute RBD===
Occurs mostly as a result of a side-effect in prescribed [[medication]]- usually [[antidepressants]].
===Chronic RBD===
Is [[idiopathic]] or associated with [[neurological disorders]]. There is a growing association of [[chronic]] RBD with [[neurodegenerative]] disorders – [[Parkinson’s disease]], [[multiple system atrophy]] (MSA) or [[dementia]]-- as an early indicator of these conditions by as much as 10 years.
Patients with [[narcolepsy]] also are more likely to develop RBD.
==See also==
* [[Dysomnia]]
* [[Insomnia]]
* [[Jactatio capitas nocturna]]
* [[Sleepwalking]]
* [[Sleepeating]]
* [[Sleep sex]]
==Reference==
* Mahowald & Schenck. Insights from studying human sleep disorders. Nature (2005); 437(7063):1279-85.
* Bassetti et al., Lancet (2000); 356: 484–485
==Notes==
{{reflist}}
==Further Reading==
*{{Cite book|title=Fire in the Brain: Clinical Tales of Hallucination|year=1992|first=Ronald|last=Siegel}}
*{{Cite book|title=The Head Trip: Adventures on the Wheel of Consciousness|year=2007|isbn=978-0679314080|first=Jeff|last=Warren}}
==External links==
* [http://www.stanford.edu/~dement/para.html Stanford]
* [http://sleep.health.am/sleep/parasomnias/ Primary Sleep Disorders: Parasomnias]
* [http://www.psychnet-uk.com/dsm_iv/parasomnias.htm Psychnet UK]
* [http://www.sleep-attention.com/prod04.htm Insomnia vs. Parasomnia]
{{Mental and behavioural disorders}}
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[[Category:Sleep disorders]]
[[Category:Parasomnias]]
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[[el:Παραϋπνία]]
[[es:Parasomnia]]
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[[pl:Parasomnia]]
[[pt:Parassônia]]
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